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Analysis of late toxicity in nasopharyngeal carcinoma patients treated with intensity modulated radiation therapy
- Source :
- Radiation Oncology (London, England)
- Publication Year :
- 2015
- Publisher :
- BioMed Central, 2015.
-
Abstract
- Purpose To observe the late toxicities in nasopharyngeal carcinoma (NPC) patients who achieved long-term survival after intensity modulated radiation therapy (IMRT). Methods 208 untreated NPC patients who received IMRT and survived more than five years with locoregional disease control and no metastasis were evaluated in this study. The prescription dose to the gross target volume of nasopharynx (GTVnx), positive neck lymph nodes (GTVnd), clinical target volume 1 (CTV1) and 2 (CTV2) was 68Gy/30f, 60-66Gy/30f, 60 Gy/30f and 54Gy/30f, respectively. The nasopharynx and upper neck targets were irradiated using IMRT, and the lower neck and supraclavicular fossae targets were irradiated using the half-beam technique with conventional irradiation. The late toxicities were evaluated according to the LENT/SOMA criteria of 1995. Results The median follow-up time was 78 months (60–96 months). The occurrence rates of cervical subcutaneous fibrosis, hearing loss, skin dystrophy, xerostomia, trismus, temporal lobe injury, cranial nerve damage, cataract, and brain stem injury induced by radiotherapy were 89.9%, 67.8%, 47.6%, 40.9%, 7.21%, 4.33%, 2.88%, 1.44%, and 0.48%, respectively. No spinal cord injury and mandible damage were found. Grade 3–4 late injuries were observed as follows: 1 (0.48%) skin dystrophy, 4 (1.92%) cervical subcutaneous fibrosis, 2 (0.96%) hearing loss, 2 (0.96%) cranial nerve palsy, and 1 (0.48%) temporal lobe necrosis. No grade 3–4 late injuries occurred in parotid, temporomandibular joints and eyes. Xerostomia decreased gradually over time and then showed only slight changes after 4 years. The change in the incisor distance stabilised by 1 year after RT, however, the incidence of hearing loss, skin dystrophy, subcutaneous fibrosis and nervous system injuries increased over time after RT. Conclusion The late injuries in most NPC patients who had long-term survivals after IMRT are alleviated. Within the 5 years of follow-up, we found xerostomia decreased gradually; The change in the incisor distance stabilised by 1 year after RT; while hearing loss, nervous system injuries increased over time after RT.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pathology
Time Factors
Adolescent
Intensity-modulated radiotherapy
medicine.medical_treatment
Nasopharyngeal neoplasm
Trismus
Xerostomia
Temporal lobe necrosis
Young Adult
Nasopharyngeal neoplasm/radiotherapy
medicine
Carcinoma
otorhinolaryngologic diseases
Humans
Radiology, Nuclear Medicine and imaging
Radiation injury
Spinal cord injury
Subcutaneous fibrosis
Aged
Neoplasm Staging
Nasopharyngeal Carcinoma
business.industry
Research
Radiotherapy Planning, Computer-Assisted
Nasopharyngeal Neoplasms
Radiotherapy Dosage
Middle Aged
medicine.disease
Prognosis
Radiation therapy
stomatognathic diseases
Oncology
Nasopharyngeal carcinoma
Radiology Nuclear Medicine and imaging
Female
Radiology
Radiotherapy, Intensity-Modulated
medicine.symptom
business
Late toxicity
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 1748717X
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Radiation Oncology (London, England)
- Accession number :
- edsair.doi.dedup.....2bac9deffeb2a49de21ac117b10091a9