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Clinical course of longer than five years after definitive radiotherapy for nasopharyngeal carcinoma

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Abstract

Background

This study aimed to reveal the long-term outcomes and late toxicities (> 5 years) after definitive intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).

Methods

Data from 43 patients (median age, 55 years; range, 17–72 years) with NPC who underwent definitive IMRT between 2001 and 2018 were analyzed. All patients were alive and disease-free 5 years after IMRT. A total dose of 70 (range, 66–70) Gy was delivered in 35 (33–35) fractions with concurrent cisplatin chemotherapy.

Results

The median follow-up duration was 119 (range, 61.5–242.1) months. Three patients developed locoregional failure at 79, 92, and 149 months after IMRT, respectively. Of these, 2 patients died of disease progression at 136 and 153 months after IMRT. One patient died of aspiration pneumonia 141 months after IMRT, despite salvage of the recurrent tumor by re-irradiation. In addition, one patient died of aspiration pneumonia 62 months after the IMRT. Thus, the 10-year overall survival, progression-free survival, and locoregional control rates were 98%, 92%, and 94%, respectively. Grade ≥ 2 and ≥ 3 late toxicities were observed in 28 (65%) and 9 (21%) patients, respectively. Nine second primary cancers, including five tongue cancers and two external auditory canal carcinomas, were observed in seven (16%) patients.

Conclusion

Late recurrences, severe late toxicities, and second primary cancers were observed > 5 years after IMRT. A long-term follow-up of > 5 years is needed in patients with NPC.

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Acknowledgements

The authors would like to acknowledge Editage (www.editage.jp) for the English language editing. This work was partially supported by JSPS KAKENHI, Grant Numbers JP 20K08009. The authors are grateful to Dr. Yasutaka Chiba from the Clinical Research Center, Kindai University Hospital, for his advice on statistical analysis.

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Authors and Affiliations

  1. Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, Japan

    Hiroshi Doi, Aritoshi Ri, Masahiro Inada, Saori Tatsuno, Takuya Uehara, Tomohiro Matsuura, Kazuki Ishikawa, Kiyoshi Nakamatsu, Makoto Hosono & Yasumasa Nishimura

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  1. Hiroshi Doi
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Doi, H., Ri, A., Inada, M. et al. Clinical course of longer than five years after definitive radiotherapy for nasopharyngeal carcinoma. Int J Clin Oncol 28, 1607–1615 (2023). https://doi.org/10.1007/s10147-023-02418-7

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