Treatment of Locally Advanced Nasopharyngeal Carcinoma by Helical Tomotherapy: An Observational, Prospective Analysis

Zhigang Liu; Chenyang Xu; Rong Jiang; Guiyun Liu; Qiaodan Liu; Jiao Zhou; Fengxin Liu; Jijin Yao; Siyang Wang; Wen Jiang

doi:10.1016/j.tranon.2019.02.011

Treatment of Locally Advanced Nasopharyngeal Carcinoma by Helical Tomotherapy: An Observational, Prospective Analysis

Transl Oncol. 2019 May;12(5):757-763. doi: 10.1016/j.tranon.2019.02.011. Epub 2019 Mar 15.

Authors

Zhigang Liu¹, Chenyang Xu², Rong Jiang², Guiyun Liu², Qiaodan Liu³, Jiao Zhou², Fengxin Liu², Jijin Yao³, Siyang Wang³, Wen Jiang⁴

Affiliations

¹ Department of head and neck oncology, Phase 1 clinical trial ward, The cancer center of the fifth affiliated hospital of Sun Yat-sen University, Zhuhai, 519001, China. Electronic address: zhigangliu1983@hotmail.com.
² Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410000, China; Department of Clinical Medicine, University of South China, Hengyang, 421000, China.
³ Department of head and neck oncology, Phase 1 clinical trial ward, The cancer center of the fifth affiliated hospital of Sun Yat-sen University, Zhuhai, 519001, China.
⁴ Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX.

Abstract

Nasopharyngeal carcinoma (NPC) is endemic in southern China. Due to the unique anatomical and biological properties of NPCs, radiotherapy or combined modality based on radiotherapy is an effective treatment option. Helical tomotherapy (HT) is an emerging intensity modulated radiotherapy technology. The advantages of dose homogeneity, steepness of dose gradient, and protection of normal organs are reflected in the treatment of head and neck cancers. We present the preliminary (2-year) clinical outcomes of HT in 85 patients with locally advanced NPC (LA-NPC). Of these patients, 3 patients (3.5%) experienced treatment interruption due to severe pulmonary infection, and 82 (96.5%) completed radiation treatments. The 2-year estimate of progression-free survival, local relapse-free survival, nodal relapse-free survival, distant metastases-free survival, and overall survival rate were 90%, 96.3%, 98.8%, 96.3%, and 96.3%, respectively. Among the three patients that died, one had stage III disease and died from fatal nasopharyngeal bleeding after radiotherapy, while the other two patients succumbed to local recurrence. Our experience suggests that HT can achieve promising disease control and survival in the treatment of LA-NPC patients with mild acute and late toxicity profiles.