Is a total dose of 54 Gy with radiochemotherapy sufficient for treatment of intermediate-risk volumes in nasopharyngeal cancer?
Strahlenther Onkol
; 200(5): 409-417, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38153435
ABSTRACT
BACKGROUND:
The mainstay treatment of nasopharyngeal cancer (NPC) is radiation therapy (RT). The doses and volumes may differ from center to center. Most studies and guidelines recommend a total dose of 60â¯Gy for elective nodal and peritumoral volume treatment. This retrospective analysis aimed to analyze whether a dose reduction to 54â¯Gy to this volume would be associated with a higher risk of recurrence.METHODS:
A total of 111 patients treated by intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy were retrospectively analyzed. The recurrent tumor volume was classified as "in field" if 95% of the recurrent volume was inside the 95% isodose, as "marginal" if 20-95% of the recurrence was inside the 95% isodose, or as "outside" if less than 20% of the recurrence was inside the 95% isodose.RESULTS:
Median follow-up was 67 months (range 6-142). The 2 and 5year overall survival (OS) rates were 88.6% and 70%, respectively. The 2year locoregional control (LRC), disease-free survival (DFS), and distant metastasis-free survival (DMFS) were 93.3%, 89.3%, and 87.4%, and the 5year LRC, DFS, and DMFS were 86.8%, 74%, and 81.1%, respectively. Ten patients (9%) had a local and or regional recurrence. Half of the patients with locoregional failure had in-field recurrences. For primary tumor, there was no recurrence in the volume of 54 Gy. For regional lymph node volume, recurrence was detected in two (1.8%) patients in the volume of 54 Gy.CONCLUSION:
These retrospective data suggest that a dose reduction may be possible for intermediate-risk volumes, especially for the primary site.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Dosagem Radioterapêutica
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Neoplasias Nasofaríngeas
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Radioterapia de Intensidade Modulada
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Quimiorradioterapia
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Recidiva Local de Neoplasia
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article