title: 3D-image-guided high-dose-rate intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma.
abstract: BACKGROUND
  To evaluate the therapeutic benefit of 3D-image-guided high-dose-rate intracavitary brachytherapy (3D-image-guided HDR-BT) used as a salvage treatment of intensity modulated radiation therapy (IMRT) in patients with locally persistent nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  Thirty-two patients with locally persistent NPC after full dose of IMRT were evaluated retrospectively. 3D-image-guided HDR-BT treatment plan was performed on a 3D treatment planning system (PLATO BPS 14.2). The median dose of 16 Gy was delivered to the 100% isodose line of the Gross Tumor Volume.
  
  
  RESULTS
  The whole procedure was well tolerated under local anesthesia. The actuarial 5-y local control rate for 3D-image-guided HDR-BT was 93.8%, patients with early-T stage at initial diagnosis had 100% local control rate. The 5-y actuarial progression-free survival and distant metastasis-free survival rate were 78.1%, 87.5%. One patient developed and died of lung metastases. The 5-y actuarial overall survival rate was 96.9%.
  
  
  CONCLUSIONS
  Our results showed that 3D-image-guided HDR-BT would provide excellent local control as a salvage therapeutic modality to IMRT for patients with locally persistent disease at initial diagnosis of early-T stage NPC.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, 651 Dongfeng Road East, Guangzhou 510060, China.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Ren
authors.forename: Xin-Ping
authors.initials: XP
authors.lastname: Cao
authors.forename: Jia
authors.initials: J
authors.lastname: Xu
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Ye
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Gao
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
authors.forename: Bi-Xiu
authors.initials: BX
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002277:Carcinoma; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*