Chemoradiotherapy for locally recurrent nasopharyngeal carcinoma: treatment outcome and prognostic factors.
OBJECTIVE
To evaluate the treatment outcome of patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with re-irradiation and chemotherapy.


METHODS
Between 1991 and 2004, 36 patients with locally recurrent NPC received re-irradiation and chemotherapy. The median re-irradiation dose was 37.9 Gy; the median total dose of prior irradiation and re-irradiation was 104.4 Gy. The outcome is studied retrospectively and also evaluated the prognostic factors and toxicities.


RESULTS
With a median follow-up of 40 months, 3-year overall survival (OS) was 58.3% and 3-year progression-free survival (PFS) was 25.0%. Patients aged <50 and of early stage at recurrence had a significantly better OS and PFS. Over Grade 3 of late toxicities were seen in patients received a total dose of >110 Gy.


CONCLUSIONS
Age and stage at recurrence were identified as prognostic factors for OS and PFS. Patients received external beam radiation therapy at a total dose of more than 110 Gy should be careful for severe late toxicities, and it is thought to be the optimal dose for recurrent tumor.
Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan. tatsuya.nakamura@nifty.com
Tatsuya
T
Nakamura
Takeshi
T
Kodaira
Hiroyuki
H
Tachibana
Natsuo
N
Tomita
Takuya
T
Tomoda
Rie
R
Nakahara
Haruo
H
Inokuchi
Nobutaka
N
Mizoguchi
Akinori
A
Takada
Nobukazu
N
Fuwa
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D013238:Stereotaxic Techniques; D016019:Survival Analysis; D016896:Treatment Outcome
D009944:Organoplatinum Compounds; C053989:nedaplatin; D016190:Carboplatin; D002945:Cisplatin; D005472:Fluorouracil