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Proton pencil-beam scanning radiotherapy in the treatment of nasopharyngeal cancer: dosimetric parameters and 2-year results
K. Jiří, V. Vladimír, A. Michal, N. Matěj, S. Silvia, V. Pavel, D. Kateřina, P. Jana, O. Barbora, R. Eliška, L. Petr, P. Matěj, G. Alexander, R. Jozef
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články
Grantová podpora
CZ.02.1.01/0.0/0.0/16_019/0000766
European Regional Development Fund
- MeSH
- celková dávka radioterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory nosohltanu * radioterapie MeSH
- následné studie MeSH
- nasofaryngeální karcinom radioterapie MeSH
- protonová terapie * škodlivé účinky MeSH
- protony MeSH
- radioterapie s modulovanou intenzitou škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Patients with nasopharyngeal cancer are candidates for proton radiotherapy due to large and comprehensive target volumes, and the necessity for sparing of healthy tissues. The aim of this work is to evaluate treatment outcome and toxicity profile of patients treated with proton pencil-beam scanning radiotherapy. MATERIALS AND METHODS: Between Jan 2013 and June 2018, 40 patients were treated for nasopharyngeal cancer (NPC) with IMPT (proton radiotherapy with modulated intensity). Median age was 47 years and the majority of patients had locally advanced tumors (stage 2-8 patients. (20%); stage 3-18 patients (45%); stage 4A-10 patients. (25%); stage 4B-4 patients. (10%). Median of total dose was 74 GyE (70-76 GyE) in 37 fractions (35-38). Bilateral neck irradiation was used in all cases. Concomitant chemotherapy was applied in 34 cases. (85%). Median follow-up time was 24 (1.5-62) months. RESULTS: Two-year overall survival (OS), disease-free survival (DFS), and local control (LC) were 80%, 75%, and 84%, respectively. Acute toxicity was generally mild despite large target volumes and concurrent application of chemotherapy with skin toxicity and dysphagia reported as the most frequent acute side effects. The insertion of a percutaneous endoscopic gastrectomy (PEG) was necessary in four cases (10%). Serious late toxicity (G > 3. RTOG) was observed in two patients (5%) (dysphagia and brain necrosis). CONCLUSION: IMPT for nasopharyngeal cancer patients is feasible with mild acute toxicity. Treatment outcomes are promising despite the high percentage of advanced disease in this group.
Citace poskytuje Crossref.org
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- $a Kubeš, Jiří $u Proton Therapy Center Czech, Budínova 1a, 18000, Prague 8, Czech Republic ; Department of Oncology, 1st Faculty of Medicine, General University Hospital, Charles University, Kateřinská, 32 121 08, Praha 2, Czech Republic ; Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Kateřinská, 32 121 08, Praha 2, Czech Republic ; Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University, Sítná square 3105, 272 01, Kladno, Czech Republic
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- $a OBJECTIVES: Patients with nasopharyngeal cancer are candidates for proton radiotherapy due to large and comprehensive target volumes, and the necessity for sparing of healthy tissues. The aim of this work is to evaluate treatment outcome and toxicity profile of patients treated with proton pencil-beam scanning radiotherapy. MATERIALS AND METHODS: Between Jan 2013 and June 2018, 40 patients were treated for nasopharyngeal cancer (NPC) with IMPT (proton radiotherapy with modulated intensity). Median age was 47 years and the majority of patients had locally advanced tumors (stage 2-8 patients. (20%); stage 3-18 patients (45%); stage 4A-10 patients. (25%); stage 4B-4 patients. (10%). Median of total dose was 74 GyE (70-76 GyE) in 37 fractions (35-38). Bilateral neck irradiation was used in all cases. Concomitant chemotherapy was applied in 34 cases. (85%). Median follow-up time was 24 (1.5-62) months. RESULTS: Two-year overall survival (OS), disease-free survival (DFS), and local control (LC) were 80%, 75%, and 84%, respectively. Acute toxicity was generally mild despite large target volumes and concurrent application of chemotherapy with skin toxicity and dysphagia reported as the most frequent acute side effects. The insertion of a percutaneous endoscopic gastrectomy (PEG) was necessary in four cases (10%). Serious late toxicity (G > 3. RTOG) was observed in two patients (5%) (dysphagia and brain necrosis). CONCLUSION: IMPT for nasopharyngeal cancer patients is feasible with mild acute toxicity. Treatment outcomes are promising despite the high percentage of advanced disease in this group.
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- $a Vondráček, Vladimír $u Proton Therapy Center Czech, Budínova 1a, 18000, Prague 8, Czech Republic ; Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University, Sítná square 3105, 272 01, Kladno, Czech Republic
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- $a Patzelt, Matěj $u Department of Medical Biophysics and Informatics, 3rd Faculty of Medicine, Charles University, Praha 10 Ruská 87, 100 00, Prague, Czech Republic ; Department of Plastic Surgery, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Praha 10, Czech Republic
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- $a Grebenyuk, Alexander $u Department of Health Protection and Disaster Medicine, Pavlov First Saint Petersburg State Medical University, Lva Tolstogo 6-8, 197020, Saint Petersburg, Russia
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