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Simultaneous Integrated Boost Intensity‑Modulated Radiotherapy (SIB‑IMRT) in Nasopharyngeal Cancer = Intensitätsmodulierte Radiotherapie mit simultan integriertem Boost (SIB‑IMRT) beim Nasopharynxkarzinom

Peponi, Evangelia ; Glanzmann, Christoph ; Kunz, Guntram ; Renner, Christoph ; Tomuschat, Katja ; Studer, Gabriela

In: Strahlentherapie und Onkologie, 2010, vol. 186, no. 3, p. 135-142

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    Titre
    • Simultaneous Integrated Boost Intensity‑Modulated Radiotherapy (SIB‑IMRT) in Nasopharyngeal Cancer
    Titre traduit ()
    • Intensitätsmodulierte Radiotherapie mit simultan integriertem Boost (SIB‑IMRT) beim Nasopharynxkarzinom
    Auteur
    • Peponi, Evangelia. Department of Radiation Oncology, University Hospital, Zurich, Switzerland
    • Glanzmann, Christoph. Department of Radiation Oncology, University Hospital, Zurich, Switzerland
    • Kunz, Guntram. Department of Radiation Oncology, University Hospital, Zurich, Switzerland
    • Renner, Christoph. Department of Radiation Oncology, University Hospital, Zurich, Switzerland
    • Tomuschat, Katja. Department of Radiation Oncology, University Hospital, Zurich, Switzerland
    • Studer, Gabriela. Department of Radiation Oncology, University Hospital, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Strahlentherapie und Onkologie, 2010, vol. 186, no. 3, p. 135-142. Urban and Vogel
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:313539
    Summary
    Abstract : Purpose: : To assess the efficacy and safety of using simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) to treat nasopharyngeal cancer (NPC) in a Caucasian cohort. Outcome was analyzed with respect to dose-volume histogram (DVH) values. Patients and Methods: : Between 03/2002 and 01/2008, 39 NPC patients underwent SIB-IMRT (37 Caucasians; 31 males; mean age 53 years [16-78 years]). 41% presented with WHO (World Health Organization) type 1 unfavorable histology, 85% with stage III/IV disease. 19 patients had total gross tumor volume (GTV) 16-70 cm3 (mean 36 cm3), while 16 had GTV > 70 cm3 (73-217 cm3; mean 115 cm3). All patients with stage II-IV disease received concomitant cisplatin. The prescribed SIB dose delivered to the planning target volume (PTV) was 70 Gy (2.00 Gy/fraction) in 17, 69.6 Gy (2.11 Gy/fraction) in 19, and 66 Gy (2.20 Gy/fraction) in three patients. Results: : 3-year local relapse-free, nodal relapse-free, distant metastases-free, disease-free rates and overall survival were 86%, 89%, 85%, 72%, and 85% (median follow-up 30 months [8-71 months]). Histology was a significant prognostic factor concerning overall survival, with worst prognosis in WHO type 1 compared to type 2/3 (75% vs. 93%; p = 0.03). There was a trend in favor of WHO type 2/3 regarding local control (74% vs. 94%; p = 0.052). The PTV DVHs showed a slight left shift compared to reported series. Three patients developed grade 3 late effects (xerostomia [n = 2], dysphagia [n = 1], hearing loss [n = 1]). Conclusion: : In comparison with predominantly Asian NPC IMRT series in the literature, chemo-IMRT in the own Caucasian cohort, characterized by less radioresponsive WHO type 1, was equally effective. Treatment tolerance was excellent