The results of nasopharyngeal cancer patients treated by simultaneous integrated boost technique and concomitant chemotherapy

Authors: MEHMET FAİK ÇETİNDAĞ, ATİYE YILMAZ ÖZSAVRAN, BÜLENT YALÇIN, İCLAL ÇETİNDAĞ, ŞEYDA TÜRKÖLMEZ, KARABEKİR ERCAN, DİNÇER YEĞEN

Abstract: Background/aim: To assess the efficacy and side effects of concurrent weekly chemotherapy and radiotherapy with simultaneous integrated boost (SIB) technique for nasopharyngeal cancer (NPC). Materials and methods: A total of 51 consecutive patients with diagnosis of NPC were treated between February 2010 and December 2015. The median dose for PTV70 (range: 60-82) was given in 33 fractions (range: 31-35). Forty-five of the patients received concomitant weekly chemotherapy between 3-7 cycles (median 6). Eleven patients received neoadjuvant and thirty-nine patients received adjuvant chemotherapy. Results: At a median follow-up 43 months (range: 2-76) the estimated 5-year overall survival and disease-free survival were 74.6% and 62.6%, respectively. Conclusion: In radiotherapy of advanced NPC, generally a considerable amount of normal head and neck tissues might have to be irradiated in addition to gross tumor volume, involved node, and elective neck irradiation. Together with chemoradiotherapy, poor oral hygiene and inadequate nutritional support result in excessive morbidity. Despite loco-regional success of concurrent chemoradiotherapy, distant metastasis is still the major pattern of treatment failure in the intensity modulated radiotherapy era. We need to improve our adjuvant chemotherapy regimens or develop new drugs.

Keywords: Nasopharyngeal carcinoma, helical tomotherapy, concomitant weekly chemotherapy

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