Reirradiation of Locally Recurrent Nasopharynx Cancer With External Beam Radiotherapy With or Without Brachytherapy

Journal Article · Fri Jan 15 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.01.055· OSTI ID:21367596

Koutcher, Lawrence ^[1]; Lee, Nancy; Zelefsky, Michael; Chan, Kelvin ^[1]; Cohen, Gilad ^[2]; Pfister, David ^[3]; Kraus, Dennis ^[4]; Wolden, Suzanne ^[1]

---

1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
2. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
3. Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
4. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

Purpose: To determine survival rates of patients with locally recurrent nasopharynx cancer (LRNPC) treated with modern therapeutic modalities. Methods and Materials: From July 1996 to March 2008, 29 patients were reirradiated for LRNPC. Thirteen patients received combined-modality treatment (CMT), consisting of external beam radiotherapy (EBRT) followed by intracavitary brachytherapy, whereas 16 received EBRT alone. The median age was 50 years, 59% were male, 38% were Asian, 69% had World Health Organization Class III histology, and 86% were treated for their first recurrence. Nine, 6, 8, and 6 patients had recurrent Stage I, II, III, and IV disease, respectively. Patients in the EBRT-alone group had more advanced disease. Median time to reirradiation was 3.9 years. In total, 93% underwent imaging with positron emission tomography and/or magnetic resonance imaging before reirradiation, 83% received intensity-modulated radiotherapy, and 93% received chemotherapy, which was platinum-based in 85% of cases. Results: The median follow-up for all patients was 45 months and for surviving patients was 54 months. Five-year actuarial local control, event-free survival, and overall survival rates were 52%, 44%, and 60%, respectively. No difference was observed between patients treated with EBRT or CMT. Overall survival was superior in patients who achieved local control (p = 0.0003). The incidence of late Grade >=3 events in patients re-treated with EBRT alone was significantly increased compared with those receiving CMT (73% vs. 8%; p = 0.005). Conclusions: In this modern reirradiation series of patients with LRNPC, favorable overall survival compared with historical series was achieved. Patients treated with CMT experienced significantly fewer severe late effects compared with those treated with EBRT.

• OSTI ID: 21367596
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BRACHYTHERAPY
CHEMOTHERAPY
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
EMISSION COMPUTED TOMOGRAPHY
MEDICINE
NEOPLASMS
NMR IMAGING
NUCLEAR MEDICINE
ORGANS
PHARYNX
POSITRON COMPUTED TOMOGRAPHY
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
THERAPY
TOMOGRAPHY