Late course accelerated hyperfractionation radiotherapy for nasopharyngeal carcinoma

Objective: To evaluate the long-term treatment result of late course accelerated hyperfractionation(LCAF) and of conventional fractionation(CF) radiotherapy for nasopharyngeal carcinoma(NPC) patients. Methods: Total of 96 NPC patients were divided randomly into LCAF and CF radiotherapy groups. Fifty-one patients of LCAF group were first irradiated 2.0Gy/f, 5 times a week, and the total dose was (36～40)Gy, and then followed by 1.3Gy/f bid, at more than 6 hours' interval of (6.5～7) weeks, and the total dose was (72.5~75)Gy. Forty-five patients in CF group were irradiated 2.0Gy/f, 5 times a week, to a total dose of 70Gy in 7 weeks. Results: The complete response rate in the nasopharynx was 97% in LCAF group and 88% in the CF group after 3 months of radiotherapy. The 1-,3-,5-year local control rates were 96.1%,94.1%、86.2% in LCAF group,and 86.9%,73.9%,63.1% in CF group. the difference between the two groups was significant (P0.05). The 1-,3-,5-year survival rates were 98.0%,76.5%,68.5% in LCAF group,and 93.3%,73.3%,62.1% in CF group. The difference between the two groups was insignificant (P0.05). There was no statistical significance in the acute mucosal reastion between two groups (P0.05).There was no significant difference in late complications between the two groups (P0.05). Conclusion: The local control rate of NPC treated by LCAF radiotherapy is higher than CF. But there is no significant difference in survival rates between the two groups. LCAF radiotherapy is well tolerated and not increase the toxicity.