Initial Experience for 3-D Conformal Boost Treatments in Carcinoma of the Nasopharynx

비인강암환자에서 시행한 3차원 입체조형 방사선치료의 조기 임상결과

  • Jang Ji-Young (Departments of Therapeutic Radiology, Chungnam National University) ;
  • Cho Moon-June (Departments of Therapeutic Radiology, Chungnam National University) ;
  • Kim Ki-Hwan (Departments of Therapeutic Radiology, Chungnam National University) ;
  • Song Chang-Joon (Departments of Diagnostic Radiology, Chungnam National University) ;
  • Kim Byoung-Kook (Departments of Otolaryngology, College of Medicine, Chungnam National University) ;
  • Kim Jun-Sang (Departments of Therapeutic Radiology, Chungnam National University) ;
  • Kim Jae-Sung (Departments of Therapeutic Radiology, Chungnam National University)
  • 장지영 (충남대학교병원 치료방사선과) ;
  • 조문준 (충남대학교병원 치료방사선과) ;
  • 김기환 (충남대학교병원 치료방사선과) ;
  • 송창준 (충남대학교병원 진단방사선과) ;
  • 김병국 (충남대학교병원 이비인후과) ;
  • 김준상 (충남대학교병원 치료방사선과) ;
  • 김재성 (충남대학교병원 치료방사선과)
  • Published : 2000.11.01

Abstract

Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.