Treatment outcomes and late complications of 849 patients with nasopharyngeal carcinoma treated with radiotherapy alone.
OBJECTIVE
The objective of this study was to describe the treatment outcomes and treatment-related complications of nasopharyngeal carcinoma (NPC) patients treated with radiotherapy alone.


METHODS
Retrospective analysis was performed on 849 consecutive NPC patients treated between 1983 and 1998 in our institution. Potentially significant patient-related and treatment-related variables were analyzed. Radiation-related complications were recorded.


RESULTS
The 5-year overall and disease-free survival rates of these patients were 59% and 52%, respectively. Advanced parapharyngeal space (PPS) invasion showed stronger prognostic value than PPS invasion. Multiple neck lymph node (LN) involvement was demonstrated to be one of the most powerful independent prognostic factors among all LN-related parameters. External beam radiation dose more than 72 Gy was associated with significantly higher incidence of hearing impairment, trismus, and temporal lobe necrosis.


CONCLUSIONS
We recommend that the extent of PPS should be clarified and stratified. Multiple neck LN involvement could be integrated into the N-classification in further revisions of the American Joint Committee on Cancer stage. Boost irradiation is not suggested for node-negative necks. For node-positive necks, boost irradiation is indicated and a longer interval between initial and boost irradiation would reduce the incidence of neck fibrosis without compromising the neck control rate.
Yeh
Shyh-An
SA
Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Taiwan. yehsa@hotmail.com
Tang
Yeh
Y
Lui
Chun-Chung
CC
Huang
Yu-Jie
YJ
Huang
Eng-Yen
EY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D009333:Neck; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012737:Sex Factors; D012867:Skin / Q000528:radiation effects; D016019:Survival Analysis; D014012:Tinnitus / Q000209:etiology; D016896:Treatment Outcome; D014313:Trismus / Q000209:etiology; D014987:Xerostomia / Q000209:etiology