Long-Term Outcomes of Three-Dimensional High-Dose-Rate Brachytherapy for Locally Recurrent Early T-Stage Nasopharyngeal Carcinoma

Conclusions: 3D-HDR-BT achieves favorable clinical outcomes with mild late toxicity in patients with locally rNPC. Introduction Nasopharyngeal carcinoma (NPC), a tumor of epithelial origin, is a malignant disease of the head and neck common in southern China, especially in Guangdong province (1). As a result of advances in modern imaging and irradiation techniques, the 5-year overall survival (OS) of patients with newly diagnosed NPC without metastasis has reached 75% after external beam radiotherapy (EBRT) in Asia (2, 3). However, local recurrence, which occurs in 18–40% of patients, remains a major reason for treatment failure (4, 5). Thus, treatment of patients with recurrent NPC (rNPC) is a major challenge for clinicians. Current therapies for locally rNPC include surgery, stereotactic radiosurgery, conventional radiotherapy, intensity-modulated radiation therapy (IMRT), and brachytherapy (BT) (6). Patients with rNPC should usually be considered for reirradiation, which can be performed by intracavitary brachytherapy (ICBT) with or without EBRT. BT offers the possibility of high-dose irradiation with a rapid dose fall-off beyond the target volume, thereby sparing surrounding critical structures (7). Numerous studies have demonstrated the categorical benefit of BT in achieving favorable long-term local control and improving the survival outcome of patients with rNPC (8, 9). Computed tomography (CT)-guided high-dose-rate brachytherapy (HDR-BT) is an afterloadin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research

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