The Rofe of High Dose Rate(HDR) Intracavitary Radiation Therapy for the Management of Nasopharyngeal Carcinoma

Cho, Jeong Gill; Choi, Eun Kyung; Chang, Hye Sook

Abstract

From September 1989 to June 1992, 22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stage II (T2NO), 4 with stage III(T3NO, T1-3N1), and 16 with stage IV(T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 mouths). Twenty ore patients showed a complete response one month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was 100% in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were 94% and 67%, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.