1. Local control in advanced cancer of the nasopharynx: Is a boost dose by endocavitary brachytherapy of prognostic significance?
- Author
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David N. Teguh, Inge Noever, Marjolein H.M. Idzes, Abrahim Al-Mamgani, Inger-Karine K. Kolkman-Deurloo, Maarten A. Wildeman, M. El-Gantiry, Connie de Pan, Eduardo Rosenblatt, Fatma Keskin-Cambay, Peter C. Levendag, and Radiation Oncology more...
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Male ,medicine.medical_treatment ,Brachytherapy ,SDG 3 - Good Health and Well-being ,Nasopharynx ,Prevalence ,medicine ,High doses ,Humans ,Radiology, Nuclear Medicine and imaging ,Head and neck cancer ,Endocavitary ,Netherlands ,Nasopharyngeal cancer ,Prognostic factor ,Radiotherapy ,business.industry ,Nasopharyngeal Neoplasms ,Prognosis ,Tumor control ,medicine.disease ,Advanced cancer ,Treatment Outcome ,Stereotactic radiation ,Oncology ,Radiology Nuclear Medicine and imaging ,Austria ,Concomitant ,Boost irradiation ,Dose Fractionation, Radiation ,Radiotherapy, Conformal ,business ,Nuclear medicine - Abstract
PURPOSE: To analyze whether local tumor control in advanced nasopharyngeal cancer (NPC) can be optimized by boosting the primary dose by endocavitary brachytherapy (EBT). METHODS AND MATERIALS: To study the role of EBT, three data sets on NPC, that is, the ''Vienna'', ''Rotterdam,'' and ''Amsterdam'' series, with a total number of 411 advanced NPC patients, were available. The Rotterdam series consisted of 72 patients (34 T1,2Nþ and 38 T3,4N0,þ) andwere treated withneoadjuvantchemotherapy followedbyexternal beamradiotherapy (dose 70/2 Gy). After 70/2 Gy, a boost was applied by EBT (in case of T1,2Nþ) or stereotactic radi- ation (in case of T3,4 tumors). The Amsterdam (Antoni van Leeuwenhoek Hospital/The Netherlands Cancer Institute) series consisted of 76 patients (40 T1,2Nþand 36 T3,4N0,þ) and were irradiated to a dose of 70/2 Gy with concomitant chemotherapy. No second boost by EBT was applied. RESULTS: In the case of T1,2Nþ tumors, the local relapse rate (LRR) was significantly smaller if a boost was applied, that is, 0% (0/34, EBT boost) vs. 14% (14/102, no EBT boost) (p5 0.023). For the T3,4 tumors, an LRR of 10% (4/38, EBT or stereotactic radiation boost) vs. 15% (17/111, no boost) was found (p 50.463). CONCLUSIONS: In the case of advanced NPC (T1,2Nþ vs. T3,4Nþ,0), for early T-stages (T1,2Nþ), an EBT boost seems an excellent way to deliver highly conformal high doses of radia- tion to the nasopharynx, with high local control rates. For advanced T-stages (T3,4Nþ,0), the reduc- tion in LRR (10% vs. 15%) was not significant (p 50.463). 2013 American Brachytherapy more...
- Published
- 2013
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