Volume 80, Issue 3 , Pages 661-668, 1 July 2011
How Does Intensity-Modulated Radiotherapy Versus Conventional Two-Dimensional Radiotherapy Influence the Treatment Results in Nasopharyngeal Carcinoma Patients?
Purpose
To compare the results of intensity-modulated radiotherapy (IMRT) with those of two-dimensional conventional radiotherapy (2D-CRT) in the treatment of patients with nasopharyngeal carcinoma (NPC).
Methods and Materials
A retrospective review of data from 1,276 patients with biopsy-proven, nonmetastatic NPC was performed. All patients had undergone magnetic resonance imaging and were staged according to the sixth edition of the American Joint Committee on Cancer staging criteria. Radiotherapy was the primary treatment for all patients.
Results
Of the 1,276 patients, 512 were treated with IMRT and 764 with 2D-CRT. The 5-year actuarial local relapse-free survival (LRFS), the nodal relapse-free survival (NRFS), the distant metastasis-free survival (DMFS), and the disease-free survival (DFS) rates were 92.7%, 97.0%, 84.0%, and 75.9%, respectively, for the IMRT group, and 86.8%, 95.5%, 82.6%, and 71.4%, respectively, for the 2D-CRT group. In stage T1 patients, improvement of LRFS in the IMRT group was even significantly higher than in the 2D-CRT group (100% vs. 94.4%; p = 0.016). A trend of improvement of DFS was observed in the IMRT group compared with the 2D-CRT group but without reaching statistical significance. NRFS and DMFS rates were similar in the two groups.
Conclusions
A greater improvement of treatment results with IMRT than with 2D-CRT was demonstrated primarily by achieving a higher local tumor control rate in NPC patients, especially in the early T stage patients. The goal of better control of both local failure in advanced, nonmetastatic NPC patients and of distant failure should be addressed in future studies.
Nasopharyngeal carcinoma, Intensity-modulated radiotherapy, Conventional two-dimensional radiotherapy, Treatment result, Radiotherapy
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Shu-Zhen Lai and Wen-Fei Li contributed equally to this work.
This work was supported by grants from the Science Foundation of Key Hospital Clinical Program of Ministry of Health, P.R. China (no. 2007-353), the Hi-Tech Research and Development Program of China (no. 2006AA02AA404), the International Cooperation Foundation of Guangdong Science and Technology Department of China (no. 2008B050100039), and the Specialized Research Fund for the Doctoral Program of Higher Education of China (no. 20090171110077).
Conflicts of interest: none.
PII: S0360-3016(10)00459-1
doi:10.1016/j.ijrobp.2010.03.024
© 2011 Elsevier Inc. All rights reserved.
Volume 80, Issue 3 , Pages 661-668, 1 July 2011
