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Intensity-modulated radiation therapy with simultaneous integrated boost technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma.
Head Neck 2009; 31(9):1121-8HN

Abstract

BACKGROUND

Our aim was to evaluate the feasibility and efficacy of intensity-modulated radiation therapy (IMRT) with simultaneous integrated boost (SIB) technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal cancer (NPC).

METHODS

Between April 2004 and December 2006, 25 patients with stage IIB to IVB NPC underwent 3 cycles of neoadjuvant chemotherapy followed by IMRT using SIB technique. Neoadjuvant chemotherapeutic regimens were 5-fluorouracil and cisplatin in 11 patients; docetaxel, 5-fluorouracil, and cisplatin in 8; and paclitaxel and cisplatin in 6. Dose prescription of IMRT was as follows: 67.5 Gy at 2.25 Gy/fraction to postchemotherapy gross tumor, 54 to 60 Gy at 1.8 to 2 Gy/fraction to subclinical disease, and 48 Gy at 1.6 Gy/fraction to elective neck. Seventeen patients received weekly cisplatin during the course of radiation therapy as well.

RESULTS

With a median follow-up of 29 months for survivors (range, 14-39), the 3-year local progression-free, regional progression-free, and distant metastasis-free survival rates were 89.6%, 87.2%, and 80.4%, respectively. Treatment was well tolerated despite the grade 3 mucositis (16%) and/or pharyngitis (16%). With follow-up, the frequency of xerostomia decreased. At 3 months after IMRT, the proportions of Radiation Therapy Oncology Group grades 0, 1, and 2 xerostomia were 13%, 38%, and 50%, respectively. At 24 months, the corresponding figures were 36%, 46%, and 18%, respectively.

CONCLUSION

IMRT with SIB technique for locoregionally advanced NPC was feasible and effective regarding locoregional control and development of xerostomia, even after neoadjuvant chemotherapy. Definition of gross tumor volume by postchemotherapy extent of disease was also feasible.

Authors+Show Affiliations

Department of Radiation Oncology, Seoul National University College of Medicine, 101 Daehangno, Jongno-Gu, Seoul 110-744, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19340863

Citation

Kim, Kyubo, et al. "Intensity-modulated Radiation Therapy With Simultaneous Integrated Boost Technique Following Neoadjuvant Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma." Head & Neck, vol. 31, no. 9, 2009, pp. 1121-8.
Kim K, Wu HG, Kim HJ, et al. Intensity-modulated radiation therapy with simultaneous integrated boost technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma. Head Neck. 2009;31(9):1121-8.
Kim, K., Wu, H. G., Kim, H. J., Sung, M. W., Kim, K. H., Lee, S. H., ... Park, C. I. (2009). Intensity-modulated radiation therapy with simultaneous integrated boost technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma. Head & Neck, 31(9), pp. 1121-8. doi:10.1002/hed.21076.
Kim K, et al. Intensity-modulated Radiation Therapy With Simultaneous Integrated Boost Technique Following Neoadjuvant Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma. Head Neck. 2009;31(9):1121-8. PubMed PMID: 19340863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensity-modulated radiation therapy with simultaneous integrated boost technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma. AU - Kim,Kyubo, AU - Wu,Hong-Gyun, AU - Kim,Hak Jae, AU - Sung,Myung-Whun, AU - Kim,Kwang Hyun, AU - Lee,Se-Hoon, AU - Heo,Dae Seog, AU - Kim,Hee Jung, AU - Park,Charn Il, PY - 2009/4/3/entrez PY - 2009/4/3/pubmed PY - 2009/10/29/medline SP - 1121 EP - 8 JF - Head & neck JO - Head Neck VL - 31 IS - 9 N2 - BACKGROUND: Our aim was to evaluate the feasibility and efficacy of intensity-modulated radiation therapy (IMRT) with simultaneous integrated boost (SIB) technique following neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal cancer (NPC). METHODS: Between April 2004 and December 2006, 25 patients with stage IIB to IVB NPC underwent 3 cycles of neoadjuvant chemotherapy followed by IMRT using SIB technique. Neoadjuvant chemotherapeutic regimens were 5-fluorouracil and cisplatin in 11 patients; docetaxel, 5-fluorouracil, and cisplatin in 8; and paclitaxel and cisplatin in 6. Dose prescription of IMRT was as follows: 67.5 Gy at 2.25 Gy/fraction to postchemotherapy gross tumor, 54 to 60 Gy at 1.8 to 2 Gy/fraction to subclinical disease, and 48 Gy at 1.6 Gy/fraction to elective neck. Seventeen patients received weekly cisplatin during the course of radiation therapy as well. RESULTS: With a median follow-up of 29 months for survivors (range, 14-39), the 3-year local progression-free, regional progression-free, and distant metastasis-free survival rates were 89.6%, 87.2%, and 80.4%, respectively. Treatment was well tolerated despite the grade 3 mucositis (16%) and/or pharyngitis (16%). With follow-up, the frequency of xerostomia decreased. At 3 months after IMRT, the proportions of Radiation Therapy Oncology Group grades 0, 1, and 2 xerostomia were 13%, 38%, and 50%, respectively. At 24 months, the corresponding figures were 36%, 46%, and 18%, respectively. CONCLUSION: IMRT with SIB technique for locoregionally advanced NPC was feasible and effective regarding locoregional control and development of xerostomia, even after neoadjuvant chemotherapy. Definition of gross tumor volume by postchemotherapy extent of disease was also feasible. SN - 1097-0347 UR - https://www.unboundmedicine.com/medline/citation/19340863/Intensity_modulated_radiation_therapy_with_simultaneous_integrated_boost_technique_following_neoadjuvant_chemotherapy_for_locoregionally_advanced_nasopharyngeal_carcinoma_ L2 - https://doi.org/10.1002/hed.21076 DB - PRIME DP - Unbound Medicine ER -