Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Republic of Korea.
Radiother Oncol. 2009 Dec;93(3):570-4. doi: 10.1016/j.radonc.2009.10.018. Epub 2009 Nov 16.
We reviewed survival, local control, and toxicity in patients with locally recurrent nasopharyngeal carcinoma (NPC) who had been treated with fractionated stereotactic radiotherapy (FSRT).
Between June 2002 and March 2008, we retrospectively reviewed 35 patients with locally recurrent NPC treated using FSRT with CyberKnife. Gross tumor volumes ranged from 2.6 to 64.0 ml (median, 7.9 ml). Radiation doses were prescribed at the isodose line (75-84% of the maximum dose; median, 80%). The prescribed dose of FSRT ranged from 24 to 45 Gy (median, 33 Gy) in three or five fractions.
The overall survival (OS) rate, local failure-free survival (LFFS) rate, and disease progression-free survival (DPFS) rate at 5 years were 60%, 79%, and 74%, respectively. Twenty-three patients achieved complete response after FSRT. Only T stage at recurrence was an independent prognostic factor for OS and DPFS. Five patients exhibited severe late toxicity (Grade 4 or 5).
With regard to OS and LFFS, our study provided favorable outcomes. The incidence of severe late toxicities was acceptable in our study. FSRT would be considered as the alternative treatment of choice in re-irradiation for locally recurrent NPC.
我们回顾了接受分割立体定向放疗（FSRT）治疗的局部复发性鼻咽癌（NPC）患者的生存、局部控制和毒性情况。
2002 年 6 月至 2008 年 3 月，我们回顾性分析了 35 例采用 CyberKnife 接受 FSRT 治疗的局部复发性 NPC 患者。大体肿瘤体积范围为 2.6 至 64.0ml（中位数，7.9ml）。照射剂量在等剂量线（最大剂量的 75-84%；中位数，80%）处规定。FSRT 的规定剂量范围为 24 至 45Gy（中位数，33Gy），分为 3 或 5 个分次。
5 年总生存率（OS）、局部无失败生存率（LFFS）和疾病无进展生存率（DPFS）分别为 60%、79%和 74%。23 例患者在 FSRT 后达到完全缓解。仅复发时的 T 分期是 OS 和 DPFS 的独立预后因素。5 例患者出现严重的晚期毒性（4 或 5 级）。
就 OS 和 LFFS 而言，我们的研究结果良好。在我们的研究中，严重晚期毒性的发生率是可以接受的。FSRT 可作为局部复发性 NPC 再放疗的替代治疗选择。
