Long-term results of late-course accelerated hyperfractionation radiotherapy for nasopharyngeal carcinoma

Objective To evaluate the clinical results of late course accelerated hyperfractionation(LCAF) radiotherapy for nasopharyngeal carcinoma(NPC) patients . Methods From October 1995 to September 1996, 136 NPC patients were divided into conventional fractionation(CF) and LCAF radiotherapy groups.Seventy patients in CF group received conventional radiotherapy :2.0 Gy/f,5 fractions a week to a total dose of 70 Gy in 47 49 days .Sixty six patients in LCAF group were treated with the same fractionation as CF group untill the dose of 36 40 Gy ,and then followed by LCAF radiotherapy :1.35 Gy/f ,twice daily with 6 hour interval between the two fractions,to the total dose of 75.1 76.5 Gy in 45 47 day .Results The complete response rate in the nasopharynx was 97% in the LCAF group and 90% in the CF group after 3 months of radiotherapy.The 1 ,3 ,and 5 year local control rates were 97.0%, 95.4%,89.9% in the LCAF group and 92.8%,77.1%,70.1% in the CF group ,with the difference between the two groups significant (P0.05 ) . The1 ,3 and 5 year survival rates were 98.5%,77.3%,68.2% in the LCAF group and 95.7%,72.7%,59.6% in CF group (P0.05 ),without finding any significant difference in acute mucusitis or late complications between these two groups. Conclusions The local control rate of NPC treated by LCAF radiotherapy is superior to CF. However there is no significant difference in the survival rates between the two groups .LCAF radiotherapy is well tolerated and not increase the toxicity.