Yonsei Med J.  2004 Feb;45(1):100-106. 10.3349/ymj.2004.45.1.100.

High Dose 3-Dimensional Re-Irradiation for Locally Recurrent Nasopharyngeal Cancer

Affiliations
  • 1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ycahn@smc.samsung.co.kr

Abstract

This is to report the results of 3-dimensional (3D) high dose re-irradiation (re-RT) for patients with locally recurrent nasopharyngeal cancer. Between May 1995 and Dec. 2000, 21 patients with locally recurrent cancer of the nasopharynx received high dose 3D re-RT at Samsung Medical Center. The median 55 (45 - 70) Gy was applied by daily fractions of 2.5 Gy or 3.0 Gy. The median survival period, the rates of local control, overall survival and disease-free survival at 5 years, of all patients, were 21 months, 71.8%, 32.3%, and 21.2% respectively. The number of patients who experienced treatment failures at any site was 14 (67.0%) : eight patients (38.1%) experienced distant hematogenous metastases; five patients (23.8%) experienced recurrences within the current re-RT treatment volume; and seven patients (33.0%) had recurrences outside this volume. Five patients (23.8%) experienced severe late radiation-induced complications of RTOG grade IV or V, and these were brainstem necrosis (2), temporal lobe necrosis (1), mucosal necrosis (1), and massive epistaxis (1). For locally recurrent nasopharyngeal cancer patients, high dose 3D re-RT could lead to improved results when compared with the historic data by conventional re-RT techniques. Further treatment refinements, that would be necessary, may include optimization in patient selection, improvement in target localization and patient immobilization, and the addition of systemic agents, either as a radiation sensitizer or a radiation protector.

Keyword

3-dimension; re-irradiation; recurrence; nasopharyngeal cancer

MeSH Terms

Adult
Aged
Carcinoma, Squamous Cell/mortality/*radiotherapy/secondary
Disease-Free Survival
Female
Follow-Up Studies
Human
Male
Middle Aged
Nasopharyngeal Neoplasms/mortality/pathology/*radiotherapy
Neoplasm Recurrence, Local/mortality/*radiotherapy
Radiation Dosage
*Radiotherapy, Conformal
Survival Analysis

Cited by  1 articles

Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx
Heerim Nam, Yong Chan Ahn, Kyungmi Yang, Dongryul Oh, Jae Myoung Noh
Cancer Res Treat. 2022;54(1):96-108.    doi: 10.4143/crt.2020.1349.

Full Text Links
  • YMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr