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Radiology. 1999 Nov;213(2):489-94.

Nasopharyngeal carcinoma: repeat treatment with conformal proton therapy--dose-volume histogram analysis.

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1
Department of Radiation Medicine, Loma Linda University Medical Center, CA 92354, USA.

Abstract

PURPOSE:

To analyze control, survival, and complication rates of conformal proton radiation for recurrent nasopharyngeal carcinoma.

MATERIALS AND METHODS:

Sixteen patients with nasopharyngeal carcinoma initially treated with 50.0-88.2 Gy photons were re-treated with protons to additional doses of 59.4-70.2 CGE. Local-regional control and survival were correlated with extent of relapse, recurrence versus persistence, and prescribed dose and were subjected to dose-volume histogram analysis. Mean follow-up was 23.7 months (range, 4-47 months).

RESULTS:

Twenty-four-month actuarial overall and local-regional progression-free survival rates were both 50%. The 24-month actuarial overall survival rates for patients with "optimal" dose-volume histogram coverage versus "suboptimal" coverage were 83% and 17%, respectively (P = .006). Doses to critical structures were low (0-22.0 Gy); no central nervous system side effects supervened.

CONCLUSION:

Adequate tumor coverage, as evaluated by using dose-volume histogram analysis, was found to be the most important variable influencing local-regional control and survival. No central nervous system complications were observed; increases in the dose to adjacent critical structures are being evaluated.

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