Comparison Of Quality Of Life In Patients With Nasopharyngeal Carcinomas Receiving Conventional External Beam Radiation Therapy Versus Intensity Modulated Radiation Therapy

Background and objective:Nasopharyngeal carcinoma (NPC) is one of the most common cancers in southern China. The primary treatment for NPC is radiotherapy. Intensity modulated radiotherapy (IMRT) is now gaining increasing acceptance in the treatment of NPC because of complicated vital structures surrounding the nasopharynx. Optimal therapeutic results can be achieved using IMRT by prescribing higher doses to the targets while keeping down radiation to the normal tissues. It is also reported that IMRT can increase the locoregional control rate and even the survivals, as well as improve quality of life (QOL) in patients with nasopharyngeal carcinomas.The aim of this study was to compare the acute and late adverse events and QOL in patients with nasopharyngeal carcinomas receiving conventional external beam radiation therapy (RT) versus IMRT.Metholds:Ninety-one patients with newly diagnosed nasopharyngeal carcinomas treated in our institution between August2008and September2010were systemically reviewed. Of them,35patients received conventional RT (RT group) and56IMRT (IMRT group). Conjoint facio-cervical fields plus tangential lower neck-supraclavicular field initially, and then shrinking preauricular portals plus electron beams to the neck were used in RT groups, with a total dose of70Gy/35fractions. Nine coplanar fields were used in IMRT group with a total dose of69.96Gy/33fractions. Acute and late adverse reactions were observed and compared between RT and IMRT groups. Acute reactions included those symptoms and signs like xerostomia, odynophagia, and dermatitis/mucositis, and late events like dysphagia, trismus, hypothyroidism, optic/acoustic impairments, skin injury, hypodermal fibrosis, spinal myelitis and brain injury.Results:Acute reactions like xerostomia, odynophagia, dysphagia and derm-mucositis showed statistically significant difference between RT and IMRT groups, with lesser degrees in IMRT group,(x2=85.73,56.03,26.58,69.28,55.99, P<0.01). As to late events, xerostomia, trismus and dermal fibrosis were less severe in IMRT than RT (χ2=37.95,7.48,9.49,9.49,11.87, P<0.05), whereas the degree of acoustic/optic impairments and brain injury showed no difference between the two groups.Conclusion:As compared to conventional RT, IMRT could decrease acute and some late side events, and improve QOL in patients with nasopharyngeal carcinomas.