Mixed-beam approach in locally advanced nasopharyngeal carcinoma: IMRT followed by proton therapy boost versus IMRT-only. Evaluation of toxicity and efficacy
| Autor: | Alterio, (Alterio, D, 1 ), Daniela), D'Ippolito, (D'Ippolito, E, 2 ), Emma), Vischioni, (Vischioni, B, 2 ), Barbara), Fossati, (Fossati, P, Piero)(, 1, Gandini, 2, (Gandini, S, 3 ), Sara), Bonora, (Bonora, M, 2 ), Maria), Ronchi, (Ronchi, S, 2 ), Sara), Vitolo, (Vitolo, V, 2 ), Viviana), Mastella, (Mastella, E, 2 ), Edoardo), Magro, (Magro, G, 2 ), Giuseppe), Franco, (Franco, P, 4 ), Pierfrancesco), Ricardi, (Ricardi, U, 4 ), Umberto), Krengli, Marco, (Krengli, M, 5 ), Marco), Ivaldi, (Ivaldi, G, 6 ), Giovanni), Ferrari, (Ferrari, A, 1 ), Annamaria), Fanetti, (Fanetti, G, Giuseppi)(, 1, Comi, 7, (Comi, S, 8 ), Stefania), Tagliabue, (Tagliabue, M, 9 ), Marta), Verri, (Verri, E, Elena)( 10, ), Ricotti, (Ricotti, R, 2 ), Rosalinda), Ciardo, (Ciardo, D, 1 ), Delia), Jereczek-Fossa, (Jereczek-Fossa, Ba, Barbara Alicja)(, 1, Valvo, 7, (Valvo, F, 2 ), Francesca), Orecchia, (Orecchia, R, Roberto)(, 11, Less, 12 |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_treatment Severity of Illness Index 030218 nuclear medicine & medical imaging 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Proton Therapy Neoadjuvant therapy Nasopharyngeal Carcinoma Radiotherapy Dosage Chemoradiotherapy Hematology General Medicine Middle Aged CHEMOTHERAPY CANCER Neoadjuvant Therapy Progression-Free Survival Oncology 030220 oncology & carcinogenesis Disease Progression SURVIVAL Female Radiology Adult Mucositis medicine.medical_specialty Adolescent Nasopharyngeal neoplasm Xerostomia Young Adult 03 medical and health sciences INTENSITY-MODULATED RADIOTHERAPY 2-DIMENSIONAL RADIOTHERAPY RADIATION HEAD ONCOLOGY medicine Humans Dosimetry Radiology Nuclear Medicine and imaging Radiation Injuries Proton therapy Aged Neoplasm Staging Retrospective Studies Cancer staging business.industry Dose-Response Relationship Radiation Nasopharyngeal Neoplasms medicine.disease Radiation therapy Nasopharyngeal carcinoma Radiotherapy Intensity-Modulated business Follow-Up Studies |
| DOI: | 10.6084/m9.figshare.11889378.v1 |
| Popis: | Objective: To compare radiation-induced toxicity and dosimetry parameters in patients with locally advanced nasopharyngeal cancer (LANPC) treated with a mixed-beam (MB) approach (IMRT followed by proton therapy boost) with an historic cohort of patients treated with a full course of IMRT-only. Material and methods: Twenty-seven patients with LANPC treated with the MB approach were compared to a similar cohort of 17 patients treated with IMRT-only. The MB approach consisted in a first phase of IMRT up to 54–60 Gy followed by a second phase delivered with a proton therapy boost up to 70–74 Gy (RBE). The total dose for patients treated with IMRT-only was 69.96 Gy. Induction chemotherapy was administrated to 59 and 88% and concurrent chemoradiotherapy to 88 and 100% of the MB and IMRT-only patients, respectively. The worst toxicity occurring during the entire course of treatment (acute toxicity) and early-late toxicity were registered according to the Common Terminology Criteria Adverse Events V4.03. Results: The two cohorts were comparable. Patients treated with MB received a significantly higher median total dose to target volumes (p = .02). Acute grade 3 mucositis was found in 11 and 76% (p = .0002) of patients treated with MB and IMRT-only approach, respectively, while grade 2 xerostomia was found in 7 and 35% (p = .02) of patients treated with MB and IMRT-only, respectively. There was no statistical difference in late toxicity. Local progression-free survival (PFS) and progression-free survival curves were similar between the two cohorts of patients (p = .17 and p = .40, respectively). Local control rate was 96% and 81% for patients treated with MB approach and IMRT-only, respectively. Conclusions: Sequential MB approach for LANPC patients provides a significantly lower acute toxicity profile compared to full course of IMRT. There were no differences in early-late morbidities and disease-related outcomes (censored at two-years) but a longer follow-up is required to achieve conclusive results. |
| Databáze: | OpenAIRE |
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