Short-term efficacy comparison between helical tomotherapy and intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma

Abstract

Background: To evaluate short-term safety and efficacy of helical tomotherapy (HT) versus intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).Methods: Retrospective analysis of locally advanced nasopharyngeal carcinoma treated with radiotherapy and concurrent platinum based neoadjuvant chemotherapy (cisplatin 80 mg/m2 every 3 weeks for 1 cycle) in our hospital from February 2017 to October 2019, including 70 patients in HT group and 70 in IMRT group. The target area of ​​the tumor was delineated by magnetic resonance (MRI) imaging. The prescription doses delivered to the gross tumor volume (pGTVnx) and positive lymph nodes (pGTVnd), the high risk planning target volume (PTV1), and the low risk planning target volume (PTV2), were 69.96 Gy, 66-70 Gy, 60 Gy and 50-54 Gy, in 33 fractions, respectively. Acute reactions were evaluated according to the RTOG/EORTC criteria, whereas the therapeutic efficacy was assessed according to RECTST version 1.1 criteria in a 3-months period.Results: The CI of PGTVnx, PGTVnd, PTV1 and PTV2, and HI of PGTVnx, PTV1 and PTV2 in HT group was significantly better than those in IMRT group. The OAR Dmax and Dmean in HT group were better than those in IMRT group with a significant difference (all p <0.05). Patients in the HT group were significantly better than those in the IMRT group in the protection of acute parotid gland injury and hearing damage (p <0.05), but not other acute adverse reaction. No significant difference was found on the short-term efficacy illustrated by ORR between HT group and IMRT group (x2 = 0.119; p = 0.730).Conclusions: Compared with IMRT, HT has better radiophysical-related dosimetric advantages in radiotherapy for locally advanced nasopharyngeal carcinoma. Despite similar on short-term effects, HT has lower incidence of adverse reactions than IMRT.