Re-irradiation Using Intensity-Modulated Radiation Therapy of Locally Recurrent Nasopharyngeal Carcinoma
作者单位：Department of Radiation OncologyNational University Cancer InstituteNational University Health SystemNational University of Singapore
会议名称：《第六届全国鼻咽癌学术大会》
会议日期：2010年
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
摘 要：正Purpose:Local recurrences of nasopharyngeal carcinoma（NPC） may be salvaged by re-irradiation using conventional technique,but with significant *** modulated radiation therapy（IMRT） provides potentially improvement in therapeutic ratio by reducing dose to normal *** aim of this study is to address the efficacy and toxicity profile of IMRT for a cohort of patients with locally recurrent NPC. Methods and Materials:Between August 2003 and June 2009,seventy patients with histologically proven locally recurrent NPC were treated with *** time to recurrence was 30 months after the completion of conventional radiation to definitive ***-seven percent of the cases had rT3-4 *** minimal planned dose was 59.4-60 Gy in 1.8-2 Gy per daily fractions to the gross disease with margins,with or without chemotherapy. Results:The median dose to the tumor bed was 70 Gy（range 50-77.4 Gy）.Sixty-five patients received planned radiation therapy,and 5 patients received doses between *** a median follow-up of 25 months,the 2-,and 3-year locoregional recurrence-free,disease-free survival（DFS）,and overall survival（OS） rates were 65.8%vs.49.3%,65.8%,vs.47.6%,and 67.4%vs.51.9%,respectively. Moderate to severe late toxicities were noted in 25 patients（35.7%）.Eleven patients（15.7%） had posterior nasal space ulceration,17（24.3%） developed cranial nerve palsies,12（17.1%） had trismus,and 12（17.1%） suffered *** grade 5 toxicity *** disease-free interval and advanced T-classification at presentation were adverse prognostic factors. Conclusion:Re-irradiation with IMRT provides reasonable long-term control in patients with locally recurrent NPC with acceptable profile of adverse-effects.