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Title: Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma

Abstract

Purpose: To study and report the clinical outcomes and patterns of failure after intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods and Materials: The treatment outcomes of NPC patients treated with IMRT at Pamela Youde Nethersole Eastern Hospital between 2005 and 2007 were reviewed. The location and extent of locoregional failures were transferred to the pretreatment planning computed tomography for dosimetry analysis. Statistical analyses were performed on dose coverage and locoregional failures. Results: A total of 193 NPC patients were analyzed; 93% had Stage III/IV disease. Median follow-up was 30 months. Overall disease failure (at any site) developed in 35 patients. Among these, there were 23 distant metastases, 16 local failures, and 9 regional failures. Four of the locoregional failures were marginal. Dose conformity with IMRT was excellent. Patients with at least 66.5 Gy to their target volumes had significantly less locoregional failure. The 2-year local progression-free, regional progression-free, distant metastasis-free, and overall survival rates were 95%, 96%, 90%, and 92%, respectively. Conclusions: Intensity-modulated radiotherapy provides excellent locoregional control for NPC. Distant metastasis remains the most difficult challenge, and more effective systemic agents should be explored for patients presenting with advanced locoregional diseases.

Authors:
 [1]; ; ; ; ;  [2]
  1. Department of Medical Physics, Pamela Youde Nethersole Eastern Hospital (Hong Kong)
  2. Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital (Hong Kong)
Publication Date:
OSTI Identifier:
21491580
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 79; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2009.11.024; PII: S0360-3016(09)03565-2; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; FAILURES; METASTASES; PHARYNX; RADIOTHERAPY; SURVIVAL CURVES; BODY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY; TOMOGRAPHY

Citation Formats

Ng, Wai Tong, E-mail: ngwt1@ha.org.h, Lee, Michael C.H., Hung, Wai Man, Choi, Cheuk Wai, Lee, Kin Chung, Chan, Oscar S.H., and Lee, Anne W.M. Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2009.11.024.
Ng, Wai Tong, E-mail: ngwt1@ha.org.h, Lee, Michael C.H., Hung, Wai Man, Choi, Cheuk Wai, Lee, Kin Chung, Chan, Oscar S.H., & Lee, Anne W.M. Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma. United States. https://doi.org/10.1016/j.ijrobp.2009.11.024
Ng, Wai Tong, E-mail: ngwt1@ha.org.h, Lee, Michael C.H., Hung, Wai Man, Choi, Cheuk Wai, Lee, Kin Chung, Chan, Oscar S.H., and Lee, Anne W.M. 2011. "Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma". United States. https://doi.org/10.1016/j.ijrobp.2009.11.024.
@article{osti_21491580,
title = {Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma},
author = {Ng, Wai Tong, E-mail: ngwt1@ha.org.h and Lee, Michael C.H. and Hung, Wai Man and Choi, Cheuk Wai and Lee, Kin Chung and Chan, Oscar S.H. and Lee, Anne W.M.},
abstractNote = {Purpose: To study and report the clinical outcomes and patterns of failure after intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods and Materials: The treatment outcomes of NPC patients treated with IMRT at Pamela Youde Nethersole Eastern Hospital between 2005 and 2007 were reviewed. The location and extent of locoregional failures were transferred to the pretreatment planning computed tomography for dosimetry analysis. Statistical analyses were performed on dose coverage and locoregional failures. Results: A total of 193 NPC patients were analyzed; 93% had Stage III/IV disease. Median follow-up was 30 months. Overall disease failure (at any site) developed in 35 patients. Among these, there were 23 distant metastases, 16 local failures, and 9 regional failures. Four of the locoregional failures were marginal. Dose conformity with IMRT was excellent. Patients with at least 66.5 Gy to their target volumes had significantly less locoregional failure. The 2-year local progression-free, regional progression-free, distant metastasis-free, and overall survival rates were 95%, 96%, 90%, and 92%, respectively. Conclusions: Intensity-modulated radiotherapy provides excellent locoregional control for NPC. Distant metastasis remains the most difficult challenge, and more effective systemic agents should be explored for patients presenting with advanced locoregional diseases.},
doi = {10.1016/j.ijrobp.2009.11.024},
url = {https://www.osti.gov/biblio/21491580}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 79,
place = {United States},
year = {Tue Feb 01 00:00:00 EST 2011},
month = {Tue Feb 01 00:00:00 EST 2011}
}