PRELIMINARY EVALUATION OF CONCURRENT CHEMORADIOTHERAPY USING IMRT COMBINED WITH LOW-DOSE CISPLATIN FOR STAGE II–IVA NASOPHARYNGEAL CARCINOMA AT MILITARY HOSPITAL 175
DOI:
https://doi.org/10.59354/ydth175.2025.430Từ khóa:
Nasopharyngeal carcinoma, concurrent chemoradiotherapy, IMRT, low-dose cisplatinTóm tắt
Objective: To determine the response rates at 3 and 6 months of concurrent chemoradiotherapy using intensity-modulated radiation therapy (IMRT) combined with low-dose cisplatin in patients with stage II–IVA nasopharyngeal carcinoma (NPC) and to evaluate treatment-related toxicities.
Subjects and Methods: A total of 93 patients with stage II–IVA nasopharyngeal carcinoma underwent concurrent chemoradiotherapy using IMRT combined with weekly low-dose cisplatin. This was a descriptive, retrospective study. Data were collected at 3 and 6 months following completion of treatment. The study was conducted from August 2024 to August 2025.
Results: The mean age of the study population was 49.17 ± 25.26 years. The proportions of patients with stage II, III, and IVA disease were 15.1%, 32.3%, and 52.7%, respectively. The distribution of primary tumor (T) stage was T1, T2, T3, and T4 in 14.0%, 25.8%, 28.0%, and 32.2% of patients, respectively. Nodal (N) stage distribution was N0, N1, N2, and N3 in 18.3%, 23.7%, 30.1%, and 27.9% of cases, respectively. Most patients had World Health Organization (WHO) type II and III histopathology (94.6%). At the 6-month evaluation, the complete response (CR) rates for overall disease, primary tumor, and nodal disease were 87.1%, 92.4%, and 95.6%, respectively. Several factors were associated with treatment response: patients with stage IVA disease, T4 tumors, or N3 nodal involvement had lower CR rates compared with earlier stages. Patients with WHO type III histology, who completed the full chemotherapy regimen, and who did not experience treatment interruption had higher CR rates. Most treatment-related toxicities were mild and had minimal impact on treatment compliance. The rates of grade 3 leukopenia and anemia were 15.7% and 4.3%, respectively. The incidences of grade 3 dermatitis, mucositis, and xerostomia were 15.1%, 30.1%, and 8.6%, respectively.
Conclusion: Concurrent chemoradiotherapy using IMRT combined with low-dose cisplatin in stage II–IVA nasopharyngeal carcinoma patients achieves a high complete response rate with manageable toxicity. It remains the current standard of care.
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