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A Feasibility Study Using Three-dimensional Conformal Boost Technique in Locally Advanced Carcinoma of the Nasopharynx

 Gwi Eon Kim  ;  Jihoon Lim  ;  Hee Chul Park  ;  Ki Chang Keum  ;  Yong Bae Kim  ;  Sun Rock Moon  ;  Chang Geol Lee  ;  Jinsil Seong  ;  Chang Ok Suh 
 ACTA ONCOLOGICA, Vol.40(5) : 582-587, 2001 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma/mortality ; Carcinoma/pathology ; Carcinoma/radiotherapy* ; Cavernous Sinus/pathology ; Cranial Nerve Diseases/etiology ; Disease-Free Survival ; Feasibility Studies ; Female ; Follow-Up Studies ; Hematologic Diseases/etiology ; Humans ; Life Tables ; Male ; Middle Aged ; Nasopharyngeal Neoplasms/mortality ; Nasopharyngeal Neoplasms/pathology ; Nasopharyngeal Neoplasms/radiotherapy* ; Neoplasm Invasiveness ; Neoplasm Staging ; Prospective Studies ; Radiation Injuries/etiology ; Radiodermatitis/etiology ; Radiotherapy Dosage ; Radiotherapy, Conformal/adverse effects ; Radiotherapy, Conformal/methods* ; Skull Base/pathology ; Stomatitis/etiology ; Survival Analysis ; Treatment Outcome ; Xerostomia/etiology
To investigate the feasibility and efficacy of dose escalation using three-dimensional (3-D) conformal boost technique, 21 patients with stage III or IV nasopharyngeal cancer were enrolled in a prospective protocol. All patients with node metastases initially received external radiotherapy by conventional technique up to 70.2 Gy, followed by 3-D conformal radiotherapy (3-D CRT) to the boost part up to 79.2 Gy with 9 Gy increments (daily fraction of 1.8 Gy for 5 days). A modified technique with the same dose escalation of 9 Gy using 3-D CRT was applied to 7 patients without node metastases, who were treated by conventional technique up to 54 Gy, followed by 3-D CRT to boost up to a basic dose of 70.2 Gy, and then finally with dose escalation of 9 Gy. The protocol was relatively well tolerated by the majority of patients. Acute complications during the dose escalation schedule was low, with rare occurrences of grade 3 or 4 toxicity. Although late radiation-induced complications also appeared limited, 1 patient developed a temporal lobe necrosis and 2 patients suffered from sensory-neural hearing loss. There were no radiation-induced fatal complications. At a median follow-up of 48 months, only 3 patients experienced local failure and 2 patients developed distant metastases. The 5-year overall actuarial survival rate and recurrencefree survival rate for all patients were 68% and 85%, respectively. On the basis of acceptable morbidity and encouraging treatment results, we conclude that the dose escalation in 9 Gy increments using a 3-D conformal boost technique is relatively safe and efficacious, enough to be used routinely for locally advanced nasopharyngeal cancers.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gwi Eon(김귀언)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
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