Treatment of Stage N_3 Nasopharyngeal Carcinoma with Late Course Accelerated Hyperfractionation Rationtherapy

Objective:To detect the clinical results of late course accelerated hyperfractionation(LCAF) radiotherapy in stage N3 nasopharyngeal carcinoma(NPC) patients.Methods:60 NPC patients in stage N3 were divided into conventionl(CF) and LCAF radiotherapy groups.Patients in CF group received conventional radiotherapy:the total dose of nasopharyngeal was 72~76 Gy in 7~7.5 w,and cervical lymphnode was 60~70 Gy in 6~7 w(2.0 Gy/f,5 f/w);Patients in LCAF group were treated with the same fractionation as CF group until the dose of 36~40 Gy,and then followed by LCAF radiotherapy :1.5 Gy/f,2 fractions a day with 6~8 hour interval between two fractions to the total dose of 68~76 Gy in nasopharyngeal and 60~70 Gy in cervical lymphnode.Results:The complete response rate in the nasopharyngeal was 86.7% in LCAF group and 60% in the CF group at the end of the course: the complete response rate in the in the cervical lymphnode was 90% in LCAF group and 56.6% in the CF group,with the different between the two groups significant(P0.05).The1-,3-and 5-year survival rates were 86.7%、73.3%、23.3% in the LCAF group,and 80%、66.7%、 20% in CF group,there was not any significant difference between two groups(P0.05).The 5-year local control rate of the nasopharyngeal was 93.3% in the LCAF group,and 80% in CF group;the rate of cervical lymphnode was 86.7% in LCAF group and 73.3% in the CF group,without finding any significant difference between two groups(P0.05).There was no significant difference in radiation reaction between two groups(P0.05).Conclusions:The LCAF radiotherapy can impove the preliminary results than conventional CF in stage N3 of NPC.But do not improve the survival rate and local control rates.It is worth further study.