Hyperfractionated radiation therapy for locoregionally advanced nasopharyngeal cancer.
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.
Isobe
Koichi
K
Department of Radiology, Chiba University Hospital, Chiba, Japan. isobeko@ho.chiba-u.ac.jp
Uno
Takashi
T
Kawakami
Hiroyuki
H
Ueno
Naoyuki
N
Aruga
Takashi
T
Yasuda
Shigeo
S
Hanazawa
Toyoyuki
T
Okamoto
Yoshitaka
Y
Ito
Hisao
H
Shigematsu
Naoyuki
N
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
D002945:Cisplatin