Efficacy of intensity-modulated radiotherapy on patients with locally recurrent nasopharyngeal carcinoma

Objective This study retrospectively analyzed the efficacy and toxicity profile of hyperfractionated intensity-modulated radiotherapy (HF-IMRT) for locally recurrent nasopharyngeal carcinoma (NPC). Methods Twenty-eight locally recurrent patients of NPC were enrolled, 23 male and 5 female with a median of 51 years (range 25-74 years). All patients had a median recurrent time of 17.5 months and received HF-IMRT with a total dosage of 60-70 Gy, each consisting of 1.2 Gy per fraction, each of the 2 fractions were spaced 6 hours apart and lasting for 5 days. Twenty-five patients received concurrent chemotherapy of nedaplatin or two agent regimen, 4 patients received Ad-p53 gene therapy and 6 patients received target therapy of EGFR monoclony antibody. Results The complete response and partial response rates were 89%(25/28) and 11%(3/28) after being treated by HF-IMRT for 3 months. The median follow-up time was 27.5 months. The 1, 2, 3-year overall survival rates, locoregional recurrence-free survival rates and progression-free survival rates were 100%, 91%, 80%; 100%, 80%, 55%; 88%, 65%, 55%, respectively. Three patient were observed to develop severe nasopharyngeal necrosis but recover after treatment, no patients experienced hemorrhage of nasopharynx. Multivariate analysis indicated that the poor prognostic factors included tumor stages (T3-T4)(P=0.00) and no chemotherapy (P=0.04). Conclusion HF-IMRT is feasible for locally recurrent nasopharyngeal carcinoma with satisfactory local control and controllable adverse reaction, it is worth further clinical studies. Key words: Neoplasmso recurrent, Nasopharyngeal/radiotherapy; Radiotherapy, hyperfractionated; Radiotherapy, intensity-modulated; Treatment outcome; Side-efficacy