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- Title
Should high-dose-rate brachytherapy boost be used in early nasopharyngeal carcinomas?
- Authors
Guinot, Jose Luis; Moya, Andrea; Santos, Miguel Angel; Peña, Marina; Quiles, Beatriz; Sanchez-Relucio, Juan Carlos; La Rosa, Alonso; Tortajada, Maria Isabel; Arribas, Leoncio
- Abstract
Radiation with or without chemotherapy is the main treatment of nasopharyngeal carcinomas (NPC). Local recurrence is difficult to manage. Local control is dose-dependent. To analyze the effect of an endocavitary brachytherapy boost after external beam radiation (EBRT) to decrease local recurrence. Thirty patients with T0-T2 NPC were treated: 70% T1, 20% T2 and 10% T0; 33.3% N0, 20% N1, 43.3% N2 and 3.3% N3; 90% were undifferentiated carcinoma. All they received a 192-Ir high dose rate brachytherapy (HDR-BT) boost after 60 Gy of EBRT. The Rotterdam applicator was used in most cases, 3-4 fractions of 3.75-3 Gy in two days. With median follow-up (FU) of 63 months, a single parapharyngeal failure resulted in local control of 100% at 3 years and 95% at 5 years. Local control for T0-1 was 100% and for T2 67% at five years (p = 0.02). Regional-free recurrence survival was 92% at 5 years. Metastasis-free survival was 84% at 5 years. All cases of metastasis had histopathology of undifferentiated. The overall and cause-specific survival was 96% and 86% at 3 and 5 years. No late complications related to brachytherapy were described. A HDR-BT boost is useful to decrease the incidence of local recurrence of NPC to 5%. With a fractionated schedule of 3-4 fractions in two days, Rotterdam applicator and 3-D planning, no late complications are described. Therefore we recommend to use brachytherapy boost in all early NPC.
- Publication
Reports of Practical Oncology & Radiotherapy, 2020, Vol 25, Issue 4, p479
- ISSN
1507-1367
- Publication type
Article
- DOI
10.1016/j.rpor.2020.04.001