title: Hyperfractionation compared to standard fractionation in intensity-modulated radiation therapy for patients with locally advanced recurrent nasopharyngeal carcinoma.
abstract: We prospectively studied the efficacy and safety of hyperfractionated intensity-modulated radiation therapy (HF-IMRT) and compared to a historical cohort treated with standard fractionation (SF-IMRT) in patients with locally advanced recurrent (rT3-T4, rN0-N1, M0) nasopharyngeal carcinoma (NPC). Ten patients were treated with induction chemotherapy followed by HF-IMRT (64.8 Gy/54 fr/5.5 weeks) concurrent with weekly cisplatin. They were compared to another ten patients treated with induction chemotherapy followed by SF-IMRT (60 Gy/30 fr/6 weeks) concurrent with weekly cisplatin. After a median follow-up duration of 44.6 months, we demonstrated that the median local failure-free survival (LFFS) showed a trend in favor of HF-IMRT (28.2 vs. 16.6 months, p = 0.164). Overall survival (OS) (34.8 vs. 35.5 months, p = 0.603) was not different between the two groups. Treatment-related hemorrhage was slightly less with HF-IMRT (30.0 vs. 0 %), reaching marginal significance (p = 0.060). Judging from our study results, HF-IMRT offered a marginally better LFFS and an apparently more favorable toxicity profile compared to SF-IMRT in locally advanced recurrent NPC.
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong. vhflee@hku.hk.
authors.forename: Victor H F
authors.initials: VH
authors.lastname: Lee
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong.
authors.forename: Dora L W
authors.initials: DL
authors.lastname: Kwong
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong.
authors.forename: To-Wai
authors.initials: TW
authors.lastname: Leung
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong.
authors.forename: Sherry C Y
authors.initials: SC
authors.lastname: Ng
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong.
authors.forename: Ka-On
authors.initials: KO
authors.lastname: Lam
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong.
authors.forename: Chi-Chung
authors.initials: CC
authors.lastname: Tong
authors.affiliation: Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 1/F, Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong.
authors.forename: Chun-Kin
authors.initials: CK
authors.lastname: Sze
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011446:Prospective Studies; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Hyperfractionation; Intensity-modulated radiation therapy; Locally advanced recurrence; Nasopharyngeal carcinoma; Re-irradiation; Standard fractionation