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SMART (simultaneous modulated accelerated radiotherapy) for locally advanced nasopharyngeal carcinomas

Authors
 Woong Sub Koom  ;  Tae Hyun Kim  ;  Kyung Hwan Shin  ;  Hong Ryull Pyo  ;  Joo-Young Kim  ;  Dae Yong Kim  ;  Myonggeun Yoon  ;  Sung Yong Park  ;  Dae Ho Lee  ;  Jun Sun Ryu  ;  Yoo Seok Jung  ;  Sang Hyun Lee  ;  Kwan Ho Cho 
Citation
 HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, Vol.30(2) : 159-169, 2008 
Journal Title
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
ISSN
 1043-3074 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Dose Fractionation, Radiation ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms/drug therapy* ; Nasopharyngeal Neoplasms/mortality ; Nasopharyngeal Neoplasms/radiotherapy* ; Radiotherapy, Intensity-Modulated/methods* ; Retrospective Studies ; Xerostomia/epidemiology
Keywords
Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Dose Fractionation, Radiation ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms/drug therapy* ; Nasopharyngeal Neoplasms/mortality ; Nasopharyngeal Neoplasms/radiotherapy* ; Radiotherapy, Intensity-Modulated/methods* ; Retrospective Studies ; Xerostomia/epidemiology
Abstract
BACKGROUND: Concurrent chemoradiotherapy is commonly used for locally advanced nasopharyngeal carcinoma (NPC). We retrospectively analyzed the clinical outcomes of simultaneous modulated accelerated radiotherapy (SMART) with concurrent chemotherapy. METHODS: Between January 2003 and May 2005, 24 patients with stage IIB to IVB NPC underwent SMART encompassing 3 targets: gross tumor volume (GTV), high-risk subclinical disease (CTV1), and low-risk subclinical disease (CTV2). Daily fractions of 2.4, 2.15, and 1.9 Gy were delivered to GTV, CTV1, and CTV2 to a total dose of 64.8, 58.05, and 51.3 Gy in 27 fractions over 5.5 weeks, respectively. Fifteen patients received concurrent cisplatin (DDP group), and 9 received 5-fluorouracil plus cisplatin (FP group). RESULTS: With a median follow-up of 26 months (range, 17-45 months), 3-year overall and local-, regional-, and distant-progression-free survivals were 96% and 93%, 87%, and 88%, respectively. Grade 3 acute mucositis and pharyngitis were observed in 16 (67%) and 14 (59%) patients, respectively. Severe acute mucositis (100% vs 47%) and pharyngitis (100% vs 34%) were more frequently observed in the FP group than the DDP group (p < .01). CONCLUSIONS: Despite short follow-up with a small number of patients, our preliminary results demonstrated encouraging local-regional control and survival at the cost of modest increase in treatment related toxicities. The total dose and fractionation scheme of SMART used in our study is feasible with no life-threatening or fatal complications. However, the administration of fluorouracil in addition to cisplatin during SMART was associated with increased acute and late toxicities, and it should be administered with caution
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/hed.20667/abstract
DOI
10.1002/hed.20667
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108649
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