14 Nasopharynx Cancer

Nasopharynx Cancer

17

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

Table 9. Brachytherapy (BT) Monotherapy as Salvage Re-irradiation Study Number of patients T- and N- Stage RT course

ΣEQD2

Local Control and Survival

Toxicity

Retrospective cohorts: local persistence Choy (1992) 10

5-year LC: 80%

For entire cohort: NP confined, 49% Non NP confined, 21% No re-staging, 30%

Split-palate implantation ISBT Au198 60Gy LDR Hybrid ICBT- ISBT Ir192 50-58Gy LDR

60Gy

For entire cohort of persistent and recurrent disease Headache, 47% Palatal fistula, 16% NPUN in the majority

10

5-year LC: 93% 10-year LC: 77% 5-year OS: 30% 10-year OS: 20%

Syed (2000)

5

For combined persistent and recurrent

50-58Gy

Pain, 14% Nasal regurgitation, 13% Palatal atrophy, 11% NPUN, 100% Post-op mortality, 7%

10

disease: T1, 18% T2, 35% T3, 41% Tx, 6%

5-year LC: 87.2% 5-year OS: 79.1%

Kwong (2000)

45

NP confined

Split-palate implantation ISBT Au198 61Gy LDR

61Gy

For entire cohort of persistent and recurrent disease Headache, 28% Palatal fistula, 19% NPUN, 16% TLN, 7%

10

Leung (2000)

87

No re-staging at persistence

ICBT 22.5-24Gy/3F

32.8-36Gy

5-year LFFS: 85% 5-year CSS: 72%

Deafness, 5% Trismus, 1% CNP, 1% Endocrine, 9% NPUN 4% TLN, 0

10

5-year LC: 89.5% 5-year OS: 65.2%

Law (2002)

23

T1-T2a

Endoscopic pharyngeal recess dissection and tumor debulking ICBT 40Gy LDR

40Gy

5-year major compl-free rate: 86.5%

10

Zheng (2004)

63

No re-staging at persistence

ICBT 15-30Gy/5-6F

9.8-37.5Gy

5-year LRFS: 76.3% 5-year OS: 55.8%

Deafness, 6% Trismus, 2% CNP, 3% Endocrine, 6% NPUN, 10% TLN, 2%

10

Leung (2005)

34

T2b

ICBT 22.5-24Gy/3F

32.8-36Gy

5-year LRFS: 97% 5-year OS: 78.3%

5-year major comp-free rate, 76% Endocrine, 21% NPUN, 6% For entire cohort of persistent and recurrent disease Headache, 47% Palatal fistula, 16% NPUN in the majority

10

Retrospective cohorts: local recurrence Choy (1992) 33 First LR, 28 Second LR, 5

For entire cohort: NP confined, 49% Non NP confined, 21% No re-staging, 30%

Split-palate implantation ISBT Au198 60Gy Hybrid ICBT/ ISBT 50-58Gy LDR

60Gy

5-year LC First LR, 61% Second LR, 80%

10

5-year LC: 93% 10-year LC: 77% 5-year OS: 30% 10-year OS: 20%

Syed (2000)

29

For combined persistent and recurrent

50-58Gy

Pain, 14% Nasal regurgitation, 13% Palatal atrophy, 11% NPUN, 100% Post-op mortality, 7%

10

disease: T1, 18% T2, 35% T3, 41% Tx, 6%