Advantages of using reduced-volume intensity modulated radiation therapy for the treatment of nasopharyngeal carcinoma: a retrospective paired study

• Published in: BMC cancer Vol. 19; no. 1; pp. 554 - 9
• Main Authors: Liu, Fang, Luo, Ting, Jin, Tao, Zhang, Jiahui, Xiang, Zhongzheng, Yan, Ruonan, Xie, Li, Wu, Xin, Zhang, Hong, Wang, Feng, Li, Ping, Liu, Lei
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.06.2019; BioMed Central; BMC
• Subjects: Adult; Aged; Cancer; Cancer metastasis; Cancer treatment; Carcinoma; Care and treatment; Clinical target volume; Female; Hearing loss; Humans; Intensity modulated radiation therapy; Kaplan-Meier Estimate; Magnetic Resonance Imaging; Male; Middle Aged; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - diagnosis; Nasopharyngeal Carcinoma - mortality; Nasopharyngeal Carcinoma - radiotherapy; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - mortality; Nasopharyngeal Neoplasms - radiotherapy; Neoplasm Staging; Prognosis; Radiation (Physics); Radiotherapy; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Retrospective Studies; Tomography, X-Ray Computed; Toxicity; Treatment Outcome; Tumor Burden; Xerostomia; Nasopharyngeal carcinoma; Intensity modulated radiation therapy; Radiotherapy; Clinical target volume
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-019-5774-2

The definition of clinical target volume (CTV) in intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) has not been addressed. We performed this study to assess the feasibility and efficacy of using IMRT with reduced-volume CTV for the treatment of nasopharyngeal carcinoma. We retrospectively reviewed 293 non-metastatic NPC patients treated with IMRT from 2002 to 2013. A total of 180 matched cases finally included with 90 received conventional-volume IMRT (CV-IMRT) and 90 received reduced-volume IMRT (RV-IMRT). Kaplan-Meier method and log-rank tests were used to compare NPC-specific survival. Multivariate analyses using the Cox proportional hazards model were conducted to detect independent predictors. With a median follow-up of 70 months, the 3-year overall survival, progression-free survival, distant metastasis-free survival, local recurrence-free survival, regional recurrence-free survival, locoregional recurrence-free survival rates were 88.9, 84.4, 92.2, 91.1, 98.9, 91.1% for the CV-IMRT arm and 92.2, 85.6, 90.0, 93.3, 98.9, 93.3% for the RV-IMRT arm, respectively. None significant survival difference was observed. Additionally, RV-IMRT was associated with reduced risk of late xerostomia (P = 0.039) and hearing loss (P = 0.008), compared versus CV-IMRT. The use of RV-IMRT for the treatment of NPC led to comparable survival condition and truly reduced toxicity reactions compared versus CV-IMRT.