title: Hyperfractionated radiation therapy for locoregionally advanced nasopharyngeal cancer.
abstract: OBJECTIVE
  The purpose of this study is to clarify the efficacy and toxicity of hyperfractionated radiation therapy (RT) for patients with nasopharyngeal cancer (NPC).
  
  
  METHODS
  Twenty-two patients with NPC treated at our hospital between April 1994 and December 2002 were the subjects of this study. They received hyperfractionated RT with a fraction size of 1.2 Gy, with a median tumor dose of 72 Gy (range 64.8-80.4). During this study period, our institutional strategy for locoregionally advanced NPC included neoadjuvant or concurrent chemotherapy combined with hyperfractionated RT, and 17 patients received some forms of cisplatin-containing chemotherapy.
  
  
  RESULTS
  With a median follow-up of 59 months, the estimated 5-year disease-free survival rate and overall survival rate were 72.7 and 85.2%, respectively. Acute hematological toxicities were acceptable and manageable. However, >50% of patients required nutritional support, and experienced severe pharyngitis, skin reaction and body weight loss. With regard to late sequelae, one patient developed grade 3 osteomyelitis, and one patient each developed grade 4 passage disturbance and laryngeal edema. No patients experienced any grades of optic nerve injury or temporal lobe necrosis.
  
  
  CONCLUSIONS
  Hyperfractionated RT using 1.2 Gy per fraction, for a total dose of 72 Gy, produces a comparable treatment outcome. Although deleterious neurological sequelae were not observed in this study, caution should be exercised regarding other late sequelae, such as osteomyelitis and passage disturbance.
authors.affiliation: Department of Radiology, Chiba University Hospital, Chiba, Japan. isobeko@ho.chiba-u.ac.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Isobe
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawakami
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Ueno
authors.forename: Takashi
authors.initials: T
authors.lastname: Aruga
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yasuda
authors.forename: Toyoyuki
authors.initials: T
authors.lastname: Hanazawa
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Hisao
authors.initials: H
authors.lastname: Ito
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Shigematsu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D018529:Nutritional Support; D010019:Osteomyelitis / Q000139:chemically induced; D010612:Pharyngitis / Q000139:chemically induced; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin