Nasopharyngeal carcinoma treated with facial cervical portal and late-course hyperfractionation radiotherapy

Objective: To evaluate the clinical results and side reactions of nasopharyngeal carcinoma (NPC) treated with facial cervical portal and late-course hyperfractionation radiotherapy. Methods: From July 1996 to December 1997, 93 NPC patients were divided into conventional fractionation and hyperfractionation radio- therapy groups. In 47 patients, facial cervical portal was used until the dose of 36 Gy/20 fraction in 4 weeks, and then followed by hyperfractionation radiotherapy: 1.15-1.2 Gy/fraction, 2 fraction/day, with 6-8 hour interval between, to a total dose of 74.2-76.7 Gy in 7.5 weeks without changing the shape of the portal. Forty-six patients were treated by conventional radiotherapy: 2.0 Gy/fraction, 5 fraction/week, to a total dose of 69-72 Gy in 7.5 weeks. Results: The regression rate was 100%, 96% in hyperfractionation and conventional fractionation radio-therapy group after 6 months of radiotherapy, respectively. The 1-, 3-, and 5-year local control rate was 100%, 98%, 86% in the hyperfractionation radiotherapy group and 98%, 86%, 54% in the conventional fractionation group (P<0.01). The 1-, 3-, and 5-year survival rate was 100%, 94%, 85% in the hyperfractionation radio-therapy group and 98%, 84%, 63% in conventional fractionation (P<0.01). Difference in acute mucositis and late complications was not significant (P>0.05). Conclusions: In nasopharyngeal carcinoma, the local control rate and survival rate are raised by hyperfractionation radiotherapy. But recurrence rate and distant metastasis rate are not significantly different. (authors)