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http://dx.doi.org/10.3857/roj.2015.33.3.188

Patterns of care for patients with nasopharyngeal carcinoma (KROG 11-06) in South Korea  

Sung, Soo Yoon (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Kang, Min Kyu (Department of Radiation Oncology, Yeungnam University College of Medicine)
Kay, Chul Seung (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Keum, Ki Chang (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
Kim, Sung Hwan (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
Kim, Yeon-Sil (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Kim, Won Taek (Department of Radiation Oncology, Pusan National University Hospital, Pusan National University School of Medicine)
Kim, Ji-Yoon (Department of Radiation Oncology, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Kim, Jin-Hee (Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine)
Moon, Sung Ho (Department of Radiation Oncology, Proton Therapy Center, Research Institute and Hospital, National Cancer Center)
Ahn, Yong Chan (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Oh, Young Taek (Department of Radiation Oncology, Ajou University School of Medicine)
Wu, Hong-Gyun (Department of Radiation Oncology, Seoul National University College of Medicine)
Lee, Chang-Geol (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
Chung, Woong-Ki (Department of Radiation Oncology, Chonnam National University Medical School)
Cho, Kwan Ho (Department of Radiation Oncology, Proton Therapy Center, Research Institute and Hospital, National Cancer Center)
Cho, Moon-June (Department of Radiation Oncology, Chungnam National University School of Medicine)
Choi, Jin Hwa (Department of Radiation Oncology, Chung-Ang University Hospital)
Publication Information
Radiation Oncology Journal / v.33, no.3, 2015 , pp. 188-197 More about this Journal
Abstract
Purpose: To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea. Materials and Methods: A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions. Results: Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose. Conclusion: Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.
Keywords
Nasopharyngeal neoplasms; Patterns of care; Radiotherapy; Korea;
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1 Chang JT, Chan SC, Yen TC, et al. Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys 2005;62:501-7.   DOI
2 Blanchard P, Lee A, Marguet S, et al. Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol 2015;16:645-55.   DOI
3 Clark JR, Norris CM Jr, Dreyfuss AI, et al. Nasopharyngeal carcinoma: the Dana-Farber Cancer Institute experience with 24 patients treated with induction chemotherapy and radiotherapy. Ann Otol Rhinol Laryngol 1987;96:608-14.   DOI
4 Chen L, Hu CS, Chen XZ, et al. Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial. Lancet Oncol 2012;13:163-71.   DOI
5 Lee AW, Sze WM, Au JS, et al. Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience. Int J Radiat Oncol Biol Phys 2005;61:1107-16.   DOI
6 Yan M, Kumachev A, Siu LL, Chan KK. Chemoradiotherapy regimens for locoregionally advanced nasopharyngeal carcinoma: a Bayesian network meta-analysis. Eur J Cancer 2015;51:1570-9.   DOI
7 Qin DX, Hu YH, Yan JH, et al. Analysis of 1379 patients with nasopharyngeal carcinoma treated by radiation. Cancer 1988;61:1117-24.   DOI
8 Curado MP, Edwards B, Shin HR, et al. Cancer incidence in five continents, vol. IX. Lyon, France: International Agency for Research on Cancer; 2007.
9 Korea Central Cancer Registry, National Cancer Center. Annual report of cancer statistics in Korea in 2012. Goyang, Korea: Ministry of Health and Welfare; 2014.
10 Wilson CP. The approach to the nasopharynx. Proc R Soc Med 1951;44:353-8.
11 National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): head and neck cancers v2.2014 [Internet]. Fort Washington, PA: National Comprehensive Cancer Network; c2014 [cited 2014 May 30]. Available from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
12 Ng SH, Chang TC, Ko SF, et al. Nasopharyngeal carcinoma: MRI and CT assessment. Neuroradiology 1997;39:741-6.   DOI
13 Chan AT, Teo PM, Leung TW, et al. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1995;33:569-77.   DOI
14 Loong HH, Ma BB, Leung SF, et al. Prognostic significance of the total dose of cisplatin administered during concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. Radiother Oncol 2012;104:300-4.   DOI
15 Bachouchi M, Cvitkovic E, Azli N, et al. High complete response in advanced nasopharyngeal carcinoma with bleomycin, epirubicin, and cisplatin before radiotherapy. J Natl Cancer Inst 1990;82:616-20.   DOI
16 Atichartakarn V, Kraiphibul P, Clongsusuek P, Pochanugool L, Kulapaditharom B, Ratanatharathorn V. Nasopharyngeal carcinoma: result of treatment with cis-diamminedichloroplatinum II, 5 fluorouracil, and radiation therapy. Int J Radiat Oncol Biol Phys 1988;14:461-9.   DOI
17 Ma J, Mai HQ, Hong MH, et al. Results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol 2001;19:1350-7.   DOI
18 Chua DT, Ma J, Sham JS, et al. Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: a pooled data analysis of two phase III trials. J Clin Oncol 2005;23:1118-24.   DOI
19 Chi KH, Chang YC, Guo WY, et al. A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys 2002;52:1238-44.   DOI
20 Carman J, Strojan P. Nasopharyngeal carcinoma in Slovenia, 1990-2003 (results of treatment with conventional two-dimensional radiotherapy). Rep Pract Oncol Radiother 2012; 17:71-8.   DOI
21 Zeng L, Tian YM, Sun XM, et al. Intensity-modulated radiotherapy for stage IVA/IVB nasopharyngeal carcinoma: clinical outcomes and patterns of failure in an endemic area in China. Strahlenther Onkol 2014;190:993-1000.   DOI
22 Yeh SA, Tang Y, Lui CC, Huang YJ, Huang EY. Treatment outcomes and late complications of 849 patients with nasopharyngeal carcinoma treated with radiotherapy alone. Int J Radiat Oncol Biol Phys 2005;62:672-9.   DOI
23 Yi JL, Gao L, Huang XD, et al. Nasopharyngeal carcinoma treated by radical radiotherapy alone: ten-year experience of a single institution. Int J Radiat Oncol Biol Phys 2006;65:161-8.   DOI
24 Lai SZ, Li WF, Chen L, et al. How does intensity-modulated radiotherapy versus conventional two-dimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients? Int J Radiat Oncol Biol Phys 2011;80:661-8.   DOI
25 Zong J, Lin S, Lin J, et al. Impact of intensity-modulated radiotherapy on nasopharyngeal carcinoma: validation of the 7th edition AJCC staging system. Oral Oncol 2015;51:254-9.   DOI
26 Lee N, Xia P, Quivey JM, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 2002;53:12-22.   DOI
27 Lee AW, Tung SY, Chua DT, et al. Randomized trial of radiotherapy plus concurrent-adjuvant chemotherapy vs radiotherapy alone for regionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst 2010;102:1188-98.   DOI
28 Kresnik E, Mikosch P, Gallowitsch H, et al. Evaluation of head and neck cancer with (18)F-FDG PET: a comparison with conventional methods. Eur J Nucl Med 2001;28:816-21.   DOI
29 Tang LQ, Chen QY, Fan W, et al. Prospective study of tailoring whole-body dual-modality [18F]fluorodeoxyglucose positron emission tomography/computed tomography with plasma Epstein-Barr virus DNA for detecting distant metastasis in endemic nasopharyngeal carcinoma at initial staging. J Clin Oncol 2013;31:2861-9.   DOI
30 Al-Sarraf M, LeBlanc M, Giri PG, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998;16:1310-7.   DOI
31 Wee J, Tan EH, Tai BC, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol 2005;23:6730-8.   DOI
32 Chen Y, Liu MZ, Liang SB, et al. Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of china. Int J Radiat Oncol Biol Phys 2008;71:1356-64.   DOI
33 Lee AW, Tung SY, Ngan RK, et al. Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: combined analyses of NPC-9901 and NPC-9902 trials. Eur J Cancer 2011;47:656-66.   DOI