Clinical effects of combined microwave hyperthermia and chemoradiotherapy in treatment of cervical lymph node metastasis of nasopharyngeal carcinoma

Abstract

Objective To evaluate the short- and long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating metastatic nasopharyngeal carcinoma to the cervical lymph nodes. Methods A total of 154 cases of stage N2-N3 nasopharyngeal carcinoma (1992 stage system) were randomized into two groups: group A (76 cases, treated with microwave hyperthermia combined with chemoradiotherapy) and group B (78 ca-ses, treated with chemoradiotherapy alone). Both groups received 1 to 2 cycles of chemotherappy with cisplatin and 5-fluorouracil and then received regular radiotherapy. The total doses of radiotherapy were 70-78 Gy/35-39 f, 47-51 d for the primary loci of nasopharynx and 68-72 Gy/34-36 f,46-50 d for the metastatic loci in the neck. Group A received microwave hyperthermia on the metastatic cervical node at the beginning of radiotherapy, with the micro-wave hyperthermia administered for 45 min every time,two times a week, totaling 8 to 14 times. Results The complete extinction rates of neck metastatic carcinoma were 80.3% and 61.5% , respectively, in groups A and B (P 0.05) ; and 52.6% (P< 0.01) and 41.0% (P<0.05), respectively, in group B. Conclusions Microwave hyperthermia combined with chemoradiotherapy can elevate the complete extinction rate of cervical lymph node metastasis of nasopharyngeal carcinoma and reduce the radiotherapy dose needed of effective control. The 5-year local control rate of cervical lymph node metastasis in combined therapy group is superior to that in the chemoradiotherapy alone group,and can elevate the long-term survival rate of patients. Key words: Nasopharyngeal carcinoma; Cervical lymph node metastasis; Chemoradiotherapy; Hyper-thermia; Combined therapy