Clinical course of longer than five years after definitive radiotherapy for nasopharyngeal carcinoma.

Abstract

BACKGROUND:

This study aimed to reveal the long-term outcomes and late toxicities (> 5 years) after definitive intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).

METHODS:

Data from 43 patients (median age, 55 years; range, 17-72 years) with NPC who underwent definitive IMRT between 2001 and 2018 were analyzed. All patients were alive and disease-free 5 years after IMRT. A total dose of 70 (range, 66-70) Gy was delivered in 35 (33-35) fractions with concurrent cisplatin chemotherapy.

RESULTS:

The median follow-up duration was 119 (range, 61.5-242.1) months. Three patients developed locoregional failure at 79, 92, and 149 months after IMRT, respectively. Of these, 2 patients died of disease progression at 136 and 153 months after IMRT. One patient died of aspiration pneumonia 141 months after IMRT, despite salvage of the recurrent tumor by re-irradiation. In addition, one patient died of aspiration pneumonia 62 months after the IMRT. Thus, the 10-year overall survival, progression-free survival, and locoregional control rates were 98%, 92%, and 94%, respectively. Grade ≥ 2 and ≥ 3 late toxicities were observed in 28 (65%) and 9 (21%) patients, respectively. Nine second primary cancers, including five tongue cancers and two external auditory canal carcinomas, were observed in seven (16%) patients.

CONCLUSION:

Late recurrences, severe late toxicities, and second primary cancers were observed > 5 years after IMRT. A long-term follow-up of > 5 years is needed in patients with NPC.

• Authors: Hiroshi Doi, Aritoshi Ri, Masahiro Inada, Saori Tatsuno, Takuya Uehara, Tomohiro Matsuura, Kazuki Ishikawa, Kiyoshi Nakamatsu, Makoto Hosono, Yasumasa Nishimura
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 28 Issue 12 Pg. 1607-1615 (Dec 2023) ISSN: 1437-7772 [Electronic] Japan
• PMID: 37798414 (Publication Type: Journal Article)
• Copyright: © 2023. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.

Topics

• Humans
• Middle Aged
• Nasopharyngeal Carcinoma (radiotherapy)
• Nasopharyngeal Neoplasms (drug therapy, radiotherapy, pathology)
• Neoplasms, Second Primary (pathology)
• Neoplasm Staging
• Neoplasm Recurrence, Local (pathology)
• Radiotherapy, Intensity-Modulated (adverse effects)
• Disease Progression
• Pneumonia, Aspiration (etiology, pathology)