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Title: Late toxicities after conventional radiation therapy alone for nasopharyngeal carcinoma
Authors: Tuan, J.K.L.
Ha, T.C. 
Ong, W.S.
Siow, T.R.
Tham, I.W.K. 
Yap, S.P.
Tan, T.W.K.
Chua, E.T.
Fong, K.W.
Wee, J.T.S. 
Keywords: Conventional radiation
Cranial nerve palsies
Late treatment toxicity
Nasopharyngeal cancer
Quality of life
Issue Date: Sep-2012
Citation: Tuan, J.K.L., Ha, T.C., Ong, W.S., Siow, T.R., Tham, I.W.K., Yap, S.P., Tan, T.W.K., Chua, E.T., Fong, K.W., Wee, J.T.S. (2012-09). Late toxicities after conventional radiation therapy alone for nasopharyngeal carcinoma. Radiotherapy and Oncology 104 (3) : 305-311. ScholarBank@NUS Repository.
Abstract: Background and purpose: We sought to evaluate the nature and frequency of late toxicities in a cohort of nasopharyngeal cancer (NPC) patients treated with conventional radiotherapy alone. Methods and materials: Seven-hundred and ninety-six consecutive NPC patients treated using conventional radiotherapy at a single center from 1992 to 1995 were retrospectively analyzed. Patients with histology proven, completely staged, Stage I-IVB World Health Organization Type I-III NPC and completed radical radiotherapy were included. Patients with incomplete staging investigations, distant metastases at diagnosis, previous treatment, and incomplete radiotherapy were excluded. Radiotherapy-related complications were categorized using the RTOG Late Radiation Morbidity Scoring Criteria. Results: Median follow-up was 7.2 years. The 5-year overall survival and disease free survival were 69% and 56%, respectively, and the corresponding 10-year rates were 52% and 44%. Among 771 patients with at least 3 months of follow-up post treatment, 565 (73%) developed RT-related complications. Diagnosed neurological complications were cranial nerve palsies (n = 70; 9%), temporal lobe necrosis (n = 37; 5%), Lhermitte's syndrome (n = 7; 1%), and brachial plexopathy (n = 2; 0.3%). Non-neurological complications included xerostomia (n = 353; 46%), neck fibrosis (n = 169; 22%), hypo-pituitarism (n = 48; 6%), hearing loss (n = 120; 16%), dysphagia (n = 116; 15%), otorrhea (n = 101; 13%), tinnitus (n = 94; 12%), permanent tube feeding (n = 61; 8%), trismus (n = 45; 6%), second malignancies within treatment field (n = 17; 2%), and osteo-radionecrosis (n = 13; 2%). Conclusions: While radiotherapy is curative in NPC, many patients suffer significant late treatment morbidities with conventional radiotherapy techniques. © 2012 Elsevier Ireland Ltd. All rights reserved.
Source Title: Radiotherapy and Oncology
ISSN: 01678140
DOI: 10.1016/j.radonc.2011.12.028
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