Acute and chronic side effects in concurrent chemoradiotherapy using intensity-modulated radiotherapy for stage iib-iii nasopharyngeal cancer patients
Main Article Content
Abstract
We study 45 patients with stage IIB-III nasopharyngeal carcinoma (type 3-WHO) treated in combination weekly cisplatin chemotherapy with Intensity- Modulated Radiotherapy, with or without adjuvant CF chemotherapy at K Hospital. The common complications were reported according to CTCAE 4.0. Results: complete response in tumor was 95.6%, in lymph node was 92.5%; The rate of patients who completed 5-6 cycles of chemoradiotherapy was 24.44% and 53.34%, respectively; the most severe clinical complications that affects the treatment process is grade 3- stomatitis in 27 patients (60%). Chronic complications: grade 1 and 2 chronic dermatitis are 28.9%, 4.4%, respectively; grade 1 chronic oral mucositis was 28 patients (62.2%); grade 2 was 6 patients (13.3%); grade 1 and 2 chronic salivary inflammation were 51.1% and 13.3%, respectively; loss sense of taste level 1 was 46.7%, grade 2 was 8.9%, patients with grade 3 or higher chronic complications have not been detected. The study showed that patient approval rates to the therapy were significantly high compared to the conventional treatment with cisplatin infusion on days 1st, 22nd, 43rd. Acute and chronic complications were remarkably reduced compared to 2D and 3D radiotherapy.
Article Details
Keywords
Nasopharyngeal carcinoma stage IIB-III, weekly chemoradiotherapy, IMRT, acute and chronic complications
References
2. Chen Y, Liu MZ, Liang SB et al, Preliminary results of a randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of China, Int J Radiat Oncol Biol Phys. 2008; 71(5), 1356-1364.
3. AJCC 7th Ed Cancer Staging Manual, American Joint Committee on Cancer, 2010.
4. Al-Sarraf M, Le Blanc M, Giri PGS et al., Chemoradiotherapy versus radiotherapy in patients with advanced naropharyngeal cancer- Phase III randomized Intergroup Study 0099, J Clin Oncol 1998, vol. 16, pp. 1310-1317, 1998.
5. Wee J, Tan EH, Tai BC et al, Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with AJCC/UICC stage III and IV naropharynreal cancer of edemic variety, Journal of Clinical Oncology. 2005; 23, 6730-6738.
6. Lee AVM, Lau WH, Tung SY et al, Prospective randomized study pn therapeutic gain achieved by addition of chemotherapy for T1-4N2-3M0 Naropharyngeal Carcinoma(NPC), Jounal of clinical oncology. 2004; 22, 5506.
7. Kuang W.L, Zhou Q, Shen L.F et al, Outcomes and prognostic factors of conformal radiotherapy versus intensity-modulated radiotherapy for nasopharyngeal carcinoma, Clin Transl Oncol. 2012; 14, 783-790.
8. Ozdemir S, Akin M, Coban Y, Acute Toxicity in Nasopharyngeal Carcinoma Patients Treated with IMRT/VMAT, Asian Pacific Journal of Cancer Prevention. 2015; 16, 1897-1900.
9. Lalya I, Marnouche E.A, Abdelhak M et al, Radiotherapy of nasopharyngeal cancer using Rapidarc: dosimetric study of military teaching hospital Mohamed V, Morocco, BMC Research Notes. 2017; 10, 112.
10. Eisbruch A, Dawson L.A, Kim H.M et al, Salivary Gland Sparing and Improved Target Irradiation by Conformal and Intensity Modulated Irradiation of Head and Neck Cancer, World Journal of Surgery. 2003; 27, 832-837.
11. Yao J.J, Chen F.P, Zhou G.Q et al, A prospective study on radiation doses to organs at risk (OARs) during intensity-modulated radiotherapy for nasopharyngeal carcinoma patients, oncotarget. 2016; 7(16), 21742-21752.
12. Ngô Thanh Tùng, Nghiên cứu đặc điểm lâm sàng, mô bệnh học và kết quả xạ trị ung thư biểu mô vòm họng tại bệnh viện K giai đoạn 1993-1995, Luận văn thạc sỹ y học, 2001.