Preliminary results of a phase I/II study of simultaneous modulated accelerated radiotherapy for nondisseminated nasopharyngeal carcinoma.

Abstract

PURPOSE:

To present preliminary results of intensity-modulated radiotherapy (IMRT) with the simultaneous modulated accelerated radiotherapy (SMART) boost technique in patients with nasopharyngeal carcinoma (NPC).

METHODS AND MATERIALS:

Twenty patients who underwent IMRT for nondisseminated NPC at the Asan Medical Center between September 2001 and December 2003 were prospectively evaluated. Intensity-modulated radiotherapy was delivered with the "step and shoot" SMART technique at prescribed doses of 72 Gy (2.4 Gy/day) to the gross tumor volume, 60 Gy (2 Gy/day) to the clinical target volume and metastatic nodal station, and 46 Gy (2 Gy/day) to the clinically negative neck region. Eighteen patients also received cisplatin once per week.

RESULTS:

The median follow-up period was 27 months. Nineteen patients completed the treatment without interruption; the remaining patient interrupted treatment for 2 weeks owing to severe pharyngitis and malnutrition. Five patients (25%) had Radiation Therapy Oncology Group Grade 3 mucositis, whereas 9 (45%) had Grade 3 pharyngitis. Seven patients (35%) lost more than 10% of their pretreatment weight, whereas 11 (55%) required intravenous fluids and/or tube feeding. There was no Grade 3 or 4 xerostomia. All patients showed complete response. Two patients had distant metastases and locoregional recurrence, respectively.

CONCLUSION:

Intensity-modulated radiotherapy with the SMART boost technique allows parotid sparing, as shown clinically and by dosimetry, and might also be more effective biologically. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

• Authors: Sang-wook Lee, Geum Mun Back, Byong Yong Yi, Eun Kyung Choi, Seung Do Ahn, Seong Soo Shin, Jung-hun Kim, Sang Yoon Kim, Bong-Jae Lee, Soon Yuhl Nam, Seung-Ho Choi, Seung-Bae Kim, Jin-hong Park, Kang Kyoo Lee, Sung Ho Park, Jong Hoon Kim
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 65 Issue 1 Pg. 152-60 (May 01 2006) ISSN: 0360-3016 [Print] United States
• PMID: 16472934 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Cisplatin (therapeutic use)
• Combined Modality Therapy (methods)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Nasopharyngeal Neoplasms (drug therapy, radiotherapy)
• Otitis Media (etiology)
• Prospective Studies
• Radiotherapy Dosage
• Radiotherapy, Intensity-Modulated (adverse effects, methods)
• Xerostomia (etiology)