Awm. Lee et al., RETROSPECTIVE ANALYSIS OF PATIENTS WITH NASOPHARYNGEAL CARCINOMA TREATED DURING 1976-1985 - SURVIVAL AFTER LOCAL RECURRENCE, International journal of radiation oncology, biology, physics, 26(5), 1993, pp. 773-782
Citations number
35
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To study the value of re-irradiation, the overall survival an
d pattern of failures for patients with nasopharyngeal recurrence. Met
hods and Materials: All the 891 patients with local recurrence followi
ng radiotherapy for nasopharyngeal carcinoma during 1976-1981 were ret
rospectively analyzed. Only 70% of them had local failure alone at the
time of detection, and the T-stage distribution (by Ho's system) was
31 % rT1, 16% rT2, 51% rT3, and 1% rT?. Seven hundred and six (79%) pa
tients had been reirradiated with various techniques and doses. Among
those who failed, 50 had further irradiation.Results: The overall 5- a
nd 10-year actuarial cancer-specific survival rates were 14% and 9%, r
espectively. Patients with rT3 disease had the worst prognosis. Succes
sful local salvage was achieved in 32% of those re-irradiated (26% of
the whole series). The highest control rate was achieved by those trea
ted with external radiotherapy to 60 Gy (equivalent) or above. Only 8/
50 patients responded to the third course of radiotherapy. The cumulat
ive incidence of late post-reirradiation sequelae was 24%, and the tre
atment mortality rate 1.8%. Besides local failure, 54% had regional re
lapse and/or distant metastasis. Thus, only 16% of recurrent patients
were totally disease-free at final assessment. Conclusion: The overall
prognosis for patients with nasopharyngeal recurrence was grave. High
dose re-irradiation could achieve successful local salvage in a subst
antial number of patients with early recurrence, but late complication
s did occur. Furthermore, high incidence of failure at other sites was
observed.