Failure patterns and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation in Northwest China: A pilot study

Radiation Oncology

Xiaoli Long¹  Bin Zhou¹  Jianping Li¹  Xuehai Fu¹  Feng Xiao¹  Man Xu¹  Lina Zhao¹  Shanquan Luo¹  Yuesheng Hsia¹  Mei Shi¹  Jianhua Wang¹ 

[1] Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, No.15 Changle West Road, Xi'an, China

关键词: survival;    pattern of failure;    chemotherapy;    intensity modulated radiotherapy;    nasopharyngeal carcinoma;   

Others  :  1160914
DOI  :  10.1186/1748-717X-7-2

 received in 2011-08-29, accepted in 2012-01-10,  发布年份 2012

【 摘 要 】

Purpose

To evaluate the clinical outcomes and patterns of failure in patients with nasopharyngeal carcinoma (NPC) treated with intensity modulated radiotherapy (IMRT) in Northwest China.

Methods and materials

From January 2006 to December 2009, 138 NPC patients were treated at Xijing Hospital. Of them, 25 cases with stage I-II received IMRT only, 113 cases with stage III-IVb received IMRT plus accomplished platinum-based chemotherapy. The IMRT prescribed dose was PTV 68-74 Gy to gross disease in nasopharynx and 66-72 Gy to positive lymph nodes in 30-33 fractions, and high risk and low risk region PTV was 60-63 Gy and 50.4~56 Gy in 30~33 and 28 fractions respectively. Plasma Epstein Barr virus (EBV) DNA load was measured before treatment. The clinical toxicities, outcomes and patterns of failure were observed.

Results

The median follow up time was 23 months (range 2 to 53 months). EBV infection positive was only 15.9%. Overall disease failure developed in 36 patients, 99% belonged to stage III/IV disease. Among these, there were 26 distant metastases, 6 local recurrence, and 4 regional recurrence. The 3-year local control rate(LCR), distant metastasis-free survival (MFS), disease-free survival (DFS) and the overall survival (OS) was 93.9%, 79.5%, 70% and 83.1% respectively. Multivariate analyses revealed that age and anemia pre-radiotherapy were independent predictors for OS.

Conclusion

IMRT with or without chemotherapy can improve the long term survival of NPC patients in Northwest China. Distant metastasis becomes the main cause of treatment failure. Age and anemia before radiotherapy were the main prognosis factors of NPC patients.

【 授权许可】

   
2012 Wang et al; licensee BioMed Central Ltd.

【 图 表 】

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