Abstract
BackgroundWith the improved overall survival (OS) of nasopharyngeal carcinoma (NPC) patients, the importance of quality of life (QoL) is increasingly being recognized. For some radiosensitive NPC patients, whether low-dose radiotherapy can improve the QoL without affecting clinical efficacy is unknown. This study aimed to assess the survival rates and QoL of NPC patients treated with 50 Gy radiotherapy plus hematoporphyrin derivative (HPD).MethodsForty-six newly diagnosed NPC patients treated with 50 Gy radiotherapy plus HPD between June 1988 and July 1992 were analyzed. All patients were restaged according to the 7th edition of the American Joint Committee on Cancer staging system. The radiotherapy plan was designed on the basis of pretreatment computed tomography. The OS, local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates were estimated using the Kaplan–Meier method. QoL was assessed using the Late Radiation Morbidity Scoring Criteria of the Radiation Therapy Oncology Group.ResultsThe 5-year OS, LRFS, DMFS, and DFS rates were 74.3%, 72.6%, 82.1%, and 61.2%, respectively. The corresponding 10-year rates were 38.4%, 62.9%, 78.5%, and 49.8%, respectively, and the 20-year rates were 27.7%, 51.4%, 78.5%, and 40.7%, respectively. None of the patients developed severe radiation-related complications, such as radiation-induced temporal lobe necrosis, hearing loss, trismus, and dysphagia.ConclusionSome NPC patients were sensitive to 50 Gy radiotherapy plus HPD, and this sensitivity was characterized by long-term survival without significant late treatment morbidities.
Highlights
With the improved overall survival (OS) of nasopharyngeal carcinoma (NPC) patients, the importance of quality of life (QoL) is increasingly being recognized
It is very important to improve the QoL of NPC patients without compromising the treatment efficacy and to provide individualized radiotherapy according to different radiosensitivities of NPCs
He lived cancer-free for an additional 10 years [12]. This case led us to wonder what type of nasopharyngeal tumors can be controlled with low-dose radiotherapy and whether the case is generalizable. With these questions in mind, we retrospectively identified a series of NPC patients from the Sun Yat-sen University Cancer Center who were irradiated with only 50 Gy radiotherapy plus hematoporphyrin derivative (HPD) between June 1988 and July 1992 and analyzed their 20-year survival rates and QoL
Summary
With the improved overall survival (OS) of nasopharyngeal carcinoma (NPC) patients, the importance of quality of life (QoL) is increasingly being recognized. It is very important to improve the QoL of NPC patients without compromising the treatment efficacy and to provide individualized radiotherapy according to different radiosensitivities of NPCs. In 2006, we divided NPCs into the following four types: radiosensitive and non-metastasis-prone; radioresistant and nonmetastasis-prone; radiosensitive and metastasis-prone; and radioresistant and metastasis-prone [11]. In 2006, we divided NPCs into the following four types: radiosensitive and non-metastasis-prone; radioresistant and nonmetastasis-prone; radiosensitive and metastasis-prone; and radioresistant and metastasis-prone [11] This typing provides a new approach for NPC radiation planning based on the radiosensitivity and metastatic tendency. This typing approach is limited because it does not consider other doses below or above the conventional radiotherapy doses
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