Radiation Oncology | |
3D-image-guided high-dose-rate intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma | |
Bi-Xiu Wen1  Bin S Teh3  Yuan-Hong Gao4  Wei-Jun Ye4  Jia Xu2  Xin-Ping Cao4  Yu-Feng Ren1  | |
[1] Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Rd II, Guangzhou 510080, China;Division of Emergency Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China;The Methodist Hospital Research Institute, 6565 Fannin, Houston, Texas 77030, USA;State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, China | |
关键词: Local tumor control; 3D-image-guided HDR Brachytherapy; Persistent disease; Intensity-modulated radiotherapy; Nasopharyngeal carcinoma; | |
Others : 1153563 DOI : 10.1186/1748-717X-8-165 |
|
received in 2012-12-17, accepted in 2013-05-08, 发布年份 2013 | |
【 摘 要 】
Background
To evaluate the therapeutic benefit of 3D-image-guided high-dose-rate intracavitary brachytherapy (3D-image-guided HDR-BT) used as a salvage treatment of intensity modulated radiation therapy (IMRT) in patients with locally persistent nasopharyngeal carcinoma (NPC).
Methods
Thirty-two patients with locally persistent NPC after full dose of IMRT were evaluated retrospectively. 3D-image-guided HDR-BT treatment plan was performed on a 3D treatment planning system (PLATO BPS 14.2). The median dose of 16 Gy was delivered to the 100% isodose line of the Gross Tumor Volume.
Results
The whole procedure was well tolerated under local anesthesia. The actuarial 5-y local control rate for 3D-image-guided HDR-BT was 93.8%, patients with early-T stage at initial diagnosis had 100% local control rate. The 5-y actuarial progression-free survival and distant metastasis-free survival rate were 78.1%, 87.5%. One patient developed and died of lung metastases. The 5-y actuarial overall survival rate was 96.9%.
Conclusions
Our results showed that 3D-image-guided HDR-BT would provide excellent local control as a salvage therapeutic modality to IMRT for patients with locally persistent disease at initial diagnosis of early-T stage NPC.
【 授权许可】
2013 Ren et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150407095528452.pdf | 1381KB | download | |
Figure 8. | 36KB | Image | download |
Figure 7. | 35KB | Image | download |
Figure 6. | 35KB | Image | download |
Figure 5. | 197KB | Image | download |
Figure 4. | 126KB | Image | download |
Figure 3. | 108KB | Image | download |
Figure 2. | 110KB | Image | download |
Figure 1. | 101KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
Figure 5.
Figure 6.
Figure 7.
Figure 8.
【 参考文献 】
- [1]Lee N, Harris J, Garden AS, Straube W, Glisson B, Xia P, et al.: Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol 2009, 27(22):3684-3690.
- [2]Kwong DL, Pow EH, Sham JS, McMillan AS, Leung LH, Leung WK, et al.: Intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: a prospective study on disease control and preservation of salivary function. Cancer 2004, 101(7):1584-1593.
- [3]Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, et al.: Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 2002, 53(1):12-22.
- [4]Kam MK, Teo PM, Chau RM, Cheung KY, Choi PH, Kwan WH, et al.: Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys 2004, 60(5):1440-1450.
- [5]Leung TW, Tung SY, Sze WK, Sze WM, Wong VY OSK: Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2000, 47(2):405-412.
- [6]Zhang Y, Lin ZA, Pan JJ, Zheng Z, Yang L, Lin SJ, et al.: Concurrent control study of different radiotherapy for primary nasopharyngeal carcinoma: intensity-modulated radiotherapy versus conventional radiotherapy. Chin J Cancer 2009, 28(11):1143-1148.
- [7]Kwong DL, Nicholls J, Wei WI, Chua DT, Sham JS, Yuen PW, et al.: The time course of histologic remission after treatment of patients with nasopharyngeal carcinoma. Cancer 1999, 85(7):1446-1453.
- [8]Yan JH, Xu GZ, Hu YH, Li SY, Lie YZ, Qin DX, et al.: Management of local residual primary lesion of nasopharyngeal carcinoma: II. Results of prospective randomized trial on booster dose. Int J Radiat Oncol Biol Phys 1990, 18(2):295-298.
- [9]Sze WM LAYT: The prognostic value of endoscopic findings after radical radiotherapy for nasopharyngeal carcinoma. Singapore: Proc UICC Workshop on Nasopharyngeal Cancer; 1998:239.
- [10]Yu KH, Leung SF, Tung SY, Zee B, Chua DT, Sze WM, et al.: Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck 2005, 27(5):397-405.
- [11]Yi JL, Gao L, Huang XD, Li SY, Luo JW, Cai WM, et al.: Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution. Int J Radiat Oncol Biol Phys 2006, 65(1):161-168.
- [12]Yeo R, Fong KW, Hee SW, Chua ET, Tan T, Wee J: Brachytherapy boost for T1/T2 nasopharyngeal carcinoma. Head Neck 2009, 31(12):1610-1618.
- [13]Yan JH, Qin DX, Hu YH, Cai WM, Xu GZ, Wu XL, et al.: Management of local residual primary lesion of nasopharyngeal carcinoma (NPC): are higher doses beneficial? Int J Radiat Oncol Biol Phys 1989, 16(6):1465-1469.
- [14]Chen MY, Guo X, Wen WP, Hua YJ, Guo L, Li NW, et al.: Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma. Ai Zheng 2007, 26(7):673-678.
- [15]Wu SX, Chua DT, Deng ML, Zhao C, Li FY, Sham JS, et al.: Outcome of fractionated stereotactic radiotherapy for 90 patients with locally persistent and recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2007, 69(3):761-769.
- [16]Chua DT, Sham JS, Kwong PW, Hung KN, Leung LH: Linear accelerator-based stereotactic radiosurgery for limited, locally persistent, and recurrent nasopharyngeal carcinoma: efficacy and complications. Int J Radiat Oncol Biol Phys 2003, 56(1):177-183.
- [17]Zheng XK, Chen LH, Chen YQ, Deng XG: Three-dimensional conformal radiotherapy versus intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2004, 60(1):165-170.
- [18]Milickovic N, Baltast D, Giannouli S, Lahanas M, Zamboglou N: CT imaging based digitally reconstructed radiographs and their application in brachytherapy. Phys Med Biol 2000, 45(10):2787-2800.
- [19]Wang ZY, Li SX: A 3D brachytherapy treatment planning system. Zhongguo Yi Liao Qi Xie Za Zhi 2000, 24(5):254-259.
- [20]Xiang H, Zhuang TG: CT/MRI-based software for 3-D brachytherapy planning system. Zhongguo Yi Liao Qi Xie Za Zhi 2002, 26(6):398-401.
- [21]Kolotas C, Baltas D, Zamboglou N: CT-Based interstitial HDR brachytherapy. Strahlenther Onkol 1999, 175(9):419-427.
- [22]Peiffert D: What is new in brachytherapy? Bull Cancer 2006, 93(1):125-132.
- [23]Charra-Brunaud C, Peiffert D: Preliminary results of a French prospective-multicentric study of 3D pulsed dose-rate brachytherapy for cervix carcinoma. Cancer Radiother 2008, 12(6–7):527-531.
- [24]Dolezel M, Vanasek J, Odrazka K, Tichy M: The progress in the treatment of cervical cancer--3D brachytherapy CT/MR-based planning. Ceska Gynekol 2008, 73(3):144-149.
- [25]Das RK, Patel R, Shah H, Odau H, Kuske RR: 3D CT-based high-dose-rate breast brachytherapy implants: treatment planning and quality assurance. Int J Radiat Oncol Biol Phys 2004, 59(4):1224-1228.
- [26]Martin T, Roddiger S, Kurek R, Dannenberg T, Eckart O, Kolotas C, et al.: 3D conformal HDR brachytherapy and external beam irradiation combined with temporary androgen deprivation in the treatment of localized prostate cancer. Radiother Oncol 2004, 71(1):35-41.
- [27]Hermesse J, Biver S, Jansen N, Lenaerts E, Nickers P: Dosimetric comparison of high-dose-rate brachytherapy and intensity-modulated radiation therapy as a boost to the prostate. Int J Radiat Oncol Biol Phys 2010, 76(1):269-276.
- [28]Feuvret L, Noel G, Mazeron JJ, Bey P: Conformity index: a review. Int J Radiat Oncol Biol Phys 2006, 64(2):333-342.
- [29]Miller AB, Hoogstraten B, Staquet M, Winkler A: Reporting results of cancer treatment. Cancer 1981, 47(1):207-214.
- [30]Cox JD, Stetz J, Pajak TF: Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995, 31(5):1341-1346.
- [31]Kaplan ELMP: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958, 53:457-481.
- [32]Leibel SA, Scott CB, Mohiuddin M, Marcial VA, Coia LR, Davis LW, et al.: The effect of local-regional control on distant metastatic dissemination in carcinoma of the head and neck: results of an analysis from the RTOG head and neck database. Int J Radiat Oncol Biol Phys 1991, 21(3):549-556.
- [33]Chang JT, Chan SC, Yen TC, Liao CT, Lin CY, Lin KJ, et al.: Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys 2005, 62(2):501-507.
- [34]Levendag PC, Lagerwaard FJ, De Pan C, Noever I, Van Nimwegen A, Wijers O, et al.: High-dose, high-precision treatment options for boosting cancer of the nasopharynx. Radiother Oncol 2002, 63(1):67-74.
- [35]Withers HR, Taylor JM, Maciejewski B: The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 1988, 27(2):131-146.