Concurrent Chemoradiotherapy for Loco-regionally Advanced Nasopharyngeal Carcinoma: Treatment Outcomes and Prognostic Factors

Document Type: Research Articles

Authors

Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

Abstract

Background: We conducted this study to contribute to resolving some controversial issues on management of
nasopharyngeal carcinoma. Methods: Thirty-two patients with stage III-IVB nasopharyngeal carcinoma were included
in this retrospective study. All patients received concurrent chemoradiotherapy with either 3D conformal radiotherapy
or intensity-modulated radiotherapy. We retrospectively analyzed the survival outcome, prognostic factors for survival,
and toxicity outcome. Results: The 2- and 5-year overall survival rates were 89.9% and 82.6%. The 2- and 5-year
distant metastasis-free survival rates were 83.2% and 79.4%. The 2- and 5-year loco-regional recurrence-free survival
rates were 83.3% and 79.5%. Addition of induction chemotherapy to concurrent chemoradiotherapy did not improve
survival outcomes. The survival benefit of intensity-modulated radiotherapy over 3D conformal radiotherapy was not
clear. Intensity-modulated radiotherapy significantly decreased the development of late toxicities compared with 3D
conformal radiotherapy. Total RT dose was prognostic factor for overall, loco-regional recurrence-free, and distant
metastasis-free survival. Temporary RT interruption was prognostic factor for overall survival. Daily RT dose was
prognostic factor for distant metastasis-free survival. Conclusions: Concurrent chemoradiotherapy resulted in high
survival rates with an acceptable level of toxicities in patients with loco-regionally advanced nasopharyngeal carcinoma.
To confirm the results of this study, well-designed randomized prospective trials are warranted.

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