Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience

Purpose: To study the overall treatment time (OTT) and acute toxicity of intensity-modulated radiotherapy(IMRT) treatment for nasopharyngeal carcinoma (NPC).
Methods: This retrospective study covered all NPCpatients who underwent radical IMRT treatment at the Penang General Hospital from June 2011 to February2012. Patients of any age and stage of disease with histologically proven diagnosis were included. Informationwas collected on patient demographics, clinical stage, treatment received, including any neoadjuvant and/orconcurrent chemotherapy, acute toxity and completion of IMRT within the OTT.
Results: A total of 26 NPCpatients were treated with IMRT during the study period; 88.5% had stage III/IV disease. 45.2% receivedneo-adjuvant chemotherapy while 50.0% were given concurrent chemo-irradiation. All patients completed thetreatment and 92.3% within the 7 weeks OTT. Xerostomia was present in all patients with 92.3% having grade2. Severe grade III/IV acute toxicity occurred in 73.1% of patients, the commonest of which was oral mucositis(57.6%). This was followed by dysphagia which occurred in 53.8%, skin reactions in 42.3% and weight loss in19.2%. However, haematological toxicity was mild with only one patient having leucopaenia.
Conclusion: IMRTtreatment for NPC is feasible in our center. More importantly, it can be delivered within the 7 weeks OTT inthe majority of patients. Severe grade 3/4 toxicity is very common (73.1%) and thus maximal nutritional andanalgesic support is required throughout the treatment.