Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_26_2624 - Long term outcome of definitive chemo-IMRT for locally advanced nasopharyngeal cancer patients using Helical Tomotherapy.

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Long term outcome of definitive chemo-IMRT for locally advanced nasopharyngeal cancer patients using Helical Tomotherapy.
T. Kodaira, H. Tachibana, N. Tomita, H. Tanaka, Y. Koide, D. Kato, and S. Adachi; Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya Aichi 464-8681, Japan

Purpose/Objective(s): To evaluate treatment outcome of definitive chemo-IMRT using Helical Tomotherapy (HT) for patients with nasopharyngeal cancer (NPC).

Materials/Methods: In this analysis, contiguous 132 patients with NPC treated with definitive chemo-IMRT from 2006 to 2015 were analyzed. Until 2007, chemotherapy underwent with alternating method (N=38), then followed by concurrent chemoradiation (CRT; n=91) with (n=86) or without (n=24) adjuvant chemotherapy (AC). As for IMRT method, 70/54 Gy for involved/prophylactic site in 35 fractions was delivered by SIB method until 2011. After that 2-step method was used, in which a 46 Gy in 23 fractions for the entire neck followed by boost up to 70 Gy in 35 fractions.

Results: Patient characteristics was as follows; Male: Female = 98: 34, median age 54.5 y.o (11-76), PS 0: 1: 2: 3 = 30: 99: 2: 1, T-factor 1: 2: 3: 4 = 52: 27: 27: 26, N-factor 0: 1: 2: 3 = 14: 47: 53: 18, Clinical Stage (CS; UICC v.8) I: II: III: IVA = 6: 29: 56: 41, WHO Histological Type (HT) I: II-III: unknown = 31: 100: 1. Median follow-up time was 60 months (1.9 – 136 M). Median radiation dose was 70 Gy (95%CI = 67.5-70.1) and median cisplatin dose of concurrent use and total were 240 mg/m2 (95%CI = 207.4-225.9) and 310 mg/m2 (95%CI = 301.2-349.7). At last follow-up, 100 patients lived with (N=12) or without disease (N=88), and 32 patients died for disease (N=22) or other reason (N=10). The 5-y rates of Overall Survival (OS), Progression-Free Survival (PFS), Loco-reginal Recurrence-Free Survival (LRFS) and Distant Metastasis-Free Survival (DMFS) was 75.2% (95%C.I. 67.2-83.1), 64.2% (95%C.I. 55.6-72.8), 79.9% (95%C.I. 72.4-87.4), and 86.9% (95%C.I. 80.7-93.1), respectively. By univariate analyses, Significant factors of OS was elderly (P=0.006), T4 (P=0.0007), N3 (P=0.048), CS-IVA (P=0.0018), HT-I (P=0.001), no adjuvant (p=0.013), and lower CDDP dose (p=0.0091), respectively ; for PFS it was elderly (P=0.002), T4 (P=0.003), N3 (P=0.013), CS-IVA (P=0.0033), HT-I (P=0.003), and lower CDDP (p=0.044), respectively. For LRFS it was elderly (P=0.006), T4(P=0.0025), N3 (P=0.01), and CS-IV (P=0.0025), respectively. Both adjuvant (p=0.06) and higher CDDP(P=0.06) showed only tendency for poorer DMFS. By multivariate analysis, prognostic factor was only elderly (HR=2.84; P=0.018) for OS, while there was a tendency for T4 (HR=4.62; P=0.053). For PFS it was elderly (HR=2.26; P=0.018), T4 (HR=6.63; P=0.0067), and N3 (HR=5.37; P=0.014), respectively. For LRFS it was N3 (HR=9.12; P=0.034), while there was a tendency for T4 (HR=10.8; P=0.052). For DMFS, they were N3 (HR=5.78; P=0.049) and adjuvant (HR=5.272; P=0.026). Grade 2 xerostomia at 6M, 1Y, and 2Y was 61%, 22% and 17%, respectively. Two patients required gastrostomy due to late dysphagia. Seven (5.3%) brain necrosis and 3 (2.3%) cranial nerve palsy developed.

Conclusion: Matured analysis of definite chemo-IMRT using HT for NPC was quite acceptable. Adjuvant chemotherapy seemed to be efficacious especially for DM.

Author Disclosure: T. Kodaira: None. H. Tachibana: None. N. Tomita: None. Y. Koide: None. D. Kato: None.

Send Email for Takeshi Kodaira


Assets

MO_26_2624 - Long term outcome of definitive chemo-IMRT for locally advanced nasopharyngeal cancer patients using Helical Tomotherapy.



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Long term outcome of definitive chemo-IMRT for locally advanced nasopharyngeal cancer patients using Helical Tomotherapy.