Clinical Study of Nasopharyngeal Carcinoma Treated by Helical Tomotherapy in China: 5-Year Outcomes

Du, Liqing; Zhang, Xinxin; Ma, Lin; Feng, Long; Li, Fang; Zhou, Guoli; Qu, Baolin; Xu, Shouping; Xie, Chiyu; Yang, Jack

doi:10.1155/2014/980767

Cited by 17 publications

(22 citation statements)

References 33 publications

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“…also reported excellent 3-year LRC, DMFS, and OS with minor acute and late toxicities with helical tomotherapy. 22 The present data investigated the first 100 nasopharyngeal carcinoma patients treated by helical tomotherapy in Thailand. Our short term 2-year results are excellent with a LRFFS, DMFS, and OS of 94%, 96%, and 99%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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The outcome of the first 100 nasopharyngeal cancer patients in thailand treated by helical tomotherapy

Chitapanarux

Nobnop

Sripan

et al. 2017

Radiology and Oncology

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BackgroundThe aim of the study was to analyse of two-year loco-regional failure free survival (LRFFS), distant metastasis free survival (DMFS), overall survival (OS), and toxicity outcomes of the first 100 nasopharyngeal carcinoma patients in Thailand treated by helical tomotherapy.Patients and methodsBetween March 2012 and December 2015, 100 patients with non-metastatic nasopharyngeal carcinoma were treated by helical tomotherapy. All patients were treated by platinum-based concurrent chemoradiotherapy and adjuvant or neo-adjuvant chemotherapy.ResultsThe median age was 51 years (interquartile ranges [IQR]: 42.5–57.0). The mean ± SD of D95% of planning target volume (PTV) 70, 59.4 and 54 were 70.2 ± 0.5, 59.8 ± 0.6, and 54.3 ± 0.8 Gy, respectively. The mean ± SD of conformity index, and homogeneity index were 0.89 ± 0.13 and 0.06 ± 0.07. Mean ± SD of D2 % of spinal cord and brainstem were 34.1 ± 4.4 and 53.3 ±6.3 Gy. Mean ± SD of D50 of contralateral and ipsilateral parotid gland were 28.4 ± 6.7 and 38.5 ± 11.2 Gy. At a median follow-up of 33 months (IQR: 25–41), the 2-year LRFFS, DMFS, OS were 94% (95%CI: 87–98%), 96% (95% CI: 89–98%), and 99% (95% CI: 93–100%), respectively. Acute grade 3 dermatitis, pharyngoesophagitis, and mucositis occurred in 5%, 51%, and 37%, respectively. Late pharyngoesophagitis grade 0 and 1 were found in 98% and 2% of patients. Late xerostomia grade 0, 1 and 2 were found in 17%, 78% and 5%, respectively.ConclusionsHelical tomotherapy offers good dosimetric performance and achieves excellent treatment outcome in nasopharyngeal carcinoma patients.

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Section: Discussionmentioning

confidence: 99%

“… 24 , 26 , 29 , 31 , 32 Grade 3 acute radiation dermatitis was found in 5% of our patient, these numbers are comparable to those from other series. 22 , 23 , 29 , 32 Other OARs such as brainstem and spinal cord, could be treated within the dose constraint limits.…”

Section: Discussionmentioning

confidence: 99%

The outcome of the first 100 nasopharyngeal cancer patients in thailand treated by helical tomotherapy

Chitapanarux

Nobnop

Sripan

et al. 2017

Radiology and Oncology

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“…Since HT can attain superior conformity of the dose distribution and homogeneity of the target dose, it has been widely adopted as a radiotherapy modality for various malignant tumors (2)(3)(4)(5). HT is particularly suitable for the treatment of patients with nasopharyngeal carcinoma (NPC), who have target volumes with complex shapes and numerous organs at risk (OARs) in the surrounding area (6,7). Dose optimization for HT is achieved by adjusting specific parameters of the plan, primarily the modulation factor, jaw width, and pitch (1).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Combinations of Irradiation Mode and Jaw Width in Helical Tomotherapy for Nasopharyngeal Carcinoma

et al. 2020

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Purpose: To aid in the selection of a suitable combination of irradiation mode and jaw width in helical tomotherapy (HT) for the treatment of nasopharyngeal carcinoma (NPC). Materials and Methods:Twenty patients with NPC who underwent radiotherapy were retrospectively selected. Four plans using a jaw width of 2.5 or 5-cm in dynamic jaw (DJ) or fix jaw (FJ) modes for irradiation were designed (2.5DJ, 2.5FJ, 5.0DJ, and 5.0FJ). The dose parameters of planning target volume (PTV) and organs at risk (OARs) of the plans were compared and analyzed, as well as the beam on time (BOT) and monitor unit (MU). The plans in each group were ranked by scoring the doses received by the OARs and the superity was assessed in combination with the planned BOT and MU. Results:The prescribed dose coverage of PTV met the clinical requirements for all plans in the four groups. The groups using a 2.5-cm jaw width or a DJ mode provided better protection to most OARs, particularly for those at the longitudinal edges of the PTV (P < 0.05). The 2.5DJ group had the best ranking for OAR-dose, followed by the 2.5FJ and 5.0DJ groups with a same score. The BOT and MU of the groups using a 5.0-cm jaw width reduced nearly 45% comparing to those of the 2.5-cm jaw groups.Conclusion: 2.5DJ has the best dose distribution, while 5.0DJ has satisfactory dose distribution and less BOT and MU that related to the leakage dose. Both 2.5DJ or 5DJ were recommended for HT treatment plan for NPC based on the center workload.

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“…As a newly emerging IMRT technology, HT integrates IMRT, Image-Guided Intensity Modulated Radiotherapy (IGRT), and Dose-Guided Intensity Modulated Radiotherapy (DGRT) via combining 360°spiral tomography scan with straight accelerator in tumor radiotherapy, thereby realizing real dynamic intensity modulation. Regarding few study, small sample size and inconsistent results on the e cacy of HT in nasopharyngeal carcinoma radiotherapy in China and worldwide [6][7][8], elucidation of the role of HT in nasopharyngeal carcinoma treatment via a large sample study is required.…”

Section: Introductionmentioning

confidence: 99%

Short-term efficacy comparison between helical tomotherapy and intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma

Cui

Liu

Sun³

et al. 2020

Preprint

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Background: To evaluate short-term safety and efficacy of helical tomotherapy (HT) versus intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).Methods: Retrospective analysis of locally advanced nasopharyngeal carcinoma treated with radiotherapy and concurrent platinum based neoadjuvant chemotherapy (cisplatin 80 mg/m2 every 3 weeks for 1 cycle) in our hospital from February 2017 to October 2019, including 70 patients in HT group and 70 in IMRT group. The target area of the tumor was delineated by magnetic resonance (MRI) imaging. The prescription doses delivered to the gross tumor volume (pGTVnx) and positive lymph nodes (pGTVnd), the high risk planning target volume (PTV1), and the low risk planning target volume (PTV2), were 69.96 Gy, 66-70 Gy, 60 Gy and 50-54 Gy, in 33 fractions, respectively. Acute reactions were evaluated according to the RTOG/EORTC criteria, whereas the therapeutic efficacy was assessed according to RECTST version 1.1 criteria in a 3-months period.Results: The CI of PGTVnx, PGTVnd, PTV1 and PTV2, and HI of PGTVnx, PTV1 and PTV2 in HT group was significantly better than those in IMRT group. The OAR Dmax and Dmean in HT group were better than those in IMRT group with a significant difference (all p <0.05). Patients in the HT group were significantly better than those in the IMRT group in the protection of acute parotid gland injury and hearing damage (p <0.05), but not other acute adverse reaction. No significant difference was found on the short-term efficacy illustrated by ORR between HT group and IMRT group (x2 = 0.119; p = 0.730).Conclusions: Compared with IMRT, HT has better radiophysical-related dosimetric advantages in radiotherapy for locally advanced nasopharyngeal carcinoma. Despite similar on short-term effects, HT has lower incidence of adverse reactions than IMRT.

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Clinical Study of Nasopharyngeal Carcinoma Treated by Helical Tomotherapy in China: 5-Year Outcomes

Cited by 17 publications

References 33 publications

The outcome of the first 100 nasopharyngeal cancer patients in thailand treated by helical tomotherapy

The outcome of the first 100 nasopharyngeal cancer patients in thailand treated by helical tomotherapy

Comparison of Different Combinations of Irradiation Mode and Jaw Width in Helical Tomotherapy for Nasopharyngeal Carcinoma

Short-term efficacy comparison between helical tomotherapy and intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma

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