IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer: Plan evaluation and treatment outcome

Jun Won Kim, Jae Ho Cho, Ki Chang Keum, Joo Ho Kim, Gwi Eon Kim, Jong Young Lee, Soo Kon Kim, Chang Geol Lee

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5%. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8%; 87.6 and 87.6%; 77.5 and 70.5%; and 86.4 and 82.1%, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107% of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.

Original languageEnglish
Article numberhys169
Pages (from-to)1152-1160
Number of pages9
JournalJapanese Journal of Clinical Oncology
Volume42
Issue number12
DOIs
Publication statusPublished - 2012 Dec 1

Fingerprint

Nasopharyngeal Neoplasms
Radiotherapy
Drug Therapy
Intensity-Modulated Radiotherapy
Leukopenia
Xerostomia
Mucositis
Induction Chemotherapy
Dermatitis
Cisplatin
Disease-Free Survival
Therapeutics
Survival Rate
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Kim, Jun Won ; Cho, Jae Ho ; Keum, Ki Chang ; Kim, Joo Ho ; Kim, Gwi Eon ; Lee, Jong Young ; Kim, Soo Kon ; Lee, Chang Geol. / IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer : Plan evaluation and treatment outcome. In: Japanese Journal of Clinical Oncology. 2012 ; Vol. 42, No. 12. pp. 1152-1160.
@article{89317e02cd1a4d83a76474ec6dd7c6d1,
title = "IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer: Plan evaluation and treatment outcome",
abstract = "Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5{\%}. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8{\%}; 87.6 and 87.6{\%}; 77.5 and 70.5{\%}; and 86.4 and 82.1{\%}, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107{\%} of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.",
author = "Kim, {Jun Won} and Cho, {Jae Ho} and Keum, {Ki Chang} and Kim, {Joo Ho} and Kim, {Gwi Eon} and Lee, {Jong Young} and Kim, {Soo Kon} and Lee, {Chang Geol}",
year = "2012",
month = "12",
day = "1",
doi = "10.1093/jjco/hys169",
language = "English",
volume = "42",
pages = "1152--1160",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
publisher = "Oxford University Press",
number = "12",

}

IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer : Plan evaluation and treatment outcome. / Kim, Jun Won; Cho, Jae Ho; Keum, Ki Chang; Kim, Joo Ho; Kim, Gwi Eon; Lee, Jong Young; Kim, Soo Kon; Lee, Chang Geol.

In: Japanese Journal of Clinical Oncology, Vol. 42, No. 12, hys169, 01.12.2012, p. 1152-1160.

Research output: Contribution to journalArticle

TY - JOUR

T1 - IMRT with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer

T2 - Plan evaluation and treatment outcome

AU - Kim, Jun Won

AU - Cho, Jae Ho

AU - Keum, Ki Chang

AU - Kim, Joo Ho

AU - Kim, Gwi Eon

AU - Lee, Jong Young

AU - Kim, Soo Kon

AU - Lee, Chang Geol

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5%. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8%; 87.6 and 87.6%; 77.5 and 70.5%; and 86.4 and 82.1%, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107% of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.

AB - Objective: This study evaluated the outcome of intensity-modulated radiation therapy with simultaneous integrated boost and concurrent chemotherapy for nasopharyngeal cancer. Methods: We analyzed 53 consecutive nasopharyngeal cancer patients who received definitive treatment using intensity-modulated radiation therapy with simultaneous integrated boost and cisplatin-based concurrent chemotherapy. Forty-six patients were treated with concurrent chemoradiation and seven patients with induction chemotherapy plus concurrent chemoradiation. The gross tumor (PTV. 70) received 69.96 Gy (2.12 Gy/fraction), high-risk subclinical disease (PTV. 60) received 59.4 Gy (1.8 Gy/fraction) and low-risk subclinical disease (PTV. 56) received 56.1 Gy (1.7 Gy/fraction) in 33 fractions. Twenty-eight patients were treated with step-and-shoot intensity-modulated radiation therapy and 25 patients with helical tomotherapy. Dosimetric parameters were compared between the two modalities. Results: The median treatment duration was 49 days (range: 41-65 days). The complete response rate was 92.5%. Three local, two regional, one locoregional and seven distant failures were observed. With the median follow-up of 41 months (range: 8-89 months), the 3- and 5-year local control, locoregional control, disease-free survival and overall survival rates were 91.8 and 91.8%; 87.6 and 87.6%; 77.5 and 70.5%; and 86.4 and 82.1%, respectively. Grade 3 mucositis, dermatitis, leucopenia and grade 4 leucopenia were observed in 10, 1, 2 and 1 patient, respectively. No grade 3 or higher xerostomia occurred. Helical tomotherapy significantly improved dosimetric parameters including the maximum dose, volume receiving >107% of the prescribed dose and uniformity index (D5/D95). Conclusions: Intensity-modulated radiation therapy with simultaneous integrated boost with concurrent chemotherapy is a safe and effective treatment modality for nasopharyngeal cancer. Helical tomotherapy has a dosimetric advantage over step-and-shoot intensity-modulated radiation therapy in a clinical setting.

UR - http://www.scopus.com/inward/record.url?scp=84870435613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870435613&partnerID=8YFLogxK

U2 - 10.1093/jjco/hys169

DO - 10.1093/jjco/hys169

M3 - Article

C2 - 23077243

AN - SCOPUS:84870435613

VL - 42

SP - 1152

EP - 1160

JO - Japanese Journal of Clinical Oncology

JF - Japanese Journal of Clinical Oncology

SN - 0368-2811

IS - 12

M1 - hys169

ER -