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Article: Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976-1985: Overall survival and patterns of failure

TitleRetrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976-1985: Overall survival and patterns of failure
Authors
KeywordsLong-term survival results
Patterns of relapse
Nasopharyngeal carcinoma
Failure-free rates
Issue Date1992
Citation
International Journal of Radiation Oncology - Biology - Physics, 1992, v. 23, n. 2, p. 261-270 How to Cite?
AbstractThis is a retrospective analysis of 5037 patients with squamous cell carcinoma of the nasopharynx treated during the years 1976-1985. The stage distribution according to Ho's classification was 9% Stage 1, 13% II, 50% III, 22% IV, and 6% Stage V. Only 4488 (89%) patients had a full course of megavoltage radiation therapy. The median equivalent dose to the nasopharyngeal region was 65 Gy and cervical region in node-positive patients 53 Gy. Seventy percent (906/1290) of the node-negative patients had no prophylactic neck irradiation. The overall actuarial 10-year survival rate was 43%, and the corresponding failure-free survival 34%. Altogether, 4157 (83%) patients achieved complete remission lasting more than 6 months, but 53% (2205/4157) of them relapsed after a median interval of 1.4 years. The 10-year actuarial local, regional, and distant failure-free rates were 61%, 64%, and 59%, respectively. Thirty-eight percent ( 338 891) of all patients with local recurrence achieved second local remission. The local complete remission rate with aggressive re-irradiation alone was 47% ( 333 706). But 37% ( 124 338) of the responders recurred the second time. The incidence of distant failure correlated significantly with both the N-stage and the T-stage, with the highest (57%) occurring in patients with N3 disease. The incidence of nodal relapse in node-negative patients was 11% ( 44 384) among those given prophylactic neck irradiation, but 40% ( 362 906) among those without. Therapeutic irradiation achieved a complete regional remission rate of 90% ( 306 339). However, despite successful salvage, these patients had a significantly higher distant failure rate than those without nodal relapse, even if they remained local-failure-free (21% vs 6%). Patients treated during 1981-1985 achieved significantly better treatment results than those treated during 1976-1980, especially in terms of the overall survival (57% vs 47% at 5-year), the overall failure-free survival (42% vs 35% at 5-year), and the local failure-free rate (70% vs 63% at 5-year). The possible contributing factors are discussed. © 1992.
Persistent Identifierhttp://hdl.handle.net/10722/213845
ISSN
2023 Impact Factor: 6.4
2023 SCImago Journal Rankings: 1.992
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, Anne W M-
dc.contributor.authorPoon, Y. F.-
dc.contributor.authorFoo, William-
dc.contributor.authorLaw, Stephen C K-
dc.contributor.authorCheung, Fred K.-
dc.contributor.authorChan, David K K-
dc.contributor.authorTung, Stewart Y.-
dc.contributor.authorThaw, Myo-
dc.contributor.authorHo, John H C-
dc.date.accessioned2015-08-19T13:40:56Z-
dc.date.available2015-08-19T13:40:56Z-
dc.date.issued1992-
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 1992, v. 23, n. 2, p. 261-270-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/213845-
dc.description.abstractThis is a retrospective analysis of 5037 patients with squamous cell carcinoma of the nasopharynx treated during the years 1976-1985. The stage distribution according to Ho's classification was 9% Stage 1, 13% II, 50% III, 22% IV, and 6% Stage V. Only 4488 (89%) patients had a full course of megavoltage radiation therapy. The median equivalent dose to the nasopharyngeal region was 65 Gy and cervical region in node-positive patients 53 Gy. Seventy percent (906/1290) of the node-negative patients had no prophylactic neck irradiation. The overall actuarial 10-year survival rate was 43%, and the corresponding failure-free survival 34%. Altogether, 4157 (83%) patients achieved complete remission lasting more than 6 months, but 53% (2205/4157) of them relapsed after a median interval of 1.4 years. The 10-year actuarial local, regional, and distant failure-free rates were 61%, 64%, and 59%, respectively. Thirty-eight percent ( 338 891) of all patients with local recurrence achieved second local remission. The local complete remission rate with aggressive re-irradiation alone was 47% ( 333 706). But 37% ( 124 338) of the responders recurred the second time. The incidence of distant failure correlated significantly with both the N-stage and the T-stage, with the highest (57%) occurring in patients with N3 disease. The incidence of nodal relapse in node-negative patients was 11% ( 44 384) among those given prophylactic neck irradiation, but 40% ( 362 906) among those without. Therapeutic irradiation achieved a complete regional remission rate of 90% ( 306 339). However, despite successful salvage, these patients had a significantly higher distant failure rate than those without nodal relapse, even if they remained local-failure-free (21% vs 6%). Patients treated during 1981-1985 achieved significantly better treatment results than those treated during 1976-1980, especially in terms of the overall survival (57% vs 47% at 5-year), the overall failure-free survival (42% vs 35% at 5-year), and the local failure-free rate (70% vs 63% at 5-year). The possible contributing factors are discussed. © 1992.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physics-
dc.subjectLong-term survival results-
dc.subjectPatterns of relapse-
dc.subjectNasopharyngeal carcinoma-
dc.subjectFailure-free rates-
dc.titleRetrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976-1985: Overall survival and patterns of failure-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/0360-3016(92)90740-9-
dc.identifier.pmid1587745-
dc.identifier.scopuseid_2-s2.0-0026720425-
dc.identifier.hkuros265778-
dc.identifier.volume23-
dc.identifier.issue2-
dc.identifier.spage261-
dc.identifier.epage270-
dc.identifier.isiWOS:A1992HW22500001-
dc.identifier.issnl0360-3016-

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