J Cancer 2017; 8(18):3718-3724. doi:10.7150/jca.20351

Research Paper

Survival and Toxicities of IMRT Based on the RTOG Protocols in Patients with Nasopharyngeal Carcinoma from the Endemic Regions of China

Shao-Bo Liang1, 2*, Yan Wang3*, Xue-Feng Hu1, Sha-Sha He2, Xing-Li Yang2, Li-Zhi Liu2, Chun-Yan Cui2, Yong Chen3✉, Li-Wu Fu2✉

1. Department of Radiation Oncology, Cancer Center, First People's Hospital of Foshan Affiliated to Sun Yat-sen University, Foshan 528000, China;
2. Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;
3. Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
* These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Liang SB, Wang Y, Hu XF, He SS, Yang XL, Liu LZ, Cui CY, Chen Y, Fu LW. Survival and Toxicities of IMRT Based on the RTOG Protocols in Patients with Nasopharyngeal Carcinoma from the Endemic Regions of China. J Cancer 2017; 8(18):3718-3724. doi:10.7150/jca.20351. Available from http://www.jcancer.org/v08p3718.htm

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Background: This study evaluated the survival outcomes and toxicities of intensity-modulated radiation therapy (IMRT) based on the RTOG 0225/0615 RT protocols in patients with nasopharyngeal carcinoma (NPC) from a region of China where this tumor type is endemic.

Methods: A total of 455 patients with non-metastatic, histologically-confirmed NPC were retrospectively reviewed. All patients were treated by IMRT using the RTOG 0225/0615 RT protocols; 91.1% (288/316) of patients with stage III-IVb NPC received concurrent chemotherapy +/- induction chemotherapy or adjuvant chemotherapy.

Results: Estimated four-year overall survival (OS), failure free survival (FFS), local relapse free survival (LRFS), regional relapse free survival (RRFS) and distant metastasis free survival (DMFS) were 83.8%, 80.5%, 94.3%, 96.7% and 85.8%, respectively. T and N category were significant prognostic factors for OS, FFS, RRFS and DMFS; and T category, for LRFS. In-field failure was the major loco-regional failure pattern. During RT, 206 (45.3%) patients experienced acute grade 3-4 toxicities. The most common acute toxicity was mucositis; 124 (27.2%) patients experienced grade 3-4 mucositis; 46 (10.1%) experienced serious late toxicities. The most common late toxicity was MRI-detected radiation-induced temporal lobe necrosis (6.8%).

Conclusions: The RTOG IMRT protocols are feasible for patients with NPC from the endemic regions of China.

Keywords: Nasopharyngeal carcinoma, intensity-modulated radiotherapy, RTOG 0225, RTOG 0615.