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INTENSITY-MODULATED RADIATION THERAPY WITH SIMULTANEOUS INTEGRATED BOOST TECHNIQUE FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR LOCOREGIONALLY ADVANCED NASOPHARYNGEAL CARCINOMA

Cited 25 time in Web of Science Cited 28 time in Scopus
Authors
Kim, Kyubo; Wu, Hong-Gyun; Kim, Hak Jae; Sung, Myung-Whun; Lee, Se-Hoon; Kim, Hee Jung; Park, Charn Il; Heo, Dae Seog; Kim, Kwang Hyun
Issue Date
2009-09
Publisher
JOHN WILEY & SONS INC
Citation
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK; Vol.31 9; 1121-1128
Keywords
nasopharyngeal cancerintensity-modulated radiation therapyxerostomianeoadjuvant chemotherapysimultaneous integrated boost
Abstract
Background. Our aim was to evaluate the feasibility and efficacy of intensity-modulated radiation therapy (IMRT) with simultaneous integrated boost (SIB) technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal cancer (NPC). Methods. Between April 2004 and December 2006, 25 patients with stage IIB to IVB NPC underwent 3 cycles of neoadjuvant chemotherapy followed by IMRT using SIB technique. Neoadjuvant chemotherapeutic regimens were 5-fluorouracil and cisplatin in 11 patients; docetaxel, 5-fluorouracil, and cisplatin in 8; and paclitaxel and cisplatin in 6. Dose prescription of IMRT was as follows: 67.5 Gy at 2.25 Gy/fraction to postchemotherapy gross tumor, 54 to 60 Gy at 1.8 to 2 Gy/fraction to subclinical disease, and 48 Gy at 1.6 Gy/fraction to elective neck. Seventeen patients received weekly cisplatin during the course of radiation therapy as well. Results. With a median follow-up of 29 months for survivors (range, 14-39), the 3-year local progression-free, regional progression-free, and distant metastasis-free survival rates were 89.6%, 87.2%, and 80.4%, respectively. Treatment was well tolerated despite the grade 3 mucositis (16%) and/or pharyngitis (16%). With follow-up, the frequency of xerostomia decreased. At 3 months after IMRT, the proportions of Radiation Therapy Oncology Group grades 0, 1, and 2 xerostomia were 13%, 38%, and 50%, respectively. At 24 months, the corresponding figures were 36%, 46%, and 18%, respectively. Conclusion. IMRT with SIB technique for locoregionally advanced NPC was feasible and effective regarding locoregional control and development of xerostomia, even after neoadjuvant chemotherapy. Definition of gross tumor volume by postchemotherapy extent of disease was also feasible. 2009 Wiley Periodicals, Inc. Head Neck 31: 1121-1128, 2009
ISSN
1043-3074
Language
English
URI
http://hdl.handle.net/10371/76387
DOI
https://doi.org/10.1002/hed.21076
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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