Dose volume effects of re-irradiation for locally recurrent nasopharyngeal carcinoma.

Ng, Wai-Tong; Lee, Michael Ch; Fung, Nelson Tc; Wong, Edwin Cy; Cheung, Alice Kw; Chow, James Ch; Au, Kwok-Hung; Poon, Darren Mc et al. · Head Neck · 2020

retrospective_cohort · Level III

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Abstract

This study analyzed the dose volume effects of re-irradiation for locally recurrent nasopharyngeal carcinoma (NPC) and attempts to determine the optimal dose for the best survival. Ninety-one patients were studied. The local control, fatal complication, and overall survival were analyzed against the dose (in Equivalent Dose at 2 Gy/fractions) and recurrent gross tumor volume (GTV). The local control and fatal complication rate appear to increase with prescribed dose. The overall survival peaks at around 60 Gy<sub>10</sub> . Local control decreases significantly with increasing GTV (P < .001) while overall survival shows similar trend (P = .06). No correlation was observed between the fatal complication rate and GTV volume. The dose response of local control appears to be stronger for smaller tumors. GTV volume plays a significant role in local control. A 60 Gy<sub>10</sub> appears to be optimal for the best survival outcome; higher doses might be considered for small tumors.

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