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- Publisher Website: 10.1016/S0167-8140(00)00312-1
- Scopus: eid_2-s2.0-0035252323
- PMID: 11166862
- WOS: WOS:000167169500002
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Article: Retrospective analysis on treating nasopharyngeal carcinoma with accelerated fractionation (6 fractions per week) in comparison with conventional fractionation (5 fractions per week): Report on 3-year tumor control and normal tissue toxicity
Title | Retrospective analysis on treating nasopharyngeal carcinoma with accelerated fractionation (6 fractions per week) in comparison with conventional fractionation (5 fractions per week): Report on 3-year tumor control and normal tissue toxicity |
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Authors | |
Keywords | Nasopharyngeal neoplasm Conventional fractionation Accelerated fractionation |
Issue Date | 2001 |
Citation | Radiotherapy and Oncology, 2001, v. 58, n. 2, p. 121-130 How to Cite? |
Abstract | Background and purpose: To assess the therapeutic gain achieved by accelerated fractionation for non-keratinizing/undifferentiated nasopharyngeal carcinoma (NPC). Materials and methods: During January 1994 to October 1997, 325 patients were treated to a total dose of 66 Gy in 33-37 fractions: 167 (irradiated before mid-January 1996) with 5 daily fractions (CF) and subsequent 158 with 6 daily fractions (AF) per week. Their median treatment times were 46 and 39 days, respectively. Additional boost to parapharyngeal extension had been given to 181 and Cisplatin-based chemotherapy to 57 patients (24 concurrent with radiotherapy). Results: The AF group had significantly higher progression-free rate than the CF Group (74 vs. 63% at 3 years, P = 0.02 by the log-rank test). However, the difference in disease-specific survival (86 vs. 80%, P = 0.39) and overall survival (81 vs. 78%, P = 0.9) did not reach statistical significance. Strongly significant improvement in local failure-free rate was achieved for patients with T3-4 tumors (87 vs. 62%, P < 0.01). Multivariate analyses showed that fractionation was an independent significant factor for overall progression: hazard ratio = 0.63, 95% confidence interval: 0.41-0.98, P = 0.04. Among the 268 patients treated with radiotherapy alone, those treated by AF had significantly higher incidence of acute reaction grade ≥3 (72 vs. 13%, P < 0.01). However, all patients completed the scheduled dose without excessive prolongation, and no significant increase in late complications was observed (20 vs. 15% at 3 years, P = 0.19). Conclusions: The current analyses suggested that acceleration to 6 daily fractions per week could significantly improve the progression-free rate for NPC without excessive late toxicity. Improvement in local control was confined to T3-4 tumors. © 2001 Elsevier Science Ireland Ltd. |
Persistent Identifier | http://hdl.handle.net/10722/213882 |
ISSN | 2023 Impact Factor: 4.9 2023 SCImago Journal Rankings: 1.702 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lee, Anne W M | - |
dc.contributor.author | Sze, Wai Man | - |
dc.contributor.author | Yau, Tsz Kok | - |
dc.contributor.author | Yeung, Rebecca M W | - |
dc.contributor.author | Chappell, Rick | - |
dc.contributor.author | Fowler, John F. | - |
dc.date.accessioned | 2015-08-19T13:41:04Z | - |
dc.date.available | 2015-08-19T13:41:04Z | - |
dc.date.issued | 2001 | - |
dc.identifier.citation | Radiotherapy and Oncology, 2001, v. 58, n. 2, p. 121-130 | - |
dc.identifier.issn | 0167-8140 | - |
dc.identifier.uri | http://hdl.handle.net/10722/213882 | - |
dc.description.abstract | Background and purpose: To assess the therapeutic gain achieved by accelerated fractionation for non-keratinizing/undifferentiated nasopharyngeal carcinoma (NPC). Materials and methods: During January 1994 to October 1997, 325 patients were treated to a total dose of 66 Gy in 33-37 fractions: 167 (irradiated before mid-January 1996) with 5 daily fractions (CF) and subsequent 158 with 6 daily fractions (AF) per week. Their median treatment times were 46 and 39 days, respectively. Additional boost to parapharyngeal extension had been given to 181 and Cisplatin-based chemotherapy to 57 patients (24 concurrent with radiotherapy). Results: The AF group had significantly higher progression-free rate than the CF Group (74 vs. 63% at 3 years, P = 0.02 by the log-rank test). However, the difference in disease-specific survival (86 vs. 80%, P = 0.39) and overall survival (81 vs. 78%, P = 0.9) did not reach statistical significance. Strongly significant improvement in local failure-free rate was achieved for patients with T3-4 tumors (87 vs. 62%, P < 0.01). Multivariate analyses showed that fractionation was an independent significant factor for overall progression: hazard ratio = 0.63, 95% confidence interval: 0.41-0.98, P = 0.04. Among the 268 patients treated with radiotherapy alone, those treated by AF had significantly higher incidence of acute reaction grade ≥3 (72 vs. 13%, P < 0.01). However, all patients completed the scheduled dose without excessive prolongation, and no significant increase in late complications was observed (20 vs. 15% at 3 years, P = 0.19). Conclusions: The current analyses suggested that acceleration to 6 daily fractions per week could significantly improve the progression-free rate for NPC without excessive late toxicity. Improvement in local control was confined to T3-4 tumors. © 2001 Elsevier Science Ireland Ltd. | - |
dc.language | eng | - |
dc.relation.ispartof | Radiotherapy and Oncology | - |
dc.subject | Nasopharyngeal neoplasm | - |
dc.subject | Conventional fractionation | - |
dc.subject | Accelerated fractionation | - |
dc.title | Retrospective analysis on treating nasopharyngeal carcinoma with accelerated fractionation (6 fractions per week) in comparison with conventional fractionation (5 fractions per week): Report on 3-year tumor control and normal tissue toxicity | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/S0167-8140(00)00312-1 | - |
dc.identifier.pmid | 11166862 | - |
dc.identifier.scopus | eid_2-s2.0-0035252323 | - |
dc.identifier.hkuros | 266065 | - |
dc.identifier.volume | 58 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 121 | - |
dc.identifier.epage | 130 | - |
dc.identifier.isi | WOS:000167169500002 | - |
dc.identifier.issnl | 0167-8140 | - |