Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지

'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) Intensity-Modulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma : the Asan Medical Center

비인강암의 세기조절방사선치료기술을 이용한 동시차등조사가속치료의 예비성적

  • Lee Sang-Wook (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Back Geum-Mun (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Yi Byong-Yong (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Choi Eun-Kyung (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim Jong-Hoon (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Ahn Seung-Do (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Shin Seong-Soo (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim Sang-Yoon (Departments of Otorhinolaryngology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Nam Soon-Yuhl (Departments of Otorhinolaryngology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Choi Seung-Ho (Departments of Otorhinolaryngology, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim Sung-Bae (Departments of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Song Si-Yeol (Departments of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan)
  • 이상욱 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 백금문 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 이병용 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 최은경 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 김종훈 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 안승도 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 신성수 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 김상윤 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 남순열 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 최승호 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 김성배 (울산대학교 의과대학 서울아산병원 내과) ;
  • 송시열 (울산대학교 의과대학 서울아산병원 방사선종양학과)
  • Published : 2003.05.01
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Abstract

Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

Keywords

References

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