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La radiologia medica

, Volume 117, Issue 4, pp 690–714 | Cite as

A benchmark study on 883 nasopharyngeal cancer patients treated in two Italian Centres from 1977 to 2000. Part I: evolving technical choices and survival

  • S. Tonoli
  • S. M. Magrini
  • L. CostaEmail author
  • F. Paiar
  • G. Simontacchi
  • V. Scotti
  • N. Pasinetti
  • R. Barca
  • D. Barbieri
  • A. De Stefani
  • E. Cellai
  • M. Buglione
  • G. Biti
Radiotherapy / Radioterapia

Abstract

Purpose

The authors sought to define treatment results according to the different accrual periods and clinical-therapeutic features in a large series of nasopharyngeal cancer (NPC) patients treated in two Italian centres over more than two decades.

Materials and methods

A total of 883 patients consecutively treated with radiotherapy between 1977 and 2000 at the Florence (FLO) and Brescia (IRA) Radiation Oncology centres were studied. Five-year overall (OS) and disease-specific (DSS) actuarial survival rates in the different pathological, clinical and therapeutic subgroups were calculated, along with the actuarial local-regional control (LRC) probability.

Results

At univariate analysis, survival and local control rates were significantly better in the more recent accrual periods and in the more favourable disease presentations; treatment-related parameters mainly affect LRC. At multivariate analysis, patient- and disease-related factors had a more evident prognostic effect than did therapeutic factors, although dose to the nasopharynx and treatment technique had a marginally significant impact on DSS and OS.

Conclusions

Results of this benchmark study may be useful for understanding the development of new radio-therapy techniques for NPC, such as three-dimensional conformal radiotherapy (3D-CRT) and particularly intensity-modulated radiotherapy (IMRT).

Keywords

Nasopharyngeal cancer Radiotherapy Treatment techniques Survival Patterns of care 

Uno studio di riferimento su 883 pazienti affetti da neoplasia della rinofaringe trattati in due Centri italiani dal 1977 al 2000. Parte I: evoluzione delle scelte tecniche e sopravvivenza

Riassunto

Obiettivo

L’obiettivo primario di questo studio è di definire i risultati del trattamento di una vasta serie di pazienti affetti da neoplasie della rinofaringe (NPC), trattati in due centri italiani per oltre un ventennio, secondo i diversi periodi di reclutamento e le caratteristiche cliniche dei pazienti.

Materiali e metodi

Sono stati studiati 883 pazienti consecutivamente trattati con radioterapia dal 1977 al 2000 a Firenze (FLO, Florence) e Brescia (IRA, Istituto del Radio Alberti). Sono stati calcolati, nei diversi sottogruppi patologici, clinici e terapeutici, i valori attuariali a 5 anni della sopravvivenza globale (OS), della sopravvivenza specifica per malattia (DSS) e del controllo loco-regionale (LCR).

Risultati

All’analisi univariata, la sopravvivenza globale e il controllo locale sono risultati significativamente migliori nei periodi più recenti e nelle presentazioni di malattia più favorevoli; i parametri legati al trattamento influenzano prevalentemente il LCR. All’analisi multivariata, i fattori legati al paziente e alla malattia hanno un effetto prognostico più evidente rispetto a quelli legati al trattamento, benché la dose alla rinofaringe e la tecnica di trattamento abbiano un impatto marginale anche sulla DSS e sull’OS.

Conclusioni

I risultati di questo studio di riferimento potrebbero essere utili per la comprensione dell’evoluzione di nuove tecniche radioterapiche per il trattamento dei tumori della rinofaringe, come la radioterapia tridimensionale conformazionale (3DCRT) e specialmente la radioterapia a modulazione d’intensità (IMRT).

Parole chiave

Neoplasia della rinofaringe Radioterapia Tecniche di trattamento Sopravvivenza Terapie 

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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • S. Tonoli
    • 1
  • S. M. Magrini
    • 1
    • 2
  • L. Costa
    • 1
    Email author
  • F. Paiar
    • 3
  • G. Simontacchi
    • 3
  • V. Scotti
    • 3
  • N. Pasinetti
    • 1
  • R. Barca
    • 3
  • D. Barbieri
    • 1
  • A. De Stefani
    • 4
  • E. Cellai
    • 3
    • 5
  • M. Buglione
    • 1
    • 2
  • G. Biti
    • 3
    • 5
  1. 1.Istituto del Radio “O. Alberti”Spedali CiviliBresciaItaly
  2. 2.RadioterapiaUniversità degli Studi di BresciaBresciaItaly
  3. 3.RadioterapiaOspedale CareggiFirenzeItaly
  4. 4.RadioterapiaOspedale di TreviglioBergamoItaly
  5. 5.Università degli Studi di FirenzeFirenzeItaly

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