title: Effectiveness and toxicity of helical tomotherapy for patients with locally recurrent nasopharyngeal carcinoma.
abstract: OBJECTIVE
  We assessed therapeutic outcomes of reirradiation with helical tomotherapy (HT) for locoregional recurrent nasopharyngeal carcinoma (LRNPC) patients.
  
  
  METHODS
  Treatment outcomes were evaluated retrospectively in 17 consecutive LRNPC patients receiving HT between 2006 and 2012. Median age was 57 years and most patients (n = 13) were male. Simultaneous systemic therapy was applied in 5 patients. Initial treatment covered the gross tumor volume with a median dose of 70 Gy (60-81.6 Gy). Reirradiation was confined to the local relapse region with a median dose of 63 Gy (50-70.2 Gy), resulting in a median cumulative dose of 134 Gy (122-148.2 Gy). The median time interval between initial and subsequent treatment was 42 months (11-126).
  
  
  RESULTS
  The median follow-up for the entire cohort was 23 and 35 months for survivors. Three patients (18 %) developed both local and distant recurrences and only one patient (6 %) suffered from isolated local recurrence. Two-year actuarial DFS and LC rates were 74 and 82 %, respectively. Two-year OS rate was 79 %. Acute and late grade 2 toxicities were observed in 8 patients (47 %). No patient experienced late grade ≥3 toxicity. Late toxicity included fibrosis of skin, hypoacusia, dysphagia, and xerostomia. Patients with higher Karnofsky performance status scores associated with a lower risk of mortality (HR 0.85, p = 0.015).
  
  
  CONCLUSIONS
  Reirradiation with HT in patients with LRNPC is feasible and yields encouraging results in terms of local control and overall survival with acceptable toxicity.
authors.affiliation: Department of Radiation Oncology, San Carlos University Hospital, Madrid, Spain.|Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Puebla
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain. chanodetriana@yahoo.es.|Department of Radiation Oncology, Virgen del Rocío University Hospital, s/n. 41013, Manuel Siurot Avenue, Seville, Spain. chanodetriana@yahoo.es.
authors.forename: J L
authors.initials: JL
authors.lastname: Lopez Guerra
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Garcia Ramirez
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Matute
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Marrone
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Radiation Physics, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Miguez
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Radiation Physics, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Sevillano
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Radiation Physics, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sanchez-Reyes
authors.affiliation: Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Rivin Del Campo
authors.affiliation: Methodology Unit, Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla, Virgen del Rocío University Hospital, Seville, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Praena-Fernandez
authors.affiliation: Máster en Aplicaciones tecnológicas avanzadas en Oncología Radioterápica, Universidad de Murcia y Fundación Grupo IMO, Madrid, Spain.|Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Azinovic
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
keywords: Helical tomotherapy; Local recurrence; Nasopharyngeal carcinoma; Reirradiation; Toxicity