Aichi cancer center initial experience of intensity modulated radiation therapy for nasopharyngeal cancer using helical tomotherapy

Int J Radiat Oncol Biol Phys. 2009 Mar 15;73(4):1129-34. doi: 10.1016/j.ijrobp.2008.06.1936. Epub 2008 Oct 14.

Abstract

Purpose: To assess the feasibility of helical tomotherapy (HT) for patients with nasopharyngeal carcinoma.

Methods and materials: From June 2006 to June 2007, 20 patients with nasopharyngeal carcinoma were treated with HT with (n = 18) or without (n = 2) systemic chemotherapy. The primary tumor and involved lymph node (PTV1) were prescribed 70 Gy and the prophylactic region 54 Gy at D95, respectively. The majority of patients received 2 Gy per fraction for PTV1 in 35 fractions. Parotid function was evaluated using quantitative scintigraphy at pretreatment, and posttreatment at 3 months and 1 year later.

Results: The median patient age was 53 years, ranging from 15 to 83. Our cohort included 5, 8, 4, 2, and 1 patients with disease Stages IIB, III, IVA, IVB, and IVC, respectively. Histopathological record revealed two for World Health Organization Type I and 18 for Type 2 or 3. The median duration time for treatment preparation was 9.5 days, and all plans were thought to be acceptable regarding dose constraints of both the planning target volume and organ at risk. All patients completed their treatment procedure of intensity-modulated radiation therapy (IMRT). All patients achieved clinical remission after IMRT. The majority of patients had Grade 3 or higher toxicity of skin, mucosa, and neutropenia. At the median follow-up of 10.9 months, two patients recurred, and one patient died from cardiac disease. Parotid gland function at 1 year after completion of IMRT was significantly improved compared with that at 3 months.

Conclusion: HT was clinically effective in terms of IMRT planning and utility for patients with nasopharyngeal cancer.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Cancer Care Facilities
  • Feasibility Studies
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / drug therapy
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Parotid Gland / physiopathology
  • Parotid Gland / radiation effects
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / instrumentation
  • Radiotherapy, Intensity-Modulated / methods*
  • Remission Induction
  • Tomography, Spiral Computed / instrumentation
  • Tomography, Spiral Computed / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents