Prognostic Analysis Of Intensity-modulated Radiotherapy(IMRT) For Nasopharyngeal Carcinoma In Young Adult Patients

Objective：The aim of this study was to evaluate the treatment outcome and prognosticfactors of young adults with nasopharyngeal carcinoma under intensity-modulatedradiotherapy(IMRT).Methods：One hundred and one nasopharyngeal carcinoma patients of young adults(18~35years) who were treated by IMRT at our institution from January2004toDecember2007were reviewed and analyzed. We analyzed the5-year overall survival (OS), disease-free survival (DFS), local-regional recurrence-free survival (LRRFS),and distant metastasis free survival (DMFS).Results：The median follow-up for all101patients was70.3months (range,7.5–110.5months).The5-year LRRFS, OS, DMFS, and DFS were93.8%,85.0%,79.9%and76.6%, respectively. Multivariate factors analyses revealed that N classification wasthe significant prognosticator for OS (P=0.01), DMFS (P=0.003) and DFS (P=0.001); and pre-treatment VCA/IgA was the independent prognostic factor forOS(P=0.007), LRRFS(P=0.043) and DFS(P=0.028); The prolonged of radiotherapywas the significant prognosticator for DMFS (P=0.008) and DFS (P=0.012); Thepre-treatment level of LDH was only the independent prognostic factor for DFS (P=0.047). Chemotherapy fails to benefit treatment outcome (P>0.05). The most severeacute toxicities included Grades III-IV mucositis in28patients(27.72%), Grade III skindesquamation in6patients(5.94%), and Grades III-IV leucocytopenia in20(19.80%).Conclusion：Intensity-modulated radiotherapy seems to lengthen5-year OS and toachieve a reasonable local-regional control in young adults nasopharyngeal carcinomapatients. N classification was the related prognostic factor influencing the long-termcurative effect of IMRT of the youth with nasopharyngeal carcinoma, and distantmetastasis remained the dominant failure pattern of our series.