Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma

Ng, Wai Tong; Lee, Michael C. H.; Hung, Wai Man; Choi, Cheuk-Wai; Lee, Kin Chung; Chan, Oscar S.H.; Lee, Anne W.M.

doi:10.1016/j.ijrobp.2009.11.024

Cited by 252 publications

(236 citation statements)

References 22 publications

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“…This rate was similar to the rate reported by a Hong Kong study involving 193 NPC patients treated with IMRT where severe acute toxicity occurred in 69.4% of the patients including 3 treatment related deaths (grade 5 toxicity) related to pneumonia and fulminant sepsis (Ng et al, 2011). Another IMRT study in Hong Kong with 50 patients had 78% of their patients having severe acute toxicity with one treatment related death (Kwong et al, DOI:http://dx.doi.org/10.7314/APJCP.2012.13.7.3287 Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience 2006.…”

Section: Discussionsupporting

confidence: 88%

“…Available data from other IMRT studies including those from China reported a rate of between 4.5-5.1% for severe skin reaction (Lin et al, 2009;Han et al, 2010;Lu et al, 2010;Wang et al, 2012). However, data from Hong Kong reported a higher rate ranging from 13-46% (Kwong et al, 2006;Ng et al, 2011). Although the rate of skin reaction was high in our study, however all patients had complete resolution of this reaction 6 weeks post IMRT.…”

Section: Discussioncontrasting

confidence: 70%

“…Grade 3 dysphagia occurred in 53.8% of our study population and all these patients required intensive dietary support and/or nasogastric tube feeding. However, Hu and colleagues (2010) in China reported a rate of only 9.1% while the study in Hong Kong involving 193 patients reported a rate of 15% (Ng et al, 2011). Unfortunately, this complication was not specifically reported in the other studies.…”

Section: Discussionmentioning

confidence: 93%

“…This rate was similar to the studies in Hong Kong on IMRT for NPC. Recent IMRT studies in Hong Kong had rates between 65-78% (Kwong et al, 2006;Ng et al, 2011). However, the studies in China reported lower rates ranging from 3.2-29.5% ( (Lin et al, 2009;Han et al, 2010;Lu et al, 2010;Wang et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…The 3 years OS rate was 83.1% (Wang et al, 2012). Early results from the Pamela Youde Nethersole Eastern Hospital, Hongkong utilizing IMRT reported a 2 years OS of 92.0% in a study with 193 patients of which 93% had stage III or IV disease (Ng et al, 2011). Meanwhile, the University of Hongkong, Queen Mary Hospital published its early result for 50 patients with stage III or IV NPC who were treated with IMRT which showed an encouraging 2 years OS of 92.1% (Kwong et al, 2006).…”

Section: Introductionmentioning

confidence: 97%

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Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience

Phua

Tan²,

Tan³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Purpose: To study the overall treatment time (OTT) and acute toxicity of intensity-modulated radiotherapy (IMRT) treatment for nasopharyngeal carcinoma (NPC). Methods: This retrospective study covered all NPC patients who underwent radical IMRT treatment at the Penang General Hospital from June 2011 to February 2012. Patients of any age and stage of disease with histologically proven diagnosis were included. Information was collected on patient demographics, clinical stage, treatment received, including any neoadjuvant and/or concurrent chemotherapy, acute toxity and completion of IMRT within the OTT. Results: A total of 26 NPC patients were treated with IMRT during the study period; 88.5% had stage III/IV disease. 45.2% received neo-adjuvant chemotherapy while 50.0% were given concurrent chemo-irradiation. All patients completed the treatment and 92.3% within the 7 weeks OTT. Xerostomia was present in all patients with 92.3% having grade 2. Severe grade III/IV acute toxicity occurred in 73.1% of patients, the commonest of which was oral mucositis (57.6%). This was followed by dysphagia which occurred in 53.8%, skin reactions in 42.3% and weight loss in 19.2%. However, haematological toxicity was mild with only one patient having leucopaenia. Conclusion: IMRT treatment for NPC is feasible in our center. More importantly, it can be delivered within the 7 weeks OTT in the majority of patients. Severe grade 3/4 toxicity is very common (73.1%) and thus maximal nutritional and analgesic support is required throughout the treatment.

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Section: Discussionsupporting

confidence: 88%