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

Abstract

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.

Treatment Outcome for Nasopharyngeal Carcinoma in University Malaya Medical Centre from 2004-2008

“…The usage of IMRT for NPC in this country remains sparse. The only published data available regarding its use comes from a study based in Penang General Hospital on NPC patients who underwent radical IMRT treatment from June 2011 to February 2012 (Phua et al, 2012). Another cause for concern is the effect of prolonged OTT.…”

Relationship between Age and Gender with Histopathological Type of Nasopharyngeal Carcinoma

“…9 Tipe Squamous cell carcinoma dan differentiated non-keratinizing cell carcinoma memiliki risiko yang lebih tinggi untuk mengalami prognosis yang lebih buruk dibandingkan dengan tipe undifferentiated non-keratinizing cell carcinoma yang kejadiannya lebih umum. 30 Berdasarkan penelitian sebelumnya, beberapa faktor risiko karsinoma nasofaring seperti usia, jenis kelamin, dan tipe histopatologi memiliki alasan yang sama mengapa ketiganya dapat memengaruhi insidensi karsinoma nasofaring, khususnya akibat paparan lingkungan, seperti merokok, konsumsi alkohol, dan riwayat pekerjaan. 14,[31][32] Hal ini memungkinkan adanya hubungan antara usia dan jenis kelamin dengan tipe histopatologi karsinoma nasofaring.…”