3D-image-guided HDR-brachytherapy versus 2D HDR - brachytherapy after external beam radiotherapy for early T-stage nasopharyngeal carcinoma

BMC Cancer

YuFeng Ren⁵  QuanCheng Zhao¹  Hui Liu⁵  YingJuan Huang³  ZhenYu Wang⁴  XinPing Cao⁵  Bin S Teh²  BiXiu Wen⁴ 

[1] Department of Neurosurgery, Binzhou People’s hospital, Binzhou P.R.China

[2] Department of Radiation Oncology, the Methodist Hospital, 6565 Fannin, Houston, Texas 77030, USA

[3] Department of Traditional Chinese medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P.R.China

[4] Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P.R.China

[5] State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, P.R.China

关键词: Local control;    Brachytherapy;    3D-image-guided;    Radiotherapy;    Nasopharyngeal carcinoma;   

Others  :  1117979
DOI  :  10.1186/1471-2407-14-894

 received in 2014-05-27, accepted in 2014-11-17,  发布年份 2014

【 摘 要 】

Background

Two-dimensional high-dose-rate brachytherapy (2D-HDR-BT) is an effective method of dose escalation for local tumor control in early T-stage nasopharyngeal carcinoma (NPC). Treatment outcomes for 3D-image-guided high-dose-rate brachytherapy (3D-image-guided-HDR-BT) after external beam radiotherapy (ERT) have not been examined in early T-stage NPC patients. The current study was designed to evaluate whether addition of 3D-HDR-BT to ERT showed further improvement in treatment outcomes in patients with early T-stage NPC when compared to 2D-HDR-BT after ERT.

Methods

The current study retrospectively analyzed and compared treatment outcomes for patients with nonmetastatic stage T1-2b NPC treated with 2D-HDR-BT (n =101) or 3D-HDR-BT (n =118) after ERT. Patients in both groups were treated with ERT at a mean dose of 60 Gy and a brachytherapy dose of 12Gy (8 ~ 20Gy), 2.5 ~ 5Gy per fraction under local anesthesia.

Results

Compared to patients treated with 2D-HDR-BT after ERT, patients treated with 3D-HDR-BT after ERT showed improvement in five-year actuarial local control survival rates (p = 0.024), local/regional relapse-free survival rates (p = 0.038), and disease-free survival rates (p = 0.021). Multivariate analysis showed that NPC patients treated with 3D-HDR-BT had improved local control survival (p = 0.042). The incidence rates of acute or chronic complications were similar between two groups.

Conclusions

The current study showed that 3D-image-guided HDR-BT after ERT was an effective treatment modality for patients with stage T1-2 NPC with acceptable complications. The improvement in local tumor control and disease free survival is likely due to improved conformal dose distributions.

【 授权许可】

   
2014 Ren et al.; licensee BioMed Central Ltd.

【 图 表 】

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