Treatment Results Of Different Radiotherapy For Nasopharyngeal Carcinoma: IMRT Versus Conventional Radiotherapy

Background and Purpose : Intensity-modulated radiotherapy (IMRT) provided excellent tumor target coverage and allowed the delivery of a high dose to the target with significant sparing of the nearby critical normal tissues. It has recently gained popularity in the treatment of nasopharyngeal carcinoma (NPC) and increased the local-regional control rate. This paper was to explored whether IMRT could increase the survival rate while reduced the radiation-related injure for primary NPC patients compared with conventional radiotherapy (CRT).Methods and Materials : From Nov. 2003 to Dec. 2005, 190 patients with histologically proven nasopharyngeal carcinoma treated with IMRT in a single hospital were retrospectively analyzed .Then patients treated with conventional radiotherapy at the same period were matched by prognostic factors respectively. The survival status and treatment-induced toxicity were investigated. Treatment results, the occurrence and severity of adverse reaction were compared.Results : In the treatment of NPC ,IMRT was superior to CRT in term of 4-year overall survival rate(91.7% vs. 83.2%, P=0.039), relapse-free survival rate(86%vs. 81%, P=0.008),and local regional control rate(83%vs. 73%,P=0.007).But there were no significant differences in the 4-year progress-free survival rate (71%vs. 65%, P=0.368) and distant metastasis-free survival rate (90%vs. 84%, P=0.718).A significant reduction of the occurrence rate and severity of acute skin reaction,neck fibrosis,trismus and xerostomia was noted in IMRT arm.But there were no differences in mucositis, hematological toxicity, hearing loss and radiation induced cranial neuropathy between IMRT arm and CRT arm.Conclusin: IMRT technique improve the over-all survival rate while reduced the radiation-related complications in patients with NPC. It should be widely applied.