TITLE:
Comparative Study between Patients Treated with Conventional Radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report
AUTHORS:
Mamady Keita, Juan Li, Malick Bah, Mamadou Aliou Diallo, Alhassane Ismaël Touré, Abou Camara, Bangaly Traoré, Abdoulaye Keita, Wenbing Shen
KEYWORDS:
Nasopharyngeal Carcinoma, Conventional Radiotherapy, Intensity Modulated Radiotherapy, Chemotherapy, Prognosis
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.14 No.12,
December
26,
2023
ABSTRACT: Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and
radiotherapy alone provides better local control. Objectives: To
evaluate the clinical efficacy and acute and late toxicities of two different
treatment regimens for locally advanced nasopharyngeal carcinoma. Methods:
From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA
nasopharyngeal carcinoma were treated. Of these, 137 received conventional
radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy
plus chemotherapy. Chemotherapy was given either as induction, concurrent or
adjuvant therapy. Survival rates were calculated according to Kaplan Meier and
compared with the Log-rank test. The RTOG or EORTC criteria were used to assess
acute and late toxicities. Results: The median follow-up time was 21.5
months, and the 2-year locoregional relapse-free survival, distant
metastases-free survival, and overall survival rates in the conventional
radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively; in
the intensity-modulated radiotherapy plus chemotherapy group, they were 97%,
84%, and 100%, respectively. The difference in survival between the two groups
was significant (χ2 =
5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after
radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion:
Compared with conventional radiotherapy plus chemotherapy, intensity-modulated
radiotherapy plus chemotherapy offers better locoregional relapse-free survival
and overall survival in patients with stage III and IVA nasopharyngeal
carcinoma, and may significantly reduce the occurrence of radiation-induced
xerostomia.