Long-term outcome and pattern of failure for patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Head Neck. 2019 May;41(5):1246-1252. doi: 10.1002/hed.25545. Epub 2018 Dec 28.

Abstract

Purpose: To analyze the long-term outcome and pattern of failure for patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT).

Methods and materials: Patients with NPC after IMRT from 2001 to 2008 were recruited (n = 865). Clinical features, laboratory data, and treatments were collected.

Results: The 10-year local recurrence-free survival, distant metastasis-free survival, and disease-specific survival (DSS) were 92.0%, 83.4%, and 78.6%, respectively. A total of 209 patients died: 59% of whom died from distant metastasis. The 10-year DSS was higher in patients who received chemoradiotherapy than those who received IMRT alone for patients with high-risk stage III disease, while there was no survival difference for patients with stage II and low-risk stage III disease.

Conclusions: IMRT provides satisfactory long-term survival for patients with NPC. Distant metastasis has been the most common reason for failure. Adding chemotherapy did not improve survival in patients with stage II and low-risk stage III disease.

Keywords: intensity-modulated radiotherapy; metastasis; nasopharyngeal carcinoma; outcome; prognosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Chemoradiotherapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma / drug therapy
  • Nasopharyngeal Carcinoma / mortality
  • Nasopharyngeal Carcinoma / radiotherapy*
  • Nasopharyngeal Carcinoma / secondary
  • Nasopharyngeal Neoplasms / drug therapy
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Neoplasm Staging
  • Radiotherapy, Intensity-Modulated*
  • Survival Analysis
  • Treatment Failure
  • Treatment Outcome
  • Young Adult