Objective: To evaluate the long-term efficacy of treatment with external-beam radiotherapy (EBR) plus intracavitary branchytherapy (IBT) through using a new type of applicator for nasopharyngeal carcinoma (NPC) patients. Methods: A total of 169 NPC patients were recruited and divided into two groups. Patients in the comprehensive treatment group (CTG) were treated with EBR plus IBT. Patients in the control group (CG) were treated by EBR alone. In CTG, the 49 patients with stage T1-T2 disease received a total dose of 60-65 Gy by EBR and the 24 patients with stage T3-T4 disease received 70-75 Gy. The dose of brachytherapy ranged 6-20 Gy and the median dose was 12 Gy. In the CG, patients received a total dose of 70-80 Gy by EBR. Results: Till September 2009, 93.5% patients were followed up. The short-term effective rate of the treatment for T1-T2 patients was 93.9% in CTG and 78.2% in CG (P = 0.023 ), and that for T 3-T4 patients was 79.2% in CTG and 65.9% in CG (P = 0.255). The 5-year overall survival rate ( OSR) and 5-year local control rate (LCR) of T1-T2 patietns were 85.0% and 91.4% in CTG, and 58.5% and 74.4% in CG (P= 0.006, P = 0.031). The 5-year OSR and 5-year LCR of T3-T4 patients were 54.6% and 63.2% in CTG, and 47.4% and 58.1% in CG (P = 0.592, P= 0.721). The incidence of difficulty with opening mouth was 6.85% in CTG and 18.8% in CG (P= 0.025). Patients in CG had serious treatment related complications, including postradiation nasopharyngeal necrosis in 4 cases, nasal hemorrhea in 2 cases, brain necrosis in 2 cases, nasal hemorrhea in 2 cases, and brain necrosis in 2 recurrent cases. Two cases suffered from nasal hemorrhea and another 2 cases had brain necrosis because of undergonging the second radiotherapy after nasal and skull base recurrence. No serous complications were observed in CTG. Conclusion: EBR plus IBT, through a new type of applicator, can improve the 5-year OSR and LCR in NPC patients with stage T1-T2 disease, with a significant difference. IBT can lower the dose of EBR, reduce the radiation complications and improve patients' quality of life. NPC patients of stage T3-T4 with invasion in the bones of the skull base and former-group cranial nerves can be treated wtih IBT to increase local radiational dose and in order to decrease radiation complications.
|Original language||English (US)|
|Number of pages||4|
|Journal||Chinese Journal of Clinical Oncology|
|State||Published - Apr 30 2011|
ASJC Scopus subject areas
- Cancer Research