Role of endocavitary brachytherapy with or without chemotherapy in cancer of the nasopharynx

Levendag, Peter C.; Lagerwaard, Frank J.; Noever, Inge; dePan, Connie; vanNimwegen, Arent; Wijers, Oda B.; Schmitz, Paul; Dieren, E. van; Nowak, Peter

doi:10.1016/s0360-3016(01)02719-5

Cited by 35 publications

(20 citation statements)

References 60 publications

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“…At 3 years, we report LRFS and OS rates of 90% and 64% for stage IÁII tumors, vs. 81% and 57% for stage III ÁIV tumours. These survival rates are comparable with reported data by Levendag et al [8], who used combination of CXRT of 60Á70 Gy and IBT boost of 11 Á18 Gy in their NPC patients. The authors reported 3-year local control and OS rates of 97% and 67%, respectively, for Stage IÁIIB disease without using CHT.…”

Section: Discussionsupporting

confidence: 91%

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Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska University Hospital experience

et al. 2007

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Section: Discussionsupporting

confidence: 91%

“…Locoregional control of NPC has shown to be an independent prognostic indicator of distant metastases [6]. Innovations such as altered fractionation RT and boost treatment of the nasopharynx with intracavitary brachytherapy (IBT) have been among the other attempts aimed to improve local and locoregional tumor control [7,8].…”

mentioning

confidence: 99%

Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska University Hospital experience

et al. 2007

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“…Several retrospective analyses have addressed the role of a brachytherapy boost in nasopharyngeal carcinoma [12][13][14][15][16][17][18]. These studies have looked at brachytherapy as a technique to escalate the dose to the primary tumour and extensions without incurring in unacceptable toxicity to surrounding sensitive organs.…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy Boost in Loco-regionally Advanced Nasopharyngeal Carcinoma: A Prospective Randomized Trial of the International Atomic Energy Agency

Rosenblatt

El-Gantiry²,

Elattar³

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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AbstactBackground: The purpose was to determine whether a brachytherapy boost improves outcomes in patients with advanced nasopharyngeal carcinoma treated with standard chemo-radiotherapy. Methods:Patients with nasopharyngeal carcinoma WHO grades I-III and TNM stages III or non-metastatic stage IV were eligible for this phase III study. Patients were randomized to either arm (A) induction chemotherapy, followed by external beam radiotherapy (EBRT) with concomitant cisplatin (n = 139) or arm (B), the same schedule plus a brachytherapy boost to the nasopharynx (n = 135). The EBRT doses given were 70 Gy to the primary tumour and positive lymph nodes and 46 Gy to the negative neck. The additional brachytherapy boost in arm (B) was given by either low dose-rate (LDR -11 Gy) or high dose-rate (HDR -3 fractions of 3.0 Gy) brachytherapy. The primary endpoint was 3-year overall survival (OS) and secondary endpoints were: local control, regional control, distant metastasis and grade 3-4 adverse events. Results: 274 patients were randomized between September 2004 and December 2008. The two arms were comparable with regard to age, gender, stage and grade. 273 patients completed treatment. Median follow-up was 29 months (0.2-67 months). The effect of treatment arm, country, age, gender, WHO pathology, stage (T3-4, N2-3 versus other) and chemotherapy on overall survival (OS), disease-free survival (DFS) and local recurrence-free survival (LRFS) was studied. Stage significantly affected OS (p = 0.024) and DFS (p = 0.018) while age significantly affected OS (p = 0.014). None of the other factors studied were significant. The 3-year LRFS was 60.5% and 54.4% in arms A and B respectively (p = 0.647). The 3-year regional control rate in the neck was 59.7% and 54.3% respectively (p = 0.7). Distant metastasis developed in 59.7% of patients in arm A and 55.4% in arm B (p = 0.377). Patients with T1/T2 N + had a 3 year LRFS of 51.8% in Arm A (62 patients) versus 57.9% in Arm B (67 patients) (p = 0.343). The grade 3-4 toxicity rate was 21.6% (30/139) and 24.4% (33/135) respectively (p = 0.687).Conclusions: The addition of a brachytherapy boost to external beam radiotherapy and chemotherapy did not improve outcome in loco-regionally advanced nasopharyngeal carcinoma.

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“…Clinical results are summarized in Table 4. 71,72,78,[82][83][84][85][86][87][88][89][90] As can be observed, the outcome of patients treated with brachytherapy appears superior to that of patients treated with EBRT alone without increased toxicity. Of course, the difference may be due to a selection bias as T3 and T4 patients are not candidate to brachytherapy.…”

Section: Brachytherapymentioning

confidence: 90%

Review of photon and proton radiotherapy for skull base tumours

Fossati

Vavassori²,

Deantonio

et al. 2016

Reports of Practical Oncology & Radiotherapy

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a b s t r a c tAn extremely large variety of benign and malignant tumours occur at skull base; these tumour lesions are in the proximity to structures deputed to relevant physiologic functions, limiting extensive surgical approaches to this body district. Most recent progresses of surgery and radiotherapy have allowed to improve local control with acceptable rates of side effects. Various photon radiotherapy techniques are employed, including 3-dimensional conformal radiotherapy, intensity modulated radiotherapy (IMRT), stereotactic radiotherapy (SRT) and brachytherapy that is manly limited to the treatment of primary or recurrent nasopharyngeal carcinoma. Proton beam radiotherapy is also extensively used thanks to its physical characteristics. Our review, focusing in particular on meningioma, chordoma, and chondrosarcoma, suggests that proton therapy plays a major role in the treatment of malignant tumours whereas photon therapy still plays a relevant role in the treatment of benign tumour lesions.

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Role of endocavitary brachytherapy with or without chemotherapy in cancer of the nasopharynx

Cited by 35 publications

References 60 publications

Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska University Hospital experience

Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska University Hospital experience

Brachytherapy Boost in Loco-regionally Advanced Nasopharyngeal Carcinoma: A Prospective Randomized Trial of the International Atomic Energy Agency

Review of photon and proton radiotherapy for skull base tumours

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