14 Nasopharynx Cancer

Nasopharynx Cancer

14

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

Table 7. Brachytherapy (BT) as boost to External Beam Radiotherapy (EBRT): Pre-Chemoradiation Era Study Number of patients (Boost: No boost) Patient Age T- and N- Stage RT course ΣEQD2

Local Control and Survival

Toxicity

Retrospective cohorts Chang (1996) 183 (133:50)

>40 (64%)

T1-T2, 100% EBRT (2D): Boost:

EBRT: Boost: 64.8-68.4Gy No boost: 68.4-72Gy

5-year LRFS Boost: 86.8% No boost: 73.8%

64.8-68.4Gy/36-38F No boost: 68.4-72Gy/38-40F BT (2D ICBT): 5-5.5Gy/F, 1-3F Rx pt: 2cm from CAX

10

10

BT: 6.3-7.1Gy

/F, 1-3F

10

Teo (2000)

509 (163:346)

Boost: >40 (60%) No boost: >40 (66%)

Boost: T1, 45% T2, 55%

EBRT (2D): 60Gy/24-30F

EBRT: 60-62.5Gy

5-year LC Boost: 94.6% No boost: 90% P=0.016 5-year CSS Boost: 88.1% No boost: 83.6% P=0.043 3-year LRFS Boost: 86% No boost 94% P=0.23 3-year CSS Boost: 76% No boost: 89% P=0.29 5-year LRFS Boost: 95.8% No boost: 88.3% P=0.020

NPUN Boost:

6%

10

No boost: <1% P=<0.001

N0-1, 74% N2-3, 26% No boost: T1, 62% T2, 38% N0-1, 59% N2-3, 40% Boost: T1-2, 73% T3-4, 27% N0-1, 60% N2-3, 40% No boost: T1-2, 56% T3-4, 44% N0-1, 47% N2-3 53%

BT (2D ICBT): 24Gy/3F (n = 94) 18Gy/3F ( n = 58)

BT: 36Gy 24Gy

(n = 94) ( n = 58)

10

10

8-46Gy/1-7F (n = 11) Rx pt: 1cm from CAX

(n = 11)

8-63Gy

10

Ozyar (2002)

144 (106:38)

Boost: >40 (60%) No boost: >40 (40%)

EBRT (2D): 66Gy/33F

Boost: 80.1Gy

10

No boost: 66Gy 10

BT (2D ICBT): 12Gy/3F Rx pt: 1cm from CAX

Leung (2008)

287 (145:142)

Boost: 48.5 (22-78) No boost: 43.5 (24-76)

Boost: T1-T2a, 94% T2b, 6% N0-1, 89% N2-3, 11% No boost: T1-2a, 93% T2b, 7% N0-1, 86% N2-3, 14%

EBRT (2D): 66Gy

Boost: T1-2a: 78.6Gy 10 T2b: 82Gy 10 No boost: 66Gy 10

CNP Boost: 4% No boost: 8% TLN Boost: 0 No boost: 2% NPUN Boost: <1% No boost: 0 Endocrine Boost: 4% No boost: 10%

BT (2D ICBT): T1-2a: 10Gy/2F T2b: 12Gy/2F Rx pt: 1cm from CAX

5-year OS Boost: 91.1% No boost: 79.6% P=0.006

5-year major complication- free rate