摘要
Purpose: To minimize side effects and to achieve a high local control rate, three-dimensional (3D) small-volume irradiation was used for locally residual or recurrent nasopharyngeal carcinoma.
Methods and Materials: Between July 1992 and March 1998, 18 tumors (12 residual and 6 local recurrent cases) were treated with 3D planned small-volume irradiation. The total dose (i.e., the dose of conventional radiotherapy plus that of the 3D irradiation) was 78.4 Gy (74.8–91.0 Gy) in its mean value for residual disease and 105.0 Gy (94.8–125 Gy) for recurrence. The mean value of the 90% isodose volume was 40.3 cc (8.0–94.0 cc). The mean follow-up period from the start of the boost or re-irradiation was 39 months.
Results: The 3-year local control rate of the 12 residual tumors was 70%. Of 9 T4 residual tumors, 7 were controlled at a follow-up period between 17 and 70 months (median of 42 months). Of 6 recurrent tumors treated with re-irradiation, 3 were controlled at a follow-up period between 7 and 28 months. In the case of booster therapy, trismus occurred in 1 patient with a total dose of 91 Gy. Among the patients receiving re-irradiation, a temporary ulceration of the nasopharyngeal mucosa developed in 1 patient with a total dose of 111 Gy.
Conclusion: 3D small-volume irradiation was effective and safe in treating residual or recurrent nasopharyngeal carcinoma.