14 Nasopharynx Cancer

Nasopharynx Cancer

15

THE GEC ESTROHANDBOOKOF BRACHYTHERAPY | Part II Clinical Practice Version 1 - 10/09/2019

Boost: 89.5% No boost: 85.6% P=0.23 NPUN Boost: 18% No boost: 19%

Ren (2010)

141 (40:101)

Boost: >45 (43%) No boost: >45 (46%)

Boost: T2b, 100% N0-1, 53% N2-3, 48% No boost: T2b, 100% N0-1, 57% N2-3, 43%

EBRT (2D): Boost: 60Gy No boost: 68Gy

Boost: 77Gy

5-year LRFS Boost: 97.5% No boost: 80.2% P=0.012 5-year OS Boost: 98.3% No boost: 91.9% P=0.231 3-year LC Boost: 99.2% No boost: 94.1% P=0.030 3-year OS Boost: 91.3% No boost: 80.4% P=≤0.001

10

No boost: 68Gy 10

BT (3D ISBT): 16Gy/6F to 100% of GTV

Wu (2013)

348 (175:173)

Boost: 44 (22-69) No boost: 44 (18-74)

Boost: T1, 18% T2, 82%

EBRT (2D): Boost: 56-60Gy/28-30F No boost: 70-72Gy/35-36F

EBRT: Boost: 56-60Gy 10 No boost: 70-72Gy 10 BT: 10.4-26Gy

G ≥2 trismus Boost: 7% No boost: 21% P=<0.001

N0-1, 71% N2-3, 29% No boost: T1, 27% T2, 73% N0-1, 37% N2-3, 63%

BT (2D ICBT): 10-25Gy/4-10F BID ≥6 hours apart Rx pt: 1cm from CAX

G ≥2 neck fibrosis Boost: 13% No boost: 27% P=0.002 CNP Boost: 11% No boost: 23% P=0.003 TLN Boost: 1% No boost: 8% P=0.008 NPUN Boost: 2% No boost: 0% P=0.123

10

F, fractions; 2D, two-dimensional; BID, twice daily; ICBT, intracavitary brachytherapy; ISBT, interstitial brachytherapy; Rx pt, prescription point; CAX, central axis; ΣEQD2, cumulative dose equivalent in 2Gy; LRFS, local recurrence free survival; OS, overall survival; CSS, cancer-specific survival; NPUN, nasopharyngeal ulceration or necrosis; CNP, cranial neuropathy; TLN, temporal lobe necrosis.