Abstract
PurposeTo estimate the influence of prolonged radiation treatment time (RTT) on survival outcomes in nasopharyngeal carcinoma after continuous intensity-modulated radiation therapy.Methods and MaterialsRetrospectively review 321 patients with NPC treated between October 2009 and December 2010 and all of them underwent simultaneous accelerated intensity-modulated radiation therapy. The fractionated dose was 2–2.47 Gy/F (median 2.27 Gy), and the total dose for nasopharyngeal region was 64–74 Gy/ 28–33 fractions. The association of prolonged RTT and treatment interruption with PFS, LRFS and DFFS were assessed by univariate analysis and multivariate analysis. Survival analyses were carried out using Kaplan–Meier methodology and the log-rank test was used to assess the difference. The Cox regression proportional hazard model was used for multivariate analyses and evaluating the prognostic parameters for PFS, LRFS and DFFS.ResultsUnivariate analysis revealed no significant associations between prolonged RTT and PFS, LRFS, DFFS when dichotomized using various cut-off values (all P>0.05). In multivariate analysis, RTT (range, 36–63 days) as a continuous variable, had no influence on any survival outcome as well (P>0.05). T and N classification were independent prognostic factors for PFS, LRFS and DFFS (all P<0.05, except T classification for LRFS, P = 0.057). Age was an independent prognostic factor for PFS (hazard ratio [HR], 1.033; P = 0.008) and DFFS (HR, 1.032; P = 0.043).ConclusionWe conclude that no such association between survival outcomes and radiation treatment duration (range: 36–63 days) can be found in the present retrospective study, however, we have to remind that prolongation in treatment should be limited in clinical application and interruptions caused by any reason should be minimized as much as possible.
Highlights
Nasopharyngeal carcinoma (NPC) has an extremely uneven endemic distribution within Southern China and Southeast Asia [1]
Univariate analysis revealed no significant associations between prolonged radiation treatment time (RTT) and progression free survival (PFS), loco-regional failure-free survival (LRFS), DFFS when dichotomized using various cut-off values
We conclude that no such association between survival outcomes and radiation treatment duration can be found in the present retrospective study, we have to remind that prolongation in treatment should be limited in clinical application and interruptions caused by any reason should be minimized as much as possible
Summary
Nasopharyngeal carcinoma (NPC) has an extremely uneven endemic distribution within Southern China and Southeast Asia [1]. The last two decades have witnessed key milestones in the treatment of NPC and continual improvements in treatment outcomes. As it is radiosensitive and in an anatomically-complex location, radiotherapy remains the main treatment modality for NPC [2]. The 3-year local control rate for NPC after IMRT is approximately 84% to 95% and the 3-year overall survival rate ranges from 85% to 90% [6,7,8,9]. Overall survival varies considerably depending on tumor stage; on aggregate, approximately 76%-80% of patients survive at least 5years [5, 10, 11]
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