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Early clinical outcomes of helical tomotherapy/intensity-modulated proton therapy combination in nasopharynx cancer

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Author(s)
Seung Gyu ParkYong Chan AhnDongryul OhJae Myoung NohSang Gyu JuDongyeol KwonKwanghyun JoKwangzoo ChungEunah ChungWoojin LeeSeyjoon Park
Keimyung Author(s)
Park, Seung Gyu
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Cancer Science
Issued Date
2019
Volume
110
110
Issue
9
Keyword
acute toxicitynasopharyngeal neoplasmsproton therapyradiotherapysurviva
Abstract
This study aimed to evaluate the feasibility of combining helical tomotherapy (HT) and intensity‐modulated proton therapy (IMPT) in treating patients with nasophar‐ ynx cancer (NPC). From January 2016 to March 2018, 98 patients received definitive radiation therapy (RT) with concurrent chemotherapy (CCRT). Using simultaneous in‐ tegrated boost and adaptive re‐plan, 3 different dose levels were prescribed: 68.4 Gy in 30 parts to gross tumor volume (GTV), 60 Gy in 30 parts to high‐risk clinical target volume (CTV), and 36 Gy in 18 parts to low‐risk CTV. In all patients, the initial 18 frac‐tions were delivered by HT, and, after rival plan evaluation on the adaptive re‐plan, the later 12 fractions were delivered either by HT in 63 patients (64.3%, HT only) or IMPT in 35 patients (35.7%, HT/IMPT combination), respectively. Propensity‐score matching was conducted to control differences in patient characteristics. In all pa‐tients, grade ≥ 2 mucositis (69.8% vs 45.7%, P = .019) and grade ≥ 2 analgesic usage (54% vs 37.1%, P = .110) were found to be less frequent in HT/IMPT group. In matched patients, grade ≥ 2 mucositis were still less frequent numerically in HT/IMPT group (62.9% vs 45.7%, P = .150). In univariate analysis, stage IV disease and larger GTV volume were associated with increased grade ≥ 2 mucositis. There was no significant factor in multivariate analysis. With the median 14 month follow‐up, locoregional and distant failures occurred in 9 (9.2%) and 12 (12.2%) patients without difference by RT modality. In conclusion, comparable early oncologic outcomes with more fa vorable acute toxicity profiles were achievable by HT/IMPT combination in treating NPC patients.
Keimyung Author(s)(Kor)
박승규
Publisher
School of Medicine (의과대학)
Citation
Seung Gyu Park et al. (2019). Early clinical outcomes of helical tomotherapy/intensity-modulated proton therapy combination in nasopharynx cancer. Cancer Science, 110(9), 2867–2874. doi: 10.1111/cas.14115
Type
Article
ISSN
1349-7006
Source
https://onlinelibrary.wiley.com/doi/full/10.1111/cas.14115
DOI
10.1111/cas.14115
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42044
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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