Preliminary Results Of Intensity Modulated Radiotherapy (IMRT) Combined With Chemotherapy In The Treatment Of Nasopharyngeal Carcinomas

Purpose The aim of this study was to determine the efficacy and side-effects of intensity-modulated radiotherapy (IMRT) combined with chemotherapy in the treatment of patients with nasopharyngeal carcinomas(NPC).Methods and materials A retrospective study was conducted on 45 histologically-proven, non-metastatic NPC patients who were treated with IMRT between 2007 and 2009. MRI of the head and neck was performed on all patients except those contraindicated to MRI examinations. All plans had target volumes at three dose levels, with a prescribed dose of 6976-7412cGy to the gross disease, in 2.18 Gy/fraction over 32-34 fractions. Three cycles of concurrent cisplatin-based chemotherapy was offered to Stage III/IV patients, followed by adjuvant cisplatin plus 5-fluorouracil chemotherapy.Results Median patient age was 57 years, and 80% of them were male. Median follow-up time was 13 months. Thirty-three patients (74%) had Stage III/IV disease. During follow-up, one (2.2%) had local recurrence, and two (4.4%) developed bone metastases. of whom one died. No treatment-related death occurred. The estimated one year local recurrence-free, distant relapse-free and overall survival were 97.8%,95.5% and 97.8%, respectively. During concurrent chemoradiation, the most common toxicities were grade 2 or 3 gastrointestinal reactions and mucositis. Grade 4 bone marrow suppression occurred in 2 patients receiving concurrent chemoradiation. Grade 2 xerostoma was the most common late complication.Conclusions Using SIB-IMRT and concurrent chemotherapy, we achieved comparable results in the treatment of nasopharygeal carcinomas as compared to those reported by other centers. Both acute and late toxicities were well tolerated.