Intensity-modulated radiotherapy prolongs the survival of patients with nasopharyngeal carcinoma compared with conventional two-dimensional radiotherapy: A 10-year experience with a large cohort and long follow-up |
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| Institution: | 1. Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;2. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;3. Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510060, China;1. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA;2. Department of Radiation Oncology, Gustave Roussy, Villejuif, France;1. Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong, China;2. Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China;3. Department of Clinical Oncology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China;4. Center of Clinical Oncology, University of Hong Kong-Shenzhen Hospital, China;1. Harvard Radiation Oncology Program, Brigham and Women''s Hospital, 75 Francis Street, Boston, MA 02115, USA;2. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA;1. Clinical Oncology Center, University of Hong Kong-Shenzhen Hospital, Hong Kong;2. Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong;1. Department of Radiology, Huadong Hospital, Fudan University, Shanghai 200040, China;2. Department of Radiology, Beijing ChaoYang Hospital, Capital University of Medical Sciences, Beijing 100020, China;1. State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, PR China;2. Department of Oncology, Affiliated Hosptial of GuiYang Medical College, GuiZhou Cancer Hospital, Guiyang, PR China |
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| Abstract: | BackgroundTo evaluate the survival benefit of intensity-modulated radiotherapy (IMRT) compared with conventional two-dimensional radiotherapy (2D-CRT) in nasopharyngeal carcinoma (NPC) using a large cohort with long follow-up.MethodsWe retrospectively analysed 7081 non-metastatic NPC patients who received curative IMRT or 2D-CRT from February 2002 to December 2011.ResultsOf the 7081 patients, 2245 (31.7%) were administered IMRT, while 4836 (68.3%) were administered 2D-CRT. At 5 years, the patients administered IMRT had significantly higher local relapse-free survival (LRFS), loco-regional relapse-free survival (LRRFS), progression-free survival (PFS) and overall survival (OS) (95.6%, 92.5%, 82.1% and 87.4%, respectively) than those administered 2D-CRT (90.8%, 88.5%, 76.7% and 84.5%, respectively; p < 0.001). The distant metastasis-free survival (DMFS) was higher for IMRT than 2D-CRT, with borderline significance (87.6% and 85.7%, respectively; p = 0.056). However, no difference was observed between IMRT and 2D-CRT in nodal relapse-free survival (NRFS; 96.3% and 97.4%, respectively; p = 0.217). Multivariate analyses showed that IMRT was an independent protective prognostic factor for LRFS, LRRFS and PFS, but not NRFS, DMFS or OS.ConclusionsIMRT provided an improved LRFS, LRRFS and PFS in both the early and advanced T classifications and overall stage for non-disseminated NPC compared with 2D-CRT. However, no significant advantage was observed in NRFS, DMFS or OS when IMRT was used. |
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| Keywords: | Nasopharyngeal carcinoma Intensity-modulated radiotherapy (IMRT) Conventional two-dimensional radiotherapy (2D-CRT) Survival Retrospective study |
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