Reirradiation of Locally Recurrent Nasopharynx Cancer With External Beam Radiotherapy With or Without Brachytherapy

Koutcher, Lawrence; Lee, Nancy; Zeléfsky, Michael J.; Chan, Kelvin K.; Cohen, Gilad; Pfister, David G.; Kraus, Dennis H.; Wolden, Suzanne L.

doi:10.1016/j.ijrobp.2009.01.055

Cited by 70 publications

(49 citation statements)

References 33 publications

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“…In the reported reirradiation studies except those with BT alone, the majority of the recurrences are at advanced stage with a ratio of 15-73.3% and 8-53% for rT3-4 tumor and rStage-4 diseases, respectively (Lee et al, 1997;Xiao et al, 2001;Lu et al, 2004;Chua et al, 2005;Wu et al, 2007;Seo et al, 2009;Koutcher et al, 2010;Ozyigit et al, 2011). In our series the 41.7% of the cases were with rT3-4 and 29.2% were with rStage-4 disease.…”

Section: Discussionmentioning

confidence: 46%

See 1 more Smart Citation

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Dizman¹,

Coskun-Breuneval²,

Altinisik-Inan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 46%

“…However, dose escalation has been found relevant with improved survival in previous studies (Wang, 1987). The use of IMRT has shown encouraging results with a survival rate of 60-62% at 5 years (Low et al, 2006;Seo et al, 2009;Koutcher et al, 2010;Chee Ee Phua et al, 2013;Phua Chee Ee et al, 2013;Xiang et al, 2013;).…”

Section: Discussionmentioning

confidence: 98%

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Dizman¹,

Coskun-Breuneval²,

Altinisik-Inan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…The 5-year LC and OS were 52% and 60%, respectively. Although there were no differences in outcome between groups treated with CMT versus EBRT, grade 3 complications were significantly lower in the CMT group (Koutcher et al, 2010).…”

Section: Treatment Outcome With Brachytherapy For Recurrent Nasopharymentioning

confidence: 64%

“…In addition, combination therapy was associated with significantly less complications even in the era of IMRT (Koutcher et al, 2010;Leung et al, 2000). A combination of EBRT dose of 40Gy and normalised total dose of 10-20Gy with brachytherapy may achieve an adequate tumouricidal dose with acceptable risk of complications.…”

Section: Resultsmentioning

confidence: 99%

Treatment Outcome with Brachytherapy for Recurrent Nasopharyngeal Carcinoma

Cheah¹,

Lau²,

Yusof³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: To evaluate the treatment outcome and major late complications of all patients with recurrent nasopharyngeal carcinoma (NPC) treated with intracavitary brachytherapy (ICBT) in Hospital Kuala Lumpur. Materials and Methods: This retrospective study was conducted at the Department of Radiotherapy and Oncology, Hospital Kuala Lumpur, Malaysia. All patients with histologically confirmed recurrent NPC in the absence of distant metastasis treated in the period 1997-2010 were included in this study. These patients were treated with ICBT alone or in combination with external beam radiotherapy (EBRT). Treatment outcomes measured were local recurrence free survival (LRFS), disease free survival (DFS) and overall survival (OS). Results: Thirty three patients were eligible for this study. The median age at recurrence was 56 years with a median time to initial local recurrence of 27 months. Majority of patients were staged as rT1-2 (94%) or rN0 (82%). The proportion of patients categorised as stage III-IV at first local recurrence was only 9%. Twenty one patients received a combination of ICBT and external beam radiotherapy while 12 patients were treated with ICBT alone. Median interval of recurrence post re-irradiation was 32 months (range: 4-110 months). The median LRFS, DFS and OS were 30 months, 29 months and 36 months respectively. The 5 year LRFS, DFS and OS were 44.7%, 38.8% and 28.1% respectively. The N stage at recurrence was found to be a significant prognostic factor for LRFS and DFS after multivariate analysis. Major late complications occurred in 34.9% of our patients. Conclusions: Our study shows ICBT was associated with a reasonable long term outcome in salvaging recurrent NPC although major complications remained a significant problem. The N stage at recurrence was a significant prognostic factor for both LRFS and DFS.

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“…No randomized trials have been performed to evaluate the therapeutic ratio of different treatment methods. Brachytherapy provides advantages to treat the small tumor with very high doses and protects surrounding healthy tissues [12]. Through these cases we studied the contribution of brachytherapy in reirradiation for local recurrence of NPC (Figure 1).…”

Section: Case Reportmentioning

confidence: 99%

Brachytherapy in Reirradiation of Locally Recurrent Nasopharyngeal Cancer: Case Report

Toulba¹,

Bakkali²,

Diabate³

et al. 2017

IJRRT

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Purpose: Nasopharyngeal carcinoma (NPC) is a most cancer of head and neck in North Africa and South East Asia. The risk of local recurrence after treatment is higher. Reirradiation can be difficult and limited by the constraints of doses to organs at risk already irradiated. The aim of this study was to determine the role of brachytherapy in safety reirradiation of recurrent NPC. Methods and Materials:From 2002 to 2011, five patients were reirradiated for local recurrence nasopharyx cancer with or without external beam radiotherapy (EBRT). Results:The median age was 49 years, all were male, four patients had World Health Organization Class III histology, and one with nasopharyx cancer type I. Two, 1 and 2 patients had recurrent Stage I, II, III, respectively. Median time to reirradiation was 49 months. Four patients received combined-modality treatment, consisting of external beam radiotherapy (EBRT) with chemotherapy followed by intracavitary brachytherapy High Dose Rate (HDR) boost, one patient received intracavitary brachytherapy alone for dosimetric constraints for organs at risk. The total radiation dose EQD2 was between 60 and 70Gy. All patients received concomitant chemotherapy and two neoadjuvant chemotherapy. The median follow-up for all patients was 40 months; one patient developed an immobility of the soft palate and another had grade II trismus. Conclusion:Brachytherapy alone or after EBRT may play an important role in reirradiation of locally recurrent NPC with acceptable toxicity.

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Reirradiation of Locally Recurrent Nasopharynx Cancer With External Beam Radiotherapy With or Without Brachytherapy

Cited by 70 publications

References 33 publications

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Treatment Outcome with Brachytherapy for Recurrent Nasopharyngeal Carcinoma

Brachytherapy in Reirradiation of Locally Recurrent Nasopharyngeal Cancer: Case Report

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