The present study was conducted to evaluate the efficacy and adverse effects of intensity-modulated radiation therapy (IMRT) for recurrent nasopharyngeal carcinoma, and to analyze the relevant clinical prognostic factors.
Methods: From June 2006 to September 2010, 108 patients with recurrent nasopharyngeal carcinoma who were admitted to the radiotherapy department of the Cancer Hospital of Fudan University were included in the study. The number of patients classified as stage I-IV according to AJCC/UICC 2002 version staging accounted for 31.5%, 8.3%, 32.4% and 27.8%, respectively. The median recurrence interval was 51 months (8 to 276 months).
All patients received irradiation with IMRT, applying 6MV photons for 7 to 9 fields. Adverse effects were evaluated according to the National Cancer Institute CTC 3.0 evaluation criteria (version 3.0).
RESULTS: By September 2012, the 5-year overall survival, progression-free survival, local recurrence-free survival, and metastasis-free survival rates were 59%, 56%, 52.9%, and 55.8%, respectively, for the entire group of patients. There were 44 deaths during the follow-up period, 19 of which were due to nasopharyngeal haemorrhage, and the remaining deaths were due to organ failure and tumour metastasis. Twenty-four patients had adverse effects of grade 3 to 4 at different sites.
In the prognostic analysis, age, T-stage and overall stage were important prognostic factors for overall survival and recurrence-free survival, where T-stage was also an important prognostic factor for progression-free survival and metastasis-free survival. In the multifactorial analysis, the differences in the prognostic effects of age and overall stage on overall survival were statistically significant (P<0.05). < p=""> Conclusion: imrt is a more effective treatment modality for recurrent nasopharyngeal carcinoma, which can better increase local control and effectively improve survival rate, but high-dose reirradiation is prone to nasopharyngeal mucosal necrosis and hemorrhage, and most patients die suddenly as a result; and some patients have more serious sequelae after reirradiation, which affect the quality of life. Younger age and earlier T-stage as well as total stage are good prognostic factors for IMRT treatment.