Radiat Oncol J.
2024 Mar;42(1):74-82. 10.3857/roj.2023.00374.
Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy
- Uchinami Y1
- Yasuda K
2 - Minatogawa H3
- Dekura Y4
- Nishikawa N2
- Kinoshita R2
- Nishioka K5
- Katoh N1
- Mori T2
- Otsuka M1,3
- Miyamoto N6,7
- Suzuki R6
- Kobashi K5
- Shimizu Y8
- Taguchi J8
- Tsushima N9
- Kano S9
- Homma A9
- Aoyama H1
- Affiliations
-
- 1Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- 2Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
- 3Department of Radiation Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
- 4Department of Radiation Oncology, Kin-ikyo Chuo Hospital, Sapporo, Japan
- 5Global Center for Biomedical Science and Engineering, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- 6Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
- 7Division of Applied Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Sapporo, Japan
- 8Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- 9Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- KMID: 2553866
- DOI: http://doi.org/10.3857/roj.2023.00374
Abstract
- Purpose
To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT).
Materials and Methods
Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival.
Results
The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541).
Conclusion
Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.
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