Hyperfractionated re-irradiation using a 3-dimensional conformal techniquefor locally recurrent carcinoma of the nasopharynx; Preliminary results

To evaluate the efficacy of hyperfractionated re-irradiation using a three- dimensional conformal radiotherapy (3-D CRT) technique in patients with loc ally recurrent carcinoma of the nasopharynx. Four patients with locally rec urrent nasopharyngeal cancer were retreated with a hyperfractionated schedu le using a 3-D CRT technique. Re-irradiation was delivered in 1.1-1.2 Gy fr actions twice per day (BID), with interfraction intervals of more than 6 ho urs. The total dose ranged from 59.4 to 69.2 Gy. A 3-D CRT technique with 5 -or 6-field coplanar and/or non-coplanar beams were employed during the ent ire treatment procedure. All four patients achieved complete remission of l ocally recurrent lesions, with marked improvement of subjective symptoms, i mmediately after re-irradiation. All are alive and well without evidence of disease after limited follow-up periods, which range from 7 to 20 months. So far, there have been no radiation-induced neurologic complications. Four patients with locally recurrent carcinoma of the nasopharynx were successf ully treated by hyperfractionated re-irradiation using a 3-D CRT technique. A relatively high re-irradiation dose of more than 60 Gy may be safely del ivered with no serious acute or late radiation-induced complications in pat ients with local recurrences and who were initially treated with doses grea ter than 70 Gy.