A randomized pilot trial comparing Position Emission Tomography (PET)-guided dose escalation radiotherapy to conventional radiotherapy in chemoradiotherapy treatment of locally advanced nasopharyngeal carcinoma

Jianshe Wang, Junnian Zheng, Tianyou Tang, Feng Zhu, Yuanhu Yao, Jing Xu, Andrew Z. Wang, Longzhen Zhang

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background: This pilot trial is designed to determine whether PET/CT-guided radiotherapy dose escalation can improve local control while minimizing toxicity for the treatment of locally advanced nasopharyngeal carcinoma. Methods: 67 patients were randomized into the three treatment arms: conventional chemoradiotherapy (group A), CT-guided dose escalation chemoradiotherapy (group B) and PET/CT-guided dose escalation chemoradiotherapy (group C). Radiotherapy was delivered using the simultaneous modulated accelerated radiation therapy (SMART) technique in the dose-escalation treatment arms. Patients received concurrent and adjuvant chemotherapy. Results: The use of PET/CT significantly changed the treatment volume delineation of the gross tumor volume. 3-year local progression-free (LPF) survival rates of three groups were 83.3%, 90.9%and 100%, respectively. The 3-year regional progression-free survival (RPFS) rates were 95.8%, 95.5% and 100%, respectively. The 3-year disease free survival (DFS) rates were 79.2%, 86.4% and 95.2%, respectively. The 3-year overall survival (OS) rates were 83.3%, 90.9% and 95.2%, respectively. The 3-year disease-free survival (DFS) rates were 79.2%, 86.4% and 95.2%, respectively. No patient had grade 4 late toxicity. Conclusions: PET/CT-guided dose escalation radiotherapy is well-tolerated and appears to be superior to conventional chemoradiotherapy for locally advanced NPC. Trial Registration: ClinicalTrials.gov NCT02089204.

Original languageEnglish (US)
Article numbere0124018
JournalPloS one
Volume10
Issue number4
DOIs
StatePublished - Apr 27 2015
Externally publishedYes

ASJC Scopus subject areas

  • General

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