Treatment of nasopharyngeal carcinoma using simultaneous modulated accelerated radiation therapy via helical tomotherapy: a phase II study.

  • Lei Du Hainan Branch of Chinese PLA General Hospital;Chinese PLA General Hospital
  • Xinxin Zhang
  • Linchun Feng
  • Jing Chen
  • Jun Yang
  • Haixia Liu
  • Shouping Xu
  • Chuanbin Xie
  • Lin Ma Hainan Branch of Chinese PLA General Hospital;Chinese PLA General Hospital

Abstract

Objectives To evaluate short-term safety and efficacy of simultaneous modulated accelerated radiation therapy (SMART) delivered via helical tomotherapy in patients with nasopharyngeal carcinoma (NPC).

Methods Between August 2011 and September 2013, 132 newly diagnosed NPC patients were enrolled for a prospective phase II study. The prescription doses delivered to the gross tumor volume (pGTVnx) and positive lymph nodes (pGTVnd), the high risk planning target volume (PTV1), and the low risk planning target volume (PTV2), were 67.5Gy (2.25Gy/F), 60Gy (2.0Gy/F), and 54Gy (1.8Gy/F), in 30 fractions, respectively. Acute toxicities were evaluated according to the established RTOG/EORTC criteria. This group of patients was compared with the 190 patients in the retrospective P70 study, who were treated between September 2004 and August 2009 with helical tomotherapy, with a dose of 70-74Gy/33F/6.5W delivered to pGTVnx and pGTVnd.

Results The median follow-up was 23.7 (12 - 38) months. Acute radiation related side-effects were mainly problems graded as 1 or 2. Only a small number of patients suffered from grade 4 leucopenia (4.5%) or thrombocytopenia (2.3%). The local relapse-free survival (LRFS), nodal relapse-free survival (NRFS), local-nodal relapse-free survival (LNRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were 96.7%, 95.5%, 92.2%, 92.7% and 93.2%, at 2 years, respectively, with no significant difference compared with the P70 study.

Conclusion SMART delivered via the helical tomotherapy technique appears to be associated with an acceptable acute toxicity profile and favorable short-term outcomes for patients with NPC. Long-term toxicities and patient outcomes are under investigation.

Author Biographies

Lei Du, Hainan Branch of Chinese PLA General Hospital;Chinese PLA General Hospital
physician of Radiation Oncology, master of clinical medicine, graduated from  Medical School of Chinese PLA and mainly engaged in precise radiation therapy of head and neck cancer, lung cancer and breast cancer.
Lin Ma, Hainan Branch of Chinese PLA General Hospital;Chinese PLA General Hospital

1988 - 1990   Resident of the Department of Gynecology of General Hospital, Tianjin Medical University.

1990 - 1993    Associate physician of the Department of Radiation Oncology, Henri Mondor Hospital, Paris XII University.

1993 - 1998    Associate physician of the Department of Radiation Oncology, Saint Louis Hospital, Paris X University.

1998 - 2000   Post-doctor of INSERM, Clinical & Experimental Pharmacology Laboratory, Saint Louis Hospital.

2000 -        Professor of the Chinese PLA Medical School; Radiation oncologist of the Department of Radiation Oncology of the Chinese PLA General Hospital.

Published
2016-05-10
How to Cite
Du, L., Zhang, X., Feng, L., Chen, J., Yang, J., Liu, H., Xu, S., Xie, C., & Ma, L. (2016). Treatment of nasopharyngeal carcinoma using simultaneous modulated accelerated radiation therapy via helical tomotherapy: a phase II study. Radiology and Oncology, 50(2). Retrieved from https://radioloncol.com/index.php/ro/article/view/2453
Section
Clinical oncology