Home Professional Hub Clinical Research Publications Clinical results of proton therapy reirradiation for recurrent nasopharyngeal carcinoma

07 / 06 / 21

Clinical results of proton therapy reirradiation for recurrent nasopharyngeal carcinoma


Abstract

Background and purpose: Recurrent nasopharyngeal carcinoma (NPC) has limited curative treatment options. Reirradiation is the only potential definitive treatment in advanced stages at a cost of substantial severe and often life-threatening toxicity. Proton therapy (PT) reduces irradiated volume compared with X-ray radiotherapy and could be advantageous in terms of safety and efficacy in a population of heavily pretreated patients. We report the retrospective results of PT reirradiation in recurrent NPC patients treated at our Institution.

Methods: All recurrent NPC patients treated since the beginning of clinical activity entered the present analysis. Clinical target volume consisted of Gross Tumor volume plus a patient-specific margin depending on disease behavior, tumor location, proximity of organs at risk, previous radiation dose. No elective nodal irradiation was performed. Active scanning technique with the use of Single Field Optimization (SFO) or Multifield Optimization (MFO) was adopted. Cumulative X-ray -PT doses were calculated for all patients using a dose accumulation tool since 2016. Treatment toxicity was retrospectively collected.

Results: Between February 2015, and October 2018, 17 recurrent NPC patients were treated. Median follow-up (FUP) was 10 months (range 2-41). Median PT reirradiation dose was 60 Gy RBE (range 30.6-66). The majority of patients (53%) underwent concomitant chemotherapy. Acute toxicity was low with no ≥ G3 adverse events. Late events ≥ G3 occurred in 23.5% of patients. Most frequent late toxicity was hearing impairment (17,6%). G2 soft tissue necrosis occurred in two patients. Fatal bleeding of uncertain cause (either tumor recurrence or G5 carotid blowout) occurred in one patient. Kaplan-Meier 18 months Overall Survival (OS) and Local control (LC) rates were 54.4% and 66.6%, respectively.

Conclusions: Our initial results with the use of modern PT for reirradiation of recurrent NPC patients are encouraging. Favorable LC and OS rates were obtained at the cost of acceptable severe late toxicity.

Dionisi F, Croci S, Giacomelli I, Cianchetti M, Caldara A, Bertolin M, Vanoni V, Pertile R, Widesott L, Farace P, Schwarz M, Amichetti M. Clinical results of proton therapy reirradiation for recurrent nasopharyngeal carcinoma. Acta Oncol. 2019 Sep;58(9):1238-1245. doi: 10.1080/0284186X.2019.1622772. Epub 2019 Jun 3. PMID: 31155998.

*Please refer to the Terms and Conditions of this website when leaving the site and viewing third party content. 

Consultants we currently work with (proton therapy)

Dr Sanjay Raj

Dr Sanjay Raj’s special interest is the treatment of breast cancer with chemotherapy, radiotherapy and biological and endocrine treatments. He...

Read more
Dr Sanjay Raj

Prof Roger Taylor

Professor Roger Taylor is a Consultant Clinical Oncologist specialising in the treatment of patients with brain tumours and lymphoma. Professor...

Read more
Prof Roger Taylor

Dr Seema Arif

Dr Arif specialises in Gastrointestinal cancers (liver, pancreas, bile duct and bowel cancers). She graduated from India and completed post-graduate...

Read more
Dr Seema Arif

Dr Josef Kovarik

Dr Josef Kovarik is an acting consultant clinical oncologist and a Lead of ENT Oncology at the Northern Centre for Cancer...

Read more
Dr Josef Kovarik

Dr Christopher Herbert

Dr Chris Herbert qualified in medicine at Birmingham University in 2000. He trained in Clinical Oncology in Bristol and completed...

Read more
Dr Christopher Herbert

Dr Shanmugasundaram Ramkumar

Dr Ramkumar is a Consultant Clinical Oncologist specialising in non-surgical treatment of Head and Neck cancer, Skull Base Tumours and...

Read more
Dr Shanmugasundaram Ramkumar

Dr Sarah Harris

Dr Sarah Harris qualified from King's College Hospital in 1989. She worked as Consultant Clinical Oncologist at Guys and St...

Read more
Dr Sarah Harris

Dr Esme Hill

Dr Esme Hill graduated from Birmingham University, also completing an Intercalated BSc in the History of Medicine at University College...

Read more
Dr Esme Hill

Prof Amit Bahl

Professor Amit Bahl is a Consultant Clinical Oncologist and Clinical Director based at The Bristol Haematology & Oncology Centre, with a special...

Read more
Prof Amit Bahl

Dr Russell Banner

Dr Russell Banner is a Consultant Clinical Oncologist based in South Wales. His undergraduate training was at Christ’s College, Cambridge...

Read more
Dr Russell Banner

Dr Kein Yim

Dr Kein Yim is a Consultant Clinical Oncologist. He undertook his medical training in the prestigious institutions of Edinburgh, Cambridge,...

Read more
Dr Kein Yim

Dr Andrew Gaya

Dr Andrew Gaya is a consultant clinical specialist, who specialises in the multimodality treatment of gastroinstestinal cancers. Using a personalised...

Read more
Dr Andrew Gaya

Dr Gaurav Kumar

Dr Gaurav Kumar received primary medical education and core oncology training from India. After working as a consultant in oncology...

Read more
Dr Gaurav Kumar

Dr Jason Lester

Dr Jason Lester is a senior Consultant Clinical Oncologist based in South Wales. He trained and qualified in United Medical...

Read more
Dr Jason Lester

Dr Hans van der Voet

Dr Hans van der Voet is a senior consultant clinical oncologist and radiotherapy lead at the James Cook University Hospital...

Read more
Dr Hans van der Voet

Dr Bart Kurec

Dr Bart Kurec is a consultant clinical oncologist in substantive post in Worcestershire Oncology Centre, specialising in the management of...

Read more
Dr Bart Kurec

Dr Cheng Boon

Dr Cheng Boon is Consultant Clinical Oncologist at the Worcester Oncology Centre at Worcester Royal Hospital. He completed medical training...

Read more
Dr Cheng Boon

Dr Sanjana Masinghe

Dr Sanana Masinghe has been a consultant clinical oncologist at James Cook University Hospital, South Tees NHS Trust since 2016 and also...

Read more
Dr Sanjana Masinghe

Dr Rhian Davies

Dr Rhian Davies is a Consultant Clinical Oncologist specialising in the management of urological cancers. Her NHS post is in...

Read more
Dr Rhian Davies

Prof Peter Barrett-Lee

Professor Peter Barrett-Lee is a Consultant Clinical Oncologist, Professor of Oncology in the School of Medicine at Cardiff University and...

Read more
Prof Peter Barrett-Lee

Dr Eleanor Aynsley

Dr Aynsley graduated from Leeds Medical School in 1999. She did medical training in Durham, gaining MRCP in 2004. She...

Read more
Dr Eleanor Aynsley

Prof John Staffurth

Professor John Staffurth is a Consultant Clinical Oncologist specialising in urological oncology. His clinical base is at Velindre Cancer Centre...

Read more
Prof John Staffurth

Dr Muthiah Sivaramalingam

Dr Muthiah Sivaramalingam has been a consultant in Clinical Oncology since 2007 and has been Principal Investigator for many clinical...

Read more
Dr Muthiah Sivaramalingam

Dr Brinda Sethugavalar

Dr Brinda Sethugavalar studied primary medical education at the University of Dundee Medical School and obtained MBChB in 2004. She completed...

Read more
Dr Brinda Sethugavalar

Cancer treatments we offer

The Rutherford Cancer Centres provide high-quality cancer care by offering access to innovative and advanced treatment techniques using leading technology.

Consultants we work with

We provide exceptional patient support from diagnosis through to treatment and recovery, with leading consultants available at our centres across the country.

Centres across the UK

The Rutherford Cancer Centres provide cancer treatments and other healthcare services across the UK with our centres designed to put the patient experience first.

Contact Us

Get in Touch

If you'd like to speak to us about any of the treatments we offer please don’t hesitate to get in touch. Call us on 0800 210 0402 or

Our Trusted Healthcare Partners