Intensity-modulated radiation therapy for nasopharyngeal carcinoma: a review
- Tony J. C. WangAffiliated withDepartment of Radiation Oncology, College of Physicians and Surgeons, Columbia University
- , Nadeem RiazAffiliated withDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center
- , Simon K. ChengAffiliated withDepartment of Radiation Oncology, College of Physicians and Surgeons, Columbia University
- , Jiade J. LuAffiliated withDepartment of Radiation Oncology, National University Hospital
- , Nancy Y. LeeAffiliated withDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center Email author
Advances in radiation therapy, such as intensity-modulated radiation therapy (IMRT), have allowed high-dose delivery to tumors while sparing normal tissues. However, IMRT requires careful delineation of target volumes to prevent marginal recurrences.
Results and discussion
This review discusses the recent advances in the treatment of nasopharyngeal carcinoma with particular emphasis on IMRT. Multiple phase III trials that have relied on conventional radiotherapy have shown a survival benefit to concurrent chemoradiotherapy (CCRT) over radiotherapy (RT) alone. Two randomized trials using IMRT have demonstrated decreased xerostomia rates compared to conventional radiotherapy while still maintaining excellent local control rates, although follow-up was short. While modern locoregional results are excellent, 90 % or more, distant-metastasis-free rates are not as impressive, ranging from 66 to 93 % among studies.
IMRT is an advanced technique, its excellent treatment outcomes have been reproduced in many single institution studies. Perhaps IMRT-delivered RT can replace the benefit provided by chemotherapy when added to conventional RT. Future studies should focus on reducing target volumes to minimize toxicity while dose-escalating for high-risk patients.
KeywordsIntensity-modulated radiation therapy Nasopharyngeal carcinoma Radiotherapy
- Intensity-modulated radiation therapy for nasopharyngeal carcinoma: a review
Journal of Radiation Oncology
Volume 1, Issue 2 , pp 129-146
- Cover Date
- Print ISSN
- Online ISSN
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- Intensity-modulated radiation therapy
- Nasopharyngeal carcinoma
- Author Affiliations
- 1. Department of Radiation Oncology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- 2. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- 3. Department of Radiation Oncology, National University Hospital, Singapore, Singapore