Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2013

Open Access 01-12-2013 | Research

3D-image-guided high-dose-rate intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma

Authors: Yu Feng Ren, Xin Ping Cao, Jia Xu, Wei Jun Ye, Yuan Hong Gao, Bin S Teh, Bi Xiu Wen

Published in: Radiation Oncology | Issue 1/2013

Login to get access

Abstract

Background

To evaluate the therapeutic benefit of 3D-image-guided high-dose-rate intracavitary brachytherapy (3D-image-guided HDR-BT) used as a salvage treatment of intensity modulated radiation therapy (IMRT) in patients with locally persistent nasopharyngeal carcinoma (NPC).

Methods

Thirty-two patients with locally persistent NPC after full dose of IMRT were evaluated retrospectively. 3D-image-guided HDR-BT treatment plan was performed on a 3D treatment planning system (PLATO BPS 14.2). The median dose of 16 Gy was delivered to the 100% isodose line of the Gross Tumor Volume.

Results

The whole procedure was well tolerated under local anesthesia. The actuarial 5-y local control rate for 3D-image-guided HDR-BT was 93.8%, patients with early-T stage at initial diagnosis had 100% local control rate. The 5-y actuarial progression-free survival and distant metastasis-free survival rate were 78.1%, 87.5%. One patient developed and died of lung metastases. The 5-y actuarial overall survival rate was 96.9%.

Conclusions

Our results showed that 3D-image-guided HDR-BT would provide excellent local control as a salvage therapeutic modality to IMRT for patients with locally persistent disease at initial diagnosis of early-T stage NPC.
Appendix
Available only for authorised users
Literature
1.
Lee N, Harris J, Garden AS, Straube W, Glisson B, Xia P, et al.: Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol 2009,27(22):3684-3690. 10.1200/JCO.2008.19.9109CrossRefPubMedPubMedCentral
2.
Kwong DL, Pow EH, Sham JS, McMillan AS, Leung LH, Leung WK, et al.: Intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: a prospective study on disease control and preservation of salivary function. Cancer 2004,101(7):1584-1593. 10.1002/cncr.20552CrossRefPubMed
3.
Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, et al.: Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 2002,53(1):12-22. 10.1016/S0360-3016(02)02724-4CrossRefPubMed
4.
Kam MK, Teo PM, Chau RM, Cheung KY, Choi PH, Kwan WH, et al.: Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys 2004,60(5):1440-1450. 10.1016/j.ijrobp.2004.05.022CrossRefPubMed
5.
Leung TW, Tung SY, Sze WK, Sze WM, Wong VY OSK: Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2000,47(2):405-412. 10.1016/S0360-3016(00)00463-6CrossRefPubMed
6.
Zhang Y, Lin ZA, Pan JJ, Zheng Z, Yang L, Lin SJ, et al.: Concurrent control study of different radiotherapy for primary nasopharyngeal carcinoma: intensity-modulated radiotherapy versus conventional radiotherapy. Chin J Cancer 2009,28(11):1143-1148. 10.5732/cjc.009.10427CrossRef
7.
Kwong DL, Nicholls J, Wei WI, Chua DT, Sham JS, Yuen PW, et al.: The time course of histologic remission after treatment of patients with nasopharyngeal carcinoma. Cancer 1999,85(7):1446-1453. 10.1002/(SICI)1097-0142(19990401)85:7<1446::AID-CNCR4>3.0.CO;2-3CrossRefPubMed
8.
Yan JH, Xu GZ, Hu YH, Li SY, Lie YZ, Qin DX, et al.: Management of local residual primary lesion of nasopharyngeal carcinoma: II. Results of prospective randomized trial on booster dose. Int J Radiat Oncol Biol Phys 1990,18(2):295-298. 10.1016/0360-3016(90)90092-XCrossRefPubMed
9.
Sze WM LAYT: The prognostic value of endoscopic findings after radical radiotherapy for nasopharyngeal carcinoma. Singapore: Proc UICC Workshop on Nasopharyngeal Cancer; 1998:239.
10.
Yu KH, Leung SF, Tung SY, Zee B, Chua DT, Sze WM, et al.: Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck 2005,27(5):397-405. 10.1002/hed.20161CrossRefPubMed
11.
Yi JL, Gao L, Huang XD, Li SY, Luo JW, Cai WM, et al.: Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution. Int J Radiat Oncol Biol Phys 2006,65(1):161-168. 10.1016/j.ijrobp.2005.12.003CrossRefPubMed
12.
Yeo R, Fong KW, Hee SW, Chua ET, Tan T, Wee J: Brachytherapy boost for T1/T2 nasopharyngeal carcinoma. Head Neck 2009,31(12):1610-1618. 10.1002/hed.21130CrossRefPubMed
13.
Yan JH, Qin DX, Hu YH, Cai WM, Xu GZ, Wu XL, et al.: Management of local residual primary lesion of nasopharyngeal carcinoma (NPC): are higher doses beneficial? Int J Radiat Oncol Biol Phys 1989,16(6):1465-1469. 10.1016/0360-3016(89)90950-4CrossRefPubMed
14.
Chen MY, Guo X, Wen WP, Hua YJ, Guo L, Li NW, et al.: Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma. Ai Zheng 2007,26(7):673-678.PubMed
15.
Wu SX, Chua DT, Deng ML, Zhao C, Li FY, Sham JS, et al.: Outcome of fractionated stereotactic radiotherapy for 90 patients with locally persistent and recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2007,69(3):761-769. 10.1016/j.ijrobp.2007.03.037CrossRefPubMed
16.
Chua DT, Sham JS, Kwong PW, Hung KN, Leung LH: Linear accelerator-based stereotactic radiosurgery for limited, locally persistent, and recurrent nasopharyngeal carcinoma: efficacy and complications. Int J Radiat Oncol Biol Phys 2003,56(1):177-183. 10.1016/S0360-3016(03)00074-9CrossRefPubMed
17.
Zheng XK, Chen LH, Chen YQ, Deng XG: Three-dimensional conformal radiotherapy versus intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2004,60(1):165-170. 10.1016/j.ijrobp.2004.02.059CrossRefPubMed
18.
Milickovic N, Baltast D, Giannouli S, Lahanas M, Zamboglou N: CT imaging based digitally reconstructed radiographs and their application in brachytherapy. Phys Med Biol 2000,45(10):2787-2800. 10.1088/0031-9155/45/10/305CrossRefPubMed
19.
Wang ZY, Li SX: A 3D brachytherapy treatment planning system. Zhongguo Yi Liao Qi Xie Za Zhi 2000,24(5):254-259.PubMed
20.
Xiang H, Zhuang TG: CT/MRI-based software for 3-D brachytherapy planning system. Zhongguo Yi Liao Qi Xie Za Zhi 2002,26(6):398-401.PubMed
21.
Kolotas C, Baltas D, Zamboglou N: CT-Based interstitial HDR brachytherapy. Strahlenther Onkol 1999,175(9):419-427. 10.1007/s000660050031CrossRefPubMed
22.
Peiffert D: What is new in brachytherapy? Bull Cancer 2006,93(1):125-132.PubMed
23.
Charra-Brunaud C, Peiffert D: Preliminary results of a French prospective-multicentric study of 3D pulsed dose-rate brachytherapy for cervix carcinoma. Cancer Radiother 2008,12(6–7):527-531.CrossRefPubMed
24.
Dolezel M, Vanasek J, Odrazka K, Tichy M: The progress in the treatment of cervical cancer--3D brachytherapy CT/MR-based planning. Ceska Gynekol 2008,73(3):144-149.PubMed
25.
Das RK, Patel R, Shah H, Odau H, Kuske RR: 3D CT-based high-dose-rate breast brachytherapy implants: treatment planning and quality assurance. Int J Radiat Oncol Biol Phys 2004,59(4):1224-1228. 10.1016/j.ijrobp.2004.03.030CrossRefPubMed
26.
Martin T, Roddiger S, Kurek R, Dannenberg T, Eckart O, Kolotas C, et al.: 3D conformal HDR brachytherapy and external beam irradiation combined with temporary androgen deprivation in the treatment of localized prostate cancer. Radiother Oncol 2004,71(1):35-41. 10.1016/j.radonc.2003.10.004CrossRefPubMed
27.
Hermesse J, Biver S, Jansen N, Lenaerts E, Nickers P: Dosimetric comparison of high-dose-rate brachytherapy and intensity-modulated radiation therapy as a boost to the prostate. Int J Radiat Oncol Biol Phys 2010,76(1):269-276. 10.1016/j.ijrobp.2009.05.046CrossRefPubMed
28.
Feuvret L, Noel G, Mazeron JJ, Bey P: Conformity index: a review. Int J Radiat Oncol Biol Phys 2006,64(2):333-342. 10.1016/j.ijrobp.2005.09.028CrossRefPubMed
29.
Miller AB, Hoogstraten B, Staquet M, Winkler A: Reporting results of cancer treatment. Cancer 1981,47(1):207-214. 10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6CrossRefPubMed
30.
Cox JD, Stetz J, Pajak TF: Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995,31(5):1341-1346. 10.1016/0360-3016(95)00060-CCrossRefPubMed
31.
Kaplan ELMP: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958, 53: 457-481. 10.1080/01621459.1958.10501452CrossRef
32.
Leibel SA, Scott CB, Mohiuddin M, Marcial VA, Coia LR, Davis LW, et al.: The effect of local-regional control on distant metastatic dissemination in carcinoma of the head and neck: results of an analysis from the RTOG head and neck database. Int J Radiat Oncol Biol Phys 1991,21(3):549-556. 10.1016/0360-3016(91)90669-UCrossRefPubMed
33.
Chang JT, Chan SC, Yen TC, Liao CT, Lin CY, Lin KJ, et al.: Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys 2005,62(2):501-507. 10.1016/j.ijrobp.2004.09.057CrossRefPubMed
34.
Levendag PC, Lagerwaard FJ, De Pan C, Noever I, Van Nimwegen A, Wijers O, et al.: High-dose, high-precision treatment options for boosting cancer of the nasopharynx. Radiother Oncol 2002,63(1):67-74. 10.1016/S0167-8140(02)00008-7CrossRefPubMed
35.
Withers HR, Taylor JM, Maciejewski B: The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 1988,27(2):131-146. 10.3109/02841868809090333CrossRefPubMed
Metadata
Title
3D-image-guided high-dose-rate intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma
Authors
Yu Feng Ren
Xin Ping Cao
Jia Xu
Wei Jun Ye
Yuan Hong Gao
Bin S Teh
Bi Xiu Wen
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2013
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-8-165

Other articles of this Issue 1/2013

Radiation Oncology 1/2013 Go to the issue

Research

Changes in the micromorphology of the corneal subbasal nerve plexus in patients after plaque brachytherapy

Research

Advanced nasopharyngeal carcinoma radiotherapy with volumetric modulated arcs and the potential role of flattening filter-free beams

Research

A prostate-specific antigen doubling time of <6 months is prognostic for metastasis and prostate cancer-specific death for patients receiving salvage radiation therapy post radical prostatectomy

Research

Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety

Study protocol

Hypofractionated stereotactic radiation therapy for recurrent glioblastoma: single institutional experience

Research

Long-term effects on carotid intima-media thickness after radiotherapy in patients with nasopharyngeal carcinoma