Title: Nasopharyngeal Carcinoma- Role of External Beam Radiotherapy (EBRT) and Chemotherapy Vs EBRT, Chemotherapy and Intraluminal Brachytherapy
Authors: Dr C.S.K. Prakash, M.D (R.T), Dr.Kamreddy Ashok Reddy, M.S (ENT)
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.92
Abstract
Purpose: We analyzed treatment out in patients with nasopharyngeal carcinoma who received External Beam Radiotherapy and Chemotherapy with those with EBRT+chemotherapy + Intra Luminal High Dose Rate Brachytherapy.
Materials and Methods: Total 70 non metastic nasopharyngeal carcinomas patients treated between 2004-09 were retrospectively analyzed.
The group A consists of 48 patients who received External Beam Radiotherapy and Chemotherapy and the group B patients had EBRT+chemotherapy + Intra Luminal High Dose Rate Brachytherapy.
The EBRT dose ranged between 66-70Gy. Patients had concurrent chemotherapy with Inj.Cisplatin+5fu and adjuvant chemo. Intra Luminal High Dose Rate Brachytherapy total 3-4 fractions were delivered with minimum 6 hours gap between the two fractions, with 2 -3 Gy per fraction based on the dosage to critical normal structures.
Results: Both groups were compared in terms of Local recurrence rates were 8.34% Vs 4.5% (p value 0.4874336) , Local and regional recurrence 2.08% vs 4.5% (p value 0.131522 ), Regional recurrence 4.16% vs4.5% (p value 0.7547963), Distant metastasis 25% vs 41 % (p value 0.2994465) for group 1 and 2 respectively. Advanced nodal status and male gender were bad prognostic factors as per multivarient analysis. Administration of HDR ILRT was not significant prognostic factor in our study but none developed severe complications with brachytherapy.
Conclusion: Both acute and delayed complications in HDR ILRT group were acceptable. Despite limitations of our study being a retrospective analytical study and non uniform distribution of treatment groups, we made an attempt to treat all the patients with uniform brachytherapy protocol. This study will help to design a prospective randomized studies in centers where advanced radiotherapy technologies were not available
Key Words: Non metastatic Nasopharyngeal carcinoma, Radiotherapy, chemotherapy and Intra Luminal High Dose Rate Brachytherapy.
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