3D-image-guided HDR-brachytherapy versus 2D HDR - brachytherapy after external beam radiotherapy for early T-stage nasopharyngeal carcinoma

YuFeng F. Ren, QuanCheng C. Zhao, Hui Liu, YingJuan J. Huang, ZhenYu Y. Wang, XinPing P. Cao, Bin S. Teh, BiXiu X. Wen

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Two-dimensional high-dose-rate brachytherapy (2D-HDR-BT) is an effective method of dose escalation for local tumor control in early T-stage nasopharyngeal carcinoma (NPC). Treatment outcomes for 3D-image-guided high-dose-rate brachytherapy (3D-image-guided-HDR-BT) after external beam radiotherapy (ERT) have not been examined in early T-stage NPC patients. The current study was designed to evaluate whether addition of 3D-HDR-BT to ERT showed further improvement in treatment outcomes in patients with early T-stage NPC when compared to 2D-HDR-BT after ERT. Methods: The current study retrospectively analyzed and compared treatment outcomes for patients with nonmetastatic stage T1-2b NPC treated with 2D-HDR-BT (n =101) or 3D-HDR-BT (n =118) after ERT. Patients in both groups were treated with ERT at a mean dose of 60 Gy and a brachytherapy dose of 12Gy (8~20Gy), 2.5~5Gy per fraction under local anesthesia. Results: Compared to patients treated with 2D-HDR-BT after ERT, patients treated with 3D-HDR-BT after ERT showed improvement in five-year actuarial local control survival rates (p=0.024), local/regional relapse-free survival rates (p=0.038), and disease-free survival rates (p=0.021). Multivariate analysis showed that NPC patients treated with 3D-HDR-BT had improved local control survival (p=0.042). The incidence rates of acute or chronic complications were similar between two groups. Conclusions: The current study showed that 3D-image-guided HDR-BT after ERT was an effective treatment modality for patients with stage T1-2 NPC with acceptable complications. The improvement in local tumor control and disease free survival is likely due to improved conformal dose distributions.

Original languageEnglish (US)
Article number894
JournalBMC Cancer
Volume14
Issue number1
DOIs
StatePublished - Nov 29 2014

Keywords

  • 3D-image-guided
  • Brachytherapy
  • Local control
  • Nasopharyngeal carcinoma
  • Radiotherapy

ASJC Scopus subject areas

  • Genetics
  • Oncology
  • Cancer Research

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