Abstract
BackgroundBalancing the dose requirements between targets and normal tissue is a challenge in radiation of nasopharyngeal carcinoma (NPC). The purpose of this study is to evaluate the dosimetric parameters and clinical outcomes in NPC.MethodsWe presented a retrospective review of patients with T3‐4 NPC treated by intensity‐modulated radiation therapy (IMRT). Patient characteristics, dosimetric parameters, and the follow‐up data for survival and late toxicities were analyzed.ResultsThe 5‐year overall survival, local relapse‐free survival, and distant metastasis‐free survival were 83.0%, 90.1%, and 82.4%, respectively. Multivariate analysis revealed that the volume of involved lymph node was an independent prognostic factor. The volume of primary tumor and the maximal dose were significant factors affecting temporal lobe injury.ConclusionsIMRT provided satisfactory local control for advanced T‐stage NPC, with acceptable late toxicities. The dose constraint criteria of selected critical structures can be appropriately loosen.
Highlights
Balancing the dose requirements between targets and normal tissue is a challenge in radiation of nasopharyngeal carcinoma (NPC)
According to the logistic analysis of dosimetric factors in temporal lobe injury (TLI), the odds ratio attributed to the volume of the primary tumor to the TLI was 1.035 (95% confidence interval (CI), 1.006-1.065; P = .02), and the Dmax was 1.006
In a randomized study by Peng,[15] intensity-modulated radiation therapy (IMRT) contributed to an absolute improvement in the 5-year locoregional control of 7.7% and a 5-year overall survival (OS) of 12.5% compared with conventional 2D conventional radiation therapy (2D-CRT), similar to results reported by Lee.[16]
Summary
Balancing the dose requirements between targets and normal tissue is a challenge in radiation of nasopharyngeal carcinoma (NPC). The purpose of this study is to evaluate the dosimetric parameters and clinical outcomes in NPC. Methods: We presented a retrospective review of patients with T3-4 NPC treated by intensity-modulated radiation therapy (IMRT). Dosimetric parameters, and the follow-up data for survival and late toxicities were analyzed. Results: The 5-year overall survival, local relapse-free survival, and distant metastasis-free survival were 83.0%, 90.1%, and 82.4%, respectively. Multivariate analysis revealed that the volume of involved lymph node was an independent prognostic factor. The volume of primary tumor and the maximal dose were significant factors affecting temporal lobe injury. Conclusions: IMRT provided satisfactory local control for advanced T-stage NPC, with acceptable late toxicities. The dose constraint criteria of selected critical structures can be appropriately loosen
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