Abstract
BackgroundTo evaluate the longitudinal changes of quality of life (QoL) and survival in patients with nasopharyngeal carcinoma (NPC) treated by volumetric-modulated arc therapy (VMAT) versus intensity-modulated radiotherapy (IMRT).MethodsOne hundred and forty non-distant metastatic NPC patients treated by VMAT (n = 66) or IMRT (n = 74) with simultaneously integrated boost between March 2013 and December 2015 at a single institute were analyzed. QoL was prospectively assessed by the EORTC QLQ-C30 and HN35 questionnaires at the four time points: before RT, RT 42.4 Gy (20 fractions), and 3, 12 months after RT.ResultsThe 3-year locoregional relapse-free survival, distant metastasis-free survival, failure-free survival, and overall survival rates were 96.6, 89.4, 86.1%, and 87.4 for the VMAT group, respectively, compared with 91.4, 90.0, 79.8, and 91.3% for the IMRT group (p value > 0.05). The pattern of QoL changes was similar between the VMAT and IMRT group. No statistically or clinically significant difference in all the QoL scales was observed between VMAT and IMRT group at each time point. Compared to before RT, we observed statistically (p<0.05) and clinically (difference of mean scores≧10) better outcome in global QoL and social functioning, but worse head and neck symptomatic outcome in swallowing, taste/smell, opening mouth, dry mouth, and sticky saliva at the time point of 1 year after RT for both groups.ConclusionThe study provides the evidence that the tumor control, survival and changes of QoL is compatible for NPC patients treated by VMAT versus IMRT.
Highlights
To evaluate the longitudinal changes of quality of life (QoL) and survival in patients with nasopharyngeal carcinoma (NPC) treated by volumetric-modulated arc therapy (VMAT) versus intensity-modulated radiotherapy (IMRT)
Strong evidence has shown that the dosimetric improvement conferred by the technical advance from conventional 2D RT to IMRT in NPC could transfer to clinical benefit, regarding toxicity and tumor control, and in terms of the patient’s QoL and survival [4,5,6]
We compared the locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), failure-free survival (FFS) and overall survival (OS), as well as the changes of the EORTC QoL scales at the four time points for NPC patients treated by VMAT versus IMRT
Summary
To evaluate the longitudinal changes of quality of life (QoL) and survival in patients with nasopharyngeal carcinoma (NPC) treated by volumetric-modulated arc therapy (VMAT) versus intensity-modulated radiotherapy (IMRT). Advances in modern radiotherapy (RT) techniques for treating nasopharyngeal carcinoma (NPC) have emerged with the development of intensity-modulated radiotherapy (IMRT) or, more recently, volumetric-modulated arc therapy (VMAT). Dual arc VMAT has been reported to be technically superior, e.g. faster delivery time, use of fewer monitor units (MUs) compared to seven-field fixed beam IMRT in NPC patients, and a dosimetric advantage regarding target volume coverage or sparing some organs at risk (OARs) [1,2,3]. We compared the locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), failure-free survival (FFS) and overall survival (OS), as well as the changes of the EORTC QoL scales at the four time points for NPC patients treated by VMAT versus IMRT
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