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Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma.
Oral Oncol 2008; 44(7):703-9OO

Abstract

Stage II nasopharyngeal carcinoma (NPC) treated with conventionally fractionated radiotherapy results in suboptimal outcome. This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost (C-Boost) schedule. Forty-seven 1997 AJCC Stage II NPC patients were enrolled and analyzed in this prospective phase II clinical trial. The primary tumor and clinically involved nodes received a total dose of 72Gy in 42 fractions. C-Boost for gross disease consisted of 18Gy in 12 fractions commencing on day 19, and delivered at least 6h after the first dose. Patients were assessed for response, survival and toxicity. With a median follow-up of 30 months, 4 patients developed local recurrence only, 2 had persistent neck nodal disease or recurrence, and 1 with both locoregional recurrences. Distant metastases were seen in 5 patients, with or without locoregional recurrence. A total of 5 patients succumbed from nasopharyngeal cancer: four from effects of distant metastases and 1 from progressive local disease. The 3-year local, regional, and overall survival rates were 87.1%, 92%, and 85.9%, respectively. All patients experienced some degree of acute and/or late toxicity. Moderate to severe late toxicities (grade 3 and 4) were observed in 17% of cases. This C-Boost radiotherapy regimen administers a higher biologically effective dose compared with conventional radiation schedules. The local control after C-Boost radiation seems high for patients with stage II nasopharyngeal carcinoma, thus justifies further investigation to confirm its efficacy.

Authors+Show Affiliations

Department of Radiation Oncology, National University Hospital, Singapore.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase II
Journal Article

Language

eng

PubMed ID

18061528

Citation

Lu, Jiade Jay, et al. "Prospective Phase II Trial of Concomitant Boost Radiotherapy for Stage II Nasopharyngeal Carcinoma." Oral Oncology, vol. 44, no. 7, 2008, pp. 703-9.
Lu JJ, Kong L, Shakespeare TP, et al. Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma. Oral Oncol. 2008;44(7):703-9.
Lu, J. J., Kong, L., Shakespeare, T. P., Loh, K. S., Zhang, Q., Tan, K. S., & Lee, K. M. (2008). Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma. Oral Oncology, 44(7), pp. 703-9.
Lu JJ, et al. Prospective Phase II Trial of Concomitant Boost Radiotherapy for Stage II Nasopharyngeal Carcinoma. Oral Oncol. 2008;44(7):703-9. PubMed PMID: 18061528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma. AU - Lu,Jiade Jay, AU - Kong,Lin, AU - Shakespeare,Thomas P, AU - Loh,Kwok Seng, AU - Zhang,Qing, AU - Tan,Kim Siang Luke, AU - Lee,Khai Mun, Y1 - 2007/12/03/ PY - 2007/06/13/received PY - 2007/09/12/revised PY - 2007/09/12/accepted PY - 2007/12/7/pubmed PY - 2009/1/30/medline PY - 2007/12/7/entrez SP - 703 EP - 9 JF - Oral oncology JO - Oral Oncol. VL - 44 IS - 7 N2 - Stage II nasopharyngeal carcinoma (NPC) treated with conventionally fractionated radiotherapy results in suboptimal outcome. This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost (C-Boost) schedule. Forty-seven 1997 AJCC Stage II NPC patients were enrolled and analyzed in this prospective phase II clinical trial. The primary tumor and clinically involved nodes received a total dose of 72Gy in 42 fractions. C-Boost for gross disease consisted of 18Gy in 12 fractions commencing on day 19, and delivered at least 6h after the first dose. Patients were assessed for response, survival and toxicity. With a median follow-up of 30 months, 4 patients developed local recurrence only, 2 had persistent neck nodal disease or recurrence, and 1 with both locoregional recurrences. Distant metastases were seen in 5 patients, with or without locoregional recurrence. A total of 5 patients succumbed from nasopharyngeal cancer: four from effects of distant metastases and 1 from progressive local disease. The 3-year local, regional, and overall survival rates were 87.1%, 92%, and 85.9%, respectively. All patients experienced some degree of acute and/or late toxicity. Moderate to severe late toxicities (grade 3 and 4) were observed in 17% of cases. This C-Boost radiotherapy regimen administers a higher biologically effective dose compared with conventional radiation schedules. The local control after C-Boost radiation seems high for patients with stage II nasopharyngeal carcinoma, thus justifies further investigation to confirm its efficacy. SN - 1368-8375 UR - https://www.unboundmedicine.com/medline/citation/18061528/Prospective_phase_II_trial_of_concomitant_boost_radiotherapy_for_stage_II_nasopharyngeal_carcinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1368-8375(07)00249-7 DB - PRIME DP - Unbound Medicine ER -