A phase III study of late course accelerated hyperfractionated radiotherapy versus conventionally fractionated radiotherapy in patients with nasopharyngeal carcinoma.

Abstract

OBJECTIVE:

To compare the efficacy and toxicity of late course accelerated hyperfractionated radiotherapy (LCAF) with conventionally fractionated (CF) radiotherapy in the treatment of nasopharyngeal carcinoma (NPC).

METHODS:

Between March 1998 and November 2002, 200 eligible patients with NPC were randomized to receive either LCAF (48 Gy in 40 fractions, 2 fractions per day, 1.2 Gy/fraction, with an interval of ≥6 h, 5 d/wk, followed by 30 Gy in 20 fractions using 2 fractions per day, 1.5 Gy/fraction, 5 d/wk) or CF (35 fractions, 2.0 Gy/fraction/d, 5 d/wk, to a total dose of 70 Gy).

RESULTS:

All patients completed the treatment. Overall baseline characteristics of the study population of the 2 arms were well balanced. With a median follow-up of 6.9 years, the 5-year local control rate was higher in the LCAF arm (87.6% vs. 75.9%, P=0.044). The 5-year overall survival rates were 74.1% vs. 58.0% (P=0.024) for the LCAF arm and the CF arm, respectively. LCAF patients had a higher occurrence of acute mucositis and a more evident weight loss than CF patients, whereas incidence rates of radiation-induced damage to the central nervous system were similar in the 2 arms.

CONCLUSIONS:

LCAF achieved higher local control and overall survival rates than CF radiotherapy, without increasing radiation-related late complications such as cranial nerve palsy.

• Authors: Zi-qiang Pan, Xia-yun He, Xiao-mao Guo, Ming Ye, Zhen Zhang, Shao-qin He, Tai-fu Liu
• Journal: American journal of clinical oncology (Am J Clin Oncol) Vol. 35 Issue 6 Pg. 600-5 (Dec 2012) ISSN: 1537-453X [Electronic] United States
• PMID: 22134512 (Publication Type: Clinical Trial, Phase III, Comparative Study, Journal Article, Randomized Controlled Trial)

Topics

• Adolescent
• Adult
• Aged
• Carcinoma (radiotherapy)
• Central Nervous System (radiation effects)
• Dose Fractionation, Radiation
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Mucositis (etiology)
• Nasopharyngeal Neoplasms (radiotherapy)
• Radiation Dosage
• Radiation Injuries (etiology)
• Radiotherapy (adverse effects)
• Statistics, Nonparametric
• Weight Loss (radiation effects)
• Young Adult