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<p>With conformal radiotherapy techniques, acute and late toxicities can be reduced because of significantly better dose conformity and reduced doses to normal tissue. With Intensity Modulated Radiation Therapy (IMRT) further dose escalation is possible. To evaluate clinical outcomes and patterns of failure after IMRT-SIB (Simultaneous integrated boost)/(Volumetric modulated arc therapy) VMAT technique in nasopharyngeal cancer patients. It is a retrospective analysis of 60 nasopharyngeal squamous cell carcinoma patients, treated with IMRT/VMAT radiotherapy and chemotherapy to primary and bilateral cervical nodes from March 2017 to December 2021. 60 patients received definitive treatment using IMRT-SIB. Patients were monitored during and after treatment for local and regional failure, distant metastasis, locoregional progression free and overall survival. Patient characteristics: median age 45; 75% male; 6.7% Stage I, 18.3% Stage II, 43.3% Stage III, 31.7% Stage IVA. The median follow up was 24.5&#xa0;months (range 5.5–75.6). The 2-year local control, regional control, distant metastasis free, locoregional progression free and overall survival rates are 81.5, 82.9, 86.9, 77.7, 92.9%, respectively. 11 patients failed at the local site and 10 patients failed at regional sites, median time to failure was 12.2&#xa0;months. The 5-year estimated regional control rate for N0 vs N + disease was 100% vs 74.2%(<i>p</i>-0.07). IMRT-SIB is a safe and acceptable treatment option for patients with carcinoma nasopharynx. The pattern of local failure within the target volume suggests locally advanced T stage disease may require a higher biologic dose to gross tumor.</p>

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Clinical Outcomes and Patterns of Failure After Intensity-Modulated Radiotherapy with Simultaneous Integrated Boost for Nasopharyngeal Carcinoma: A Single Institutional Review

  • 期刊论文

  • 发表日期：

    2025年5月24日

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  • Isha B. Shah,
  • Vinay Shivhare,
  • Satyajeet Rath,
  • Niranjan K. Dash,
  • Ankita Parikh,
  • U. Suryanarayan Kunikullaya,
  • T. Arun,
  • Akash Pandya

摘要

With conformal radiotherapy techniques, acute and late toxicities can be reduced because of significantly better dose conformity and reduced doses to normal tissue. With Intensity Modulated Radiation Therapy (IMRT) further dose escalation is possible. To evaluate clinical outcomes and patterns of failure after IMRT-SIB (Simultaneous integrated boost)/(Volumetric modulated arc therapy) VMAT technique in nasopharyngeal cancer patients. It is a retrospective analysis of 60 nasopharyngeal squamous cell carcinoma patients, treated with IMRT/VMAT radiotherapy and chemotherapy to primary and bilateral cervical nodes from March 2017 to December 2021. 60 patients received definitive treatment using IMRT-SIB. Patients were monitored during and after treatment for local and regional failure, distant metastasis, locoregional progression free and overall survival. Patient characteristics: median age 45; 75% male; 6.7% Stage I, 18.3% Stage II, 43.3% Stage III, 31.7% Stage IVA. The median follow up was 24.5 months (range 5.5–75.6). The 2-year local control, regional control, distant metastasis free, locoregional progression free and overall survival rates are 81.5, 82.9, 86.9, 77.7, 92.9%, respectively. 11 patients failed at the local site and 10 patients failed at regional sites, median time to failure was 12.2 months. The 5-year estimated regional control rate for N0 vs N + disease was 100% vs 74.2%(p-0.07). IMRT-SIB is a safe and acceptable treatment option for patients with carcinoma nasopharynx. The pattern of local failure within the target volume suggests locally advanced T stage disease may require a higher biologic dose to gross tumor.