Preliminary Report Of Late Course Accelerated Hyperfractionated Radiotherapy For Advanced Nasopharyngeal Carcinoma

Purpose: To study the immediate response and radio toxicity of late course accelerated hyperfractionated radiotherapy for advanced nasopharyngeal carcinoma. Material and methods: From June 2001 to December 2002,60 patients with advanced nasopharyngeal carcinoma,43 male and 17 female , were randomized into conventional fractionation(CF) and late course accelerated hyperfractionated radiotherapy(LCAF) groups. Thirty-one patients in conventional fractionation (CF) group received conventional radiotherapy: 200cGy/f, 5 fractions a week, to total dose of 6500-7500cGy in 45-55days. Twenty-nigh patients in late course accelerated hyperfractionated (LCAF) group were treated with the same fractionation as conventional fractionation (CF) group until the dose of 3600cGy, and then followed by late course accelerated hyperfractionated radiotherapy: 120-130cGy/f, twice daily with 6-8 hour interval between the two fractions, to the total dose of 6500-7500cGy in 41-47days. The patiens who are loco-reginal advanced (stage T3 and T4) and/or cervical lymph node metastasis advanced (stage N2 and N3) were treated by chemotherapy 1-2cycles before radiotherapy. The cervix of the patients who is without cervical lymph node involved were prophylactic irradiation, to the total dose of 5500-6000cGy in 5.5-6.0 weeks. Results: The complete response rate was 79.31% in the late course accelerated hyperfractionated (LCAF) group and 54.84% in the conventionalfractionation (CF) group after 2-3 months of radiotherapy. The difference is significant between two groups, but without finding any significant difference in acute radio toxicity. 3 patients in LCAF group had distant metastasis and 2 patients had distant metastasis and 2 patients had local recurrence in CF group. Conclusion: The local control of nasopharyngeal carcinoma treated by late course accelerated hyperfractionated (LCAF) radiotherapy is superior to conventional fractionation (CF). Late course accelerated hyperfractionated (LCAF) radiotherapy is well tolerated and not increase the radio toxicity. Whether LCAF improve the long-term survival rates of nasopharyngeal carcinoma with radiotherapy, further investigation is necessary.