NDLI: Critical analysis of locoregional failures following intensity-modulated radiotherapy for nasopharyngeal carcinoma.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Orlandi, Ester Tomatis, Stefano Potepan, Paolo Bossi, Paolo Mongioj, Valeria Carrara, Mauro Palazzi, Mauro Franceschini, Marzia Bergamini, Cristiana Locati, Laura Iannacone, Eva Guzzo, Marco Ibba, Tullio Crippa, Flavio Licitra, Lisa Pignoli, Emanuele Fallai, Carlo
Description	Country affiliation: Italy Author Affiliation: Orlandi E ( Radiotherapy 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy. ester.orlandi@istitutotumori.mi.it)
Abstract	AIM: To analyze the patterns of locoregional failure following intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) at our institution, as part of an internal quality assurance program. We aimed to investigate the potential existence of a correlation between any part of the IMRT process and clinical outcome. METHODS & MATERIALS: A total of 106 non-metastatic NPC patients consecutively treated with IMRT (with or without chemotherapy) were analyzed. Radiotherapy was administered using a sequential or simultaneous integrated boost approach at the total prescribed dose of 66-70 Gy (2.00-2.12 Gy per fraction). MRI studies of recurrences were recorded with the planning computed tomography studies to identify volume of failure. Recurrence-related characteristics were analyzed with respect to the original treatment. Failures were classified as 'in-field', 'marginal' or 'out-field' if at least 95, 20-95 or less than 20% of the volume of failure, respectively, was within 95% of the total prescription dose. RESULTS: With a median follow-up of 43.4 months, 5-years local control, regional control, locoregional control and overall survival rates were 87.7, 88.0, 83.5 and 81.3% respectively. A total of 21 failures were registered in 15 patients. In particular, ten failures (47.6%) were classified as 'in-field' (seven local failures and three regional failures [RFs]), nine failures (42.9%) as 'marginal' (five local failures and four RFs) and only two failures (9.5%) as 'out-field' (both RFs). The most relevant causes of failures were suboptimal target definition and target coverage as well as a longer than planned overall treatment time. CONCLUSION: IMRT determines excellent outcome in NPC patients. However, great attention in all IMRT steps is necessary to reduce potential causes of failure.
File Format	HTM / HTML
ISSN	14796694
Issue Number	1
Volume Number	9
e-ISSN	17448301
Journal	Future Oncology
Language	English
Publisher	Future Medicine Ltd.
Publisher Date	2013-01-01
Publisher Place	Great Britain (UK)
Access Restriction	Subscribed
Subject Keyword	Discipline Oncology Nasopharyngeal Neoplasms Radiotherapy Radiotherapy, Intensity-modulated Adult Aged Aged, 80 And Over Female Follow-up Studies Humans Magnetic Resonance Imaging Male Middle Aged Diagnosis Mortality Neoplasm Staging Radiotherapy Planning, Computer-assisted Recurrence Treatment Failure Young Adult Journal Article
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology

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