The Analysis Of The Treatment Outcomes And Late Complications Of 196 Patients With Nasopharyngeal Carcinoma Treated By Radiotherapy

Purpose: To describe the treatment outcomes and late complications of nasopharyngeal carcinoma treated by radical radiotherapy.Methods: 196 patients with nasopharyngeal carcinoma treated in our department received 64~80Gy with 6-MV photons. The technique was bilateral opposed facial-cervial field and neck anterior field. Only 37 patients with high T or high N received concurrent or adjuvant 2-4cycles chemotherapy (5-FU 500mg/m2 d1-3 and DDP 30mg/ m2 d1-3,every 3 weeks). Potentially significant patient-related and treatment-related variables were analyzed. Radiation-related complications were recorded.Results: The 5-year and 10-year overall survival rates were 53.10% and 39.90% respectively. Single factors analysis showed that sex , clinical stage, T-stage, N-stage, dose of primary lesions and dose of low neck were prognostic factors. Multivariate analysis revealed that only clinical stage was independent factor for overall survival. Xerostomia,hearing impairment and eurodontia were the most frequent radiation-related complications. The incidence rates of≥2 grade were 48.96%,23.96% and 20.83% respectively. There were no significant correlations with xerostomia. Primary tumor dose was obviously correlated with trismus and hearing impairment(p=0.012, 0.007respectively).Applicating the asymmetric integer shielding lead technique was significant influence on radiation eurodontia(p=0.001). Subcutaneously fibrosis was significant associated with Cervical lymph node dose (p=0.000). Conclusions: The clinical stage was an independent prognostic factor. There were significant correlations between the dose recevied by normal tissues and radiation-related complications. Combined modalities were needed for improving outcomes and decreasing adverse reactions.