Does the prognosis of nasopharyngeal cancer differ among endemic and non-endemic regions?

Conclusion: The survival rates and prognostic factors for nasopharyngeal cancer (NPC) were found to be similar to the published series from endemic regions. Objectives: The purpose of this retrospective study was to evaluate treatment outcome and prognostic factors of NPC patients treated with radiotherapy or chemoradiotherapy in a non-endemic region. Methods: We analyzed clinical characteristics, treatment outcome, and prognostic factors of NPC patients in a non-endemic region, and compared our institution's results with the published literature including a similar patient population from endemic and non-endemic regions. Among 248 NPC patients, 71 (28.6%) were female and 177 (71.4%) were male with a median age of 48 years. Results: Within a median 59 months (range 22178) of follow-up, local recurrence developed in 22 (8.9%), regional recurrence in 2 (0.8%), locoregional recurrence in 5 (2%), distant metastases in 21 (8.5%), and both locoregional recurrence and distant metastases in 8 (3.2%) patients. Five-year locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) rates were 83.7%, 73%, 78.5%, and 71.1%, respectively. In multivariate analysis for LRC, cranial nerve involvement (CNI) (p = 0.009) and tumor response (p = 0.004); for DFS, age (p = 0.003), CNI (p = 0.02), AJCC T classification (p = 0.05), and tumor response (p = 0.01); for DSS, age (p = 0.003), CNI (p = 0.04), AJCC T classification (p = 0.04), and tumor response (p = 0.01); for OS, age (p < 0.001), AJCC T classification (p = 0.005), and tumor response (p < 0.001) were significant prognostic factors. © 2011 Informa Healthcare

Relapse patterns and related prognostic factors in mobile tongue cancer treated by postoperative adjuvant radiotherapy

49th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology -- OCT 28-NOV 01, 2007 -- Los Angeles, CAWOS: 000249950201121Amer Soc Therapeut & Onco

The measurement of entrance and exit doses with in-vivo dosimetry in head and neck cancers and comparison with treatment planning doses [Baş-boyun kanserlerinde giriş ve çi{dotless}ki{dotless}ş dozlar{dotless}ni{dotless}n in vivo dozimetri kullani{dotless}larak ölçülmesi ve tedavi planlama dozlari{dotless}yla karşi{dotless}laşti{dotless}ri{dotless}lmasi{dotless}]

OBJECTIVES We aimed to measure entrance-exit doses using in-vivo dosimetry for head and neck cancer patients and to compare with planning system doses, to facilitate determination of treatment accuracy. METHODS Three diodes were calibrated using water equivalent phantom. Correction factors had been previously assessed for in-vivo diodes and applied to the readings. Dose measurements were performed on 30 treatment setups for 3 patients treated with isocentric, asymmetric left-right two lateral and supraclavicular fields using 6MV. Measured doses were compared with expected doses. RESULTS The results indicated a small acceptable deviation from expected doses. It was found that the mean deviations for entrance and exit doses were 2.3% and 1.9%, respectively. The deviation in the delivered dose is well within the 5% International Commission on Radiation Units and Measurements (ICRU) recommendation, and thus treatment doses are determined to be in accordance with the planning system doses. CONCLUSION It has been shown that in-vivo dosimetry performed using diodes is a reliable and high-precision method for patient dose control. © 2012 Association of Oncology

Postoperative adjuvant radiotherapy in stage IB carcinomas of the uterine cervix

Between January 1987 and December 1992, amongst the cases who were evaluated and operated upon as clinical Stage IB carcinoma of the uterine cervix, 96 patients were treated with postoperative radiotherapy and the results were reviewed retrospectively in June 1996. Thirteen cases had undergone total abdominal hysterectomy and bilateral salpingoopherectomy, 41 had modified radical hysterectomy and 42 had radical hysterectomy. Postoperative radiotherapy was applied to cases with poor prognostic factors such as lymph node metastasis, deep stromal invasion and bulky tumour, or to cases with inadequate operation. External pelvic irradiation of 50.4-54 Gy without midline shielding and 20 Gy intracavitary (2 x 10 Gy of vaginal surface dose) irradiation were applied. Five-year overall and disease-free survival rates were 82.9% and 77.4%, respectively. There was no difference in survival rates due to the type of operation (P = 0.920). Factors that significantly affected the 5-year disease-free survivals by univariate analysis were lymph node metastasis (positive: 54.7%, negative: 84.8%; P 4 cm: 63.4%, < 4 cm: 83.5%, P = 0.004), surgical margins (positive: 62.1%, negative: 83.1%, P = 0.029), deep stromal invasion (positive: 71.1%, negative: 92.6%, P = 0.056) and histopathological type (P = 0.036). In multivariate analysis, lymph node metastasis was the only independent prognostic factor (P = 0.008). The complication rates of Grade II (7.4%) and Grade III (5.1%) indicates that postoperative radiotherapy was tolerated well by the patients. The efficiency of postoperative radiotherapy in clinically stage IB cervix carcinomas with inadequate surgery or with poor prognostic criteria was discussed and it was concluded that it might have a positive contribution to survival with an acceptable complication rate