J Cancer 2017; 8(11):2104-2113. doi:10.7150/jca.19078

Research Paper

CT-guided 125I brachytherapy for locally recurrent nasopharyngeal carcinoma

Huzheng Yan#, Zhiqiang Mo#, Zhanwang Xiang#, Dailin Rong#, Yanlin Zhang, Guanyu Chen, Zhihui Zhong, Fujun Zhang, Fei Gao

Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China. ADD: 651 Dongfeng Road, East, Guangzhou, China.
#These authors contributed equally to this work.

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Yan H, Mo Z, Xiang Z, Rong D, Zhang Y, Chen G, Zhong Z, Zhang F, Gao F. CT-guided 125I brachytherapy for locally recurrent nasopharyngeal carcinoma. J Cancer 2017; 8(11):2104-2113. doi:10.7150/jca.19078. Available from http://www.jcancer.org/v08p2104.htm

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Purpose: The study evaluated the feasibility, clinical effectiveness, and quality of life of computed tomography (CT)-guided 125I brachytherapy for locally recurrent nasopharyngeal carcinoma (NPC).

Methods: We recruited 81 patients diagnosed with locally recurrent NPC after previous radiotherapy with or without chemotherapy. Thirty-nine patients received 125I brachytherapy (group A) and 42 received re-irradiation (IMRT, group B). The evaluated outcomes were local control, complications, and quality of life. Cox proportional hazards regression analysis was used to compare local tumor progression-free survival (LTPFS) and overall survival (OS) in the two treatment groups.

Results: The median follow-up was 30 months (range, 5-68 months), median LTPFS was 21 in group A and 17 months in group B. The 1-, 2-, and 3-year OS in group A were 84.6%, 51.3%, 30.7%, and 85.7%, 50.0%, and 32.6% in group B. In group A, 10/39 patients (25.6%) experienced at least one ≥grade III complication; no grade V complications occurred. In group B, 28/42 (66.7%) experienced at least one ≥grade III complication and 6/42 (14.3%) died of severe grade V complications. No significant between-group difference existed in the Quality of Life score on the EORTC QLQ-H&N35 questionnaire before treatment. In group A, quality of life was significantly improved after treatment; but did not improve, or even deteriorated in group B.

Conclusions: 125I brachytherapy was a feasible, safe, and effective treatment for locally recurrent NPC. 125I brachytherapy significantly reduced complications caused by re-irradiation and improved patients' quality of life.

Keywords: 125I brachytherapy, 125I seeds, recurrent nasopharyngeal carcinoma, quality of life, complications, local control