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Advances and Challenges in Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma

  • Qu, Song (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region) ;
  • Liang, Zhong-Guo (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region) ;
  • Zhu, Xiao-Dong (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region)
  • Published : 2015.03.18

Abstract

Nasopharyngeal carcinoma is an endemic disease within specific regions in the world. Radiotherapy is the main treatment. In recent decades, intensity-modulated radiation therapy has undergone a rapid evolution. Compared with two-dimensional radiotherapy and/or three-dimensional conformal radiotherapy, evidence has shown it may improve quality of life and prognosis for patients with nasopharyngeal carcinoma. In addition, helical tomotherapy is an emerging technology of intensity-modulated radiation therapy. Its superiority in dosimetric and clinical outcomes has been demonstrated when compared to traditional intensity-modulated radiation therapy. However, many challenges need to be overcome for intensity-modulated radiation therapy of nasopharyngeal carcinoma in the future. Issues such as the status of concurrent chemotherapy, updating of target delineation, the role of replanning during IMRT, the causes of the main local failure pattern require settlement. The present study reviews traditional intensity-modulated radiation therapy, helical tomotherapy, and new challenges in the management of nasopharyngeal carcinoma.

Keywords

References

  1. Chau RM, Teo PM, Kam MK, et al (2007). Dosimetric comparison between 2-dimensional radiation therapy and intensity modulated radiation therapy in treatment of advanced T-stage nasopharyngeal carcinoma: to treat less or more in the planning organ-at-risk volume of the brainstem and spinal cord. Med Dosim, 32, 263-70. https://doi.org/10.1016/j.meddos.2007.02.006
  2. Chen AM, Yang CC, Marsano J, Liu T,Purdy JA (2012). Intensity-modulated radiotherapy for nasopharyngeal carcinoma: improvement of the therapeutic ratio with helical tomotherapy vs segmental multileaf collimator-based techniques. Br J Radiol, 85, 537-43. https://doi.org/10.1259/bjr/23807619
  3. Chen C, Lin X, Pan J, et al (2013). Is it necessary to repeat CT imaging and replanning during the course of intensitymodulated radiation therapy for locoregionally advanced nasopharyngeal carcinoma? Jpn J Radiol, 31, 593-9. https://doi.org/10.1007/s11604-013-0225-5
  4. Du L, Zhang XX, Ma L, et al (2014). Clinical study of nasopharyngeal carcinoma treated by helical tomotherapy in china: 5-year outcomes. Biomed Res Int, 2014, 980767.
  5. Fang FM, Chien CY, Tsai WL, et al (2008). Quality of life and survival outcome for patients with nasopharyngeal carcinoma receiving three-dimensional conformal radiotherapy vs intensity-modulated radiotherapy-a longitudinal study. Int J Radiat Oncol Biol Phys, 72, 356-64. https://doi.org/10.1016/j.ijrobp.2007.12.054
  6. Hong B, Lui VW, Hashiguchi M, Hui EP,Chan AT (2013). Targeting tumor hypoxia in nasopharyngeal carcinoma. Head Neck, 35, 133-45. https://doi.org/10.1002/hed.21877
  7. Hsiung CY, Ting HM, Huang HY, et al (2006). Parotidsparing intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma: Preserved parotid function after IMRT on quantitative salivary scintigraphy, and comparison with historical data after conventional radiotherapy. Int J Radiat Oncol Biol Phys, 66, 454-61. https://doi.org/10.1016/j.ijrobp.2006.04.033
  8. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  9. Kong F, Ying H, Du C, et al (2014). Patterns of local-regional failure after primary intensity modulated radiotherapy for nasopharyngeal carcinoma. Radiat Oncol, 9, 60. https://doi.org/10.1186/1748-717X-9-60
  10. Lai SZ, Li WF, Chen L, et al (2011). How does intensitymodulated radiotherapy versus conventional twodimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients? Int J Radiat Oncol Biol Phys, 80, 661-8. https://doi.org/10.1016/j.ijrobp.2010.03.024
  11. Lee AW, Ng WT, Chan LL, et al (2014). Evolution of treatment for nasopharyngeal cancer--success and setback in the intensity-modulated radiotherapy era. Radiother Oncol, 110, 377-84. https://doi.org/10.1016/j.radonc.2014.02.003
  12. Lee FK, Yip CW, Cheung FC, et al (2014). Dosimetric difference amongst 3 techniques: TomoTherapy, sliding-window intensity-modulated radiotherapy (IMRT), and RapidArc radiotherapy in the treatment of late-stage nasopharyngeal carcinoma (NPC). Med Dosim, 39, 44-9. https://doi.org/10.1016/j.meddos.2013.09.004
  13. Li JX, Huang SM, Jiang XH, et al (2014). Local failure patterns for patients with nasopharyngeal carcinoma after intensitymodulated radiotherapy. Radiat Oncol, 9, 87. https://doi.org/10.1186/1748-717X-9-87
  14. Lin S, Pan J, Han L, et al (2009). Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy: report on the 3-year outcome of a prospective series. Int J Radiat Oncol Biol Phys, 75, 1071-8. https://doi.org/10.1016/j.ijrobp.2008.12.015
  15. Lin S, Lu JJ, Han L, Chen Q, Pan J (2010). Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma: experience of 370 consecutive cases. BMC Cancer, 10, 39. https://doi.org/10.1186/1471-2407-10-39
  16. Lin S, Pan J, Han L, et al (2014). Update report of nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy and hypothesis of the optimal margin. Radiother Oncol, 110, 385-9. https://doi.org/10.1016/j.radonc.2014.01.011
  17. Lu J, Ma Y, Chen J, et al (2014). Assessment of anatomical and dosimetric changes by a deformable registration method during the course of intensity-modulated radiotherapy for nasopharyngeal carcinoma. J Radiat Res, 55, 97-104. https://doi.org/10.1093/jrr/rrt076
  18. Mackie TR, Holmes T, Swerdloff S, et al (1993). Tomotherapy: a new concept for the delivery of dynamic conformal radiotherapy. Med Phys, 20, 1709-19. https://doi.org/10.1118/1.596958
  19. Moretto F, Rampino M, Munoz F, et al (2014). Conventional 2D (2DRT) and 3D conformal radiotherapy (3DCRT) versus intensity-modulated radiotherapy (IMRT) for nasopharyngeal cancer treatment. Radiol Med, 119, 634-41. https://doi.org/10.1007/s11547-013-0359-7
  20. Peng G, Wang T, Yang KY, et al (2012). A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol, 104, 286-93. https://doi.org/10.1016/j.radonc.2012.08.013
  21. Phua Chee Ee V, Tan BS, Tan AL, et al (2013). Dose planning study of target volume coverage with intensity- modulated radiotherapy for nasopharyngeal carcinoma: Penang General Hospital experience. Asian Pac J Cancer Prev, 14, 2243-8. https://doi.org/10.7314/APJCP.2013.14.4.2243
  22. Ren G, Du L, Ma L, et al (2011). Clinical observation of 73 nasopharyngeal carcinoma patients treated by helical tomotherapy: the China experience. Technol Cancer Res Treat, 10, 259-66.
  23. Rong Y, Tang G, Welsh JS, et al (2011). Helical tomotherapy versus single-arc intensity-modulated arc therapy: a collaborative dosimetric comparison between two institutions. Int J Radiat Oncol Biol Phys, 81, 284-96. https://doi.org/10.1016/j.ijrobp.2010.10.059
  24. Sun X, Su S, Chen C, et al (2014). Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol, 110, 398-403. https://doi.org/10.1016/j.radonc.2013.10.020
  25. Sun Y, Guo R, Yin WJ, et al (2013). Which T category of nasopharyngeal carcinoma may benefit most from volumetric modulated arc therapy compared with step and shoot intensity modulated radiation therapy. PLoS One, 8, 75304. https://doi.org/10.1371/journal.pone.0075304
  26. Sun Y, Yu XL, Luo W, et al (2014). Recommendation for a contouring method and atlas of organs at risk in nasopharyngeal carcinoma patients receiving intensitymodulated radiotherapy. Radiother Oncol, 110, 390-7. https://doi.org/10.1016/j.radonc.2013.10.035
  27. Tham IW, Hee SW, Yeo RM, et al (2009). Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the national cancer centre singapore experience. Int J Radiat Oncol Biol Phys, 75, 1481-6. https://doi.org/10.1016/j.ijrobp.2009.01.018
  28. Tsang RK, Kwong DL, Ho AC, et al (2012). Long-term hearing results and otological complications of nasopharyngeal carcinoma patients: Comparison between treatment with conventional two-dimensional radiotherapy and intensitymodulated radiotherapy. ORL, 74, 228-33. https://doi.org/10.1159/000341096
  29. Wiezorek T, Brachwitz T, Georg D, et al (2011). Rotational IMRT techniques compared to fixed gantry IMRT and tomotherapy: multi-institutional planning study for head-and-neck cases. Radiat Oncol, 6, 20. https://doi.org/10.1186/1748-717X-6-20
  30. Wu WC, Mui WL,Fung WK (2010). Helical tomotherapy of nasopharyngeal carcinoma-any advantages over conventional intensity-modulated radiotherapy? Med Dosim, 35, 122-7. https://doi.org/10.1016/j.meddos.2009.04.001
  31. Yan D, Yan S, Wang Q, et al (2013). Predictors for replanning in loco-regionally advanced nasopharyngeal carcinoma patients undergoing intensity-modulated radiation therapy: a prospective observational study. BMC Cancer, 13, 548. https://doi.org/10.1186/1471-2407-13-548
  32. Yang H, Hu W, Wang W, et al (2013). Replanning during intensity modulated radiation therapy improved quality of life in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys, 85, 47-54. https://doi.org/10.1016/j.ijrobp.2012.03.008
  33. Yi JL, Gao L, Huang XD, et al (2006). Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution. Int J Radiat Oncol Biol Phys, 65, 161-8. https://doi.org/10.1016/j.ijrobp.2005.12.003
  34. Zhang Y, Lin ZA, Pan JJ, et al (2009). Concurrent control study of different radiotherapy for primary nasopharyngeal carcinoma: Intensity-modulated radiotherapy versus conventional radiotherapy. Chin J Cancer, 28, 21-6.

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