Abstract:
Treatment of Stage Ⅲ-Ⅳa Nasopharyngeal Carcinoma with Combined Late CourseAccelerated Hyperfractionation Radiotherapy and ChemotherapyJunfang HAO,Wei DONG, Jin XU, Xinhua YANG, Ming QIAN, Shui YU, Chunping YAO, Lanping LIUCorrespondence to: Lanping LIU, E-mail: 29294521@qq.comThe Third Department of Radiotherapy, Shandong Provincial Tumor Hospital, Ji’ nan 250117, ChinaAbstract Objective: To evaluate the clinical effects of the combined late course accelerated hyperfractionation radiotherapy(LCAHR) and chemotherapy on stageⅢ-Ⅳa nasopharyngeal carcinoma (NPC). Methods: A total of 60 NPC patients with stageⅢ-Ⅳadisease were randomly divided into the conventional control group (group A) treated with traditional fractionated radiotherapy, and thestudy group (group B) treated with LCAHR combined with chemotherapy. A traditional irradiation of 40 Gy at the two opposing fa-cial-cervical anterior-posterior fields (AP-PA) was conducted in both groups, with 20 fractions completed within 4 weeks. After reduc-tion of the irradiated field, LCAHR was performed in group B with a dose of 1.2Gy/f, 2 fractions a day at a 4-6 hour interval, for 14-15days. The total dose for NPC was 73.6Gy~76Gy in 7 weeks. Chemotherapeutic PF regimen was administered concurrently with radio-therapy. Group A received conventional radiotherapy with a total dose of 70Gy~74Gy for 7 - 7.5 weeks. Results: The rate of completeregression of NPC was 96.6% (29/30) in group B and 93.3% (28/30) in group A at the end of the course (P>0.05). The 1- and 3-year lo-cal control rates in group B and group A were 93.1% and 89.6%, and 82.1% and 67.8%, respectively . The 1- and 3- year survival rateswere 96.5% (28/29) and 93.1% (27/29) in group B, and 92.8% (26/28) and 71.4% (20/28) in group A (P< 0.05). The incidence of acuteradiation response was obviously higher in group B than in group A. The incidences of long-term adverse reactions, such as dry mouthand fibrosis of the soft tissues of the neck, were lower in group B than in group A. Conclusion: LCAHR can improve the local controlrate and the survival rate of NPC patients. Combining LCAHR with chemotherapy can reduce distant metastasis of NPC, with tolerableadverse reactions.Keywords Nasopharyngeal carcinoma; Late course accelerated hyperfractionated radiotherapy; Chemotherapy