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01.10.2014 | Original article

Intensity-modulated radiotherapy for stage IVA/IVB nasopharyngeal carcinoma

Clinical outcomes and patterns of failure in an endemic area in China

verfasst von: Lei Zeng, M.D., Yun-Ming Tian, M.D., Xue-Ming Sun, M.D., Ying Huang, M.D., Chun-Yan Chen, M.D., Fei Han, M.D., Shuai Liu, M.D., Mei Lan, M.D., Ying Guan, M.D., Xiao-Wu Deng, Ph.D., Tai-Xiang Lu, M.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2014

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Abstract

Purpose

The purpose of this study was to analyze the mode of relapse patterns and survival of 209 patients with stage IVA and IVB nasopharyngeal carcinoma (NPC).

Patients and materials

A total of 209 patients who underwent magnetic resonance imaging (MRI) and were subsequently histologically diagnosed with nondisseminated stage IV NPC received intensity-modulated radiotherapy (IMRT) as their primary treatment and were included in this retrospective study.

Results

Median follow-up time was 65 months (range, 3–108 months). The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates for patients with stage IVA and stage IVB NPC were 72.7 vs. 60.0 % (p = 0.319), 62.9 vs. 51.3 % (p = 0.070), 82.9 vs. 93.1 % (p = 0.070), 82.9 vs. 82.9 % (p = 0.897), 76.4 vs. 58.5 % (p = 0.003), respectively. Age older than 44 years was found to be a statistically significant adverse independent prognostic factor for OS. Patients with advanced N status had worse OS, DFS, and DMFS rates. Patients with a primary gross tumor volume (GTV-P) ≥ 55.11 ml had worse OS, DFS, and LRRFS rates.

Conclusion

The results of treating stage IVA NPC with IMRT were excellent. Distant metastasis remains the most difficult treatment challenge for patients with stage IVA and IVB NPC, and more effective systemic chemotherapy should be explored.

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Titel: Intensity-modulated radiotherapy for stage IVA/IVB nasopharyngeal carcinoma
Clinical outcomes and patterns of failure in an endemic area in China
verfasst von: Lei Zeng, M.D.
Yun-Ming Tian, M.D.
Xue-Ming Sun, M.D.
Ying Huang, M.D.
Chun-Yan Chen, M.D.
Fei Han, M.D.
Shuai Liu, M.D.
Mei Lan, M.D.
Ying Guan, M.D.
Xiao-Wu Deng, Ph.D.
Tai-Xiang Lu, M.D.
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 11/2014
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0680-7

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Intensity-modulated radiotherapy for stage IVA/IVB nasopharyngeal carcinoma

Clinical outcomes and patterns of failure in an endemic area in China