title: Intensity-modulated radiotherapy for nasopharyngeal carcinoma: Penang General Hospital experience.
abstract: OBJECTIVE
  To study the overall treatment time (OTT) and acute toxicity of intensity-modulated radiotherapy (IMRT) treatment for nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  This retrospective study covered all NPC patients who underwent radical IMRT treatment at the Penang General Hospital from June 2011 to February 2012. Patients of any age and stage of disease with histologically proven diagnosis were included. Information was collected on patient demographics, clinical stage, treatment received, including any neoadjuvant and/or concurrent chemotherapy, acute toxity and completion of IMRT within the OTT.
  
  
  RESULTS
  A total of 26 NPC patients were treated with IMRT during the study period; 88.5% had stage III/IV disease. 45.2% received neo-adjuvant chemotherapy while 50.0% were given concurrent chemo-irradiation. All patients completed the treatment and 92.3% within the 7 weeks OTT. Xerostomia was present in all patients with 92.3% having grade 2. Severe grade III/IV acute toxicity occurred in 73.1% of patients, the commonest of which was oral mucositis (57.6%). This was followed by dysphagia which occurred in 53.8%, skin reactions in 42.3% and weight loss in 19.2%. However, haematological toxicity was mild with only one patient having leucopaenia.
  
  
  CONCLUSIONS
  IMRT treatment for NPC is feasible in our center. More importantly, it can be delivered within the 7 weeks OTT in the majority of patients. Severe grade 3/4 toxicity is very common (73.1%) and thus maximal nutritional and analgesic support is required throughout the treatment.
authors.affiliation: Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. vince_phua@yahoo.com
authors.forename: Chee Ee
authors.initials: CE
authors.lastname: Phua
authors.forename: Boon Seang
authors.initials: BS
authors.lastname: Tan
authors.forename: Ai Lian
authors.initials: AL
authors.lastname: Tan
authors.forename: Kae Yann
authors.initials: KY
authors.lastname: Eng
authors.forename: Bong Seng
authors.initials: BS
authors.lastname: Ng
authors.forename: Rozita Abdul
authors.initials: RA
authors.lastname: Malik
authors.forename: Wan Zamaniah
authors.initials: WZ
authors.lastname: Wan Ishak
mesh_terms: D000368:Aged; D002277:Carcinoma; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D020360:Neoadjuvant Therapy / Q000379:methods; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies