Journal of Medical and Surgical
Research (JMSR)


...

Pages: 901-908

Date of Publication: 30-Nov--0001

Reirradiation Using Intensity-Modulated Radiotherapy For Recurrent Nasopharyngeal Carcinoma:

-A Report of 10 Case Series From A Moroccan Center-

Author: Siham Jaba, Patricia Agbanglanon, Wilfried Bassané Alain Mossé, Gaël Kietga, Sanae Elmajjaoui, Hanan El Kacemi, Tayeb Kebdani, Noureddine Benjaafar

Category: JMSR Oncology

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Abstract:

Aims and Methods: This study aimed to describe clinical outcomes and treatment-related toxicities after re-irradiation using intensity-modulated radiotherapy (IMRT) for patients with local and/or regional recurrent nasopharyngeal carcinoma (NPC) treated at the National Institute of Oncology Sidi Mohamed Ben Abdellah in Rabat- Morocco, between 2016 and 2019. The epidemiological data from the 10 patients were collected and studied. Results: Seven patients were female and 3 were male. Mean age at primary diagnosis was 39.3 years. At the time of initial diagnosis, induction chemotherapy was performed in 5 patients, and concurrent chemo-radiotherapy in all patients. The median interval between primary irradiation and recurrence was 5.3 years. Nine patients (90%) had locally advanced recurrent disease. Neoadjuvant chemotherapy was administered to 6 patients (60%) to downsize tumors before radiotherapy, and cisplatin-based concurrent chemo-radiotherapy was administrated to all patients. The mean re-irradiation dose was 61.8 Gy (range, 60-66 Gy). Treatment was delivered at 2 Gy/fraction daily, 5 days a week with a mean duration of 51 ---PlusMinusSymbol--- 5.3 days. Chemotherapy was interrupted in 2 patients (20%) during the concurrent phase to manage severe symptomatic or hematologic toxicities. After a mean follow-up time of 7.8 months, 4 patients died, 4 were alive and disease free and 2 were lost to follow-up. The median overall survival (OS) was 13 months with a 1-year OS rate of 46.9%. Fifty-eight per cent of patients experienced grade 3-4 late toxicities including various degree of hearing impairment, trismus and xerostomia. Conclusion: The use of innovative radiotherapy modalities such as IMRT has led to highly conformal radiation treatments, which allow smaller margins and decreased radiation doses to the normal organs at risk (OAR). IMRT should be considered as the preferred option in treating recurrent NPC.

Keywords: Intensity-modulated radiotherapy, Morocco, Recurrent nasopharyngeal carcinoma, Survival, Reirradiation

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