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Japanese Journal of Clinical Oncology Advance Access published online on October 19, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp136
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© The Author (2009). Published by Oxford University Press. All rights reserved

A Two-step Intensity-modulated Radiation Therapy Method for Nasopharyngeal Cancer: The Kinki University Experience

Yasumasa Nishimura1, Toru Shibata1, Kiyoshi Nakamatsu1, Shuichi Kanamori1, Ryuta Koike1, Mitsuru Okubo1, Tatsuyuki Nishikawa1, Izumi Tachibana1, Masaya Tamura1 and Masahiko Okumura2

1 Department of Radiation Oncology, Kinki University School of Medicine
2 Department of Central Radiological Service, Kinki University School of Medicine, Osaka, Japan

For reprints and all correspondence: Yasumasa Nishimura, Department of Radiation Oncology, Kinki University School of Medicine, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan. E-mail: ynishi{at}med.kindai.ac.jp

Received July 29, 2009; accepted September 14, 2009

Objective: The aim of this study was to analyze the clinical results of our adaptive radiation therapy scheme of a two-step intensity-modulated radiotherapy (IMRT) method for nasopharyngeal cancer (NPC) at Kinki University Hospital.

Methods: Between 2000 and 2007, 35 patients with Stage I–IVB NPC treated by IMRT were included. For all patients, treatment-planning computed tomography was done twice before and during IMRT to a total dose of 60–70 Gy/28–35 fractions (median 68 Gy). Chemotherapy (cisplatin 80 mg/m2/3 weeks x 1–3 courses) was given concurrently with IMRT for 31 patients.

Results: The 3- and 5-year overall survival rates for the 31 patients treated with concurrent chemotherapy were 88% and 83%, respectively. The 3- and 5-year loco-regional control rates for the 31 patients were 93% and 87%, respectively. Planning target volume delineation for the primary site or involved nodes was insufficient for three early cases, resulting in marginal recurrence in the three patients (9%). Except for one patient with early death, xerostomia scores at 1–2 years were: Grade 0, 11; Grade 1, 17; Grade 2, 5; Grade 3, 1.

Conclusions: Excellent overall survival and loco-regional control rates were obtained by a two-step IMRT method with concurrent chemotherapy for NPC, although marginal recurrence was noted in some early cases.

Key Words: intensity-modulated radiotherapy • nasopharyngeal cancer • radiation therapy


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