value of booster dose for local residual primary lesion of nasopharyngeal carcinoma

ABSTRACT

Twenty two patients with nasopharyngeal carcinoma with a documented residual lesion in the nasopharynx at 66 GY [clinically and/or pathologically] were studied. Booster dose 10-14 Gy was given in 14 patients while 8 patients did not receive the boost. The value of booster dose was reflected favourably upon the overall response rate and its duration and on the disease free survival rates. Among 14 patients received the boost, 3 have partial remission for a median 18 months and 11 patients have complete remission for a median 30 months. For the 8 patients left unboosted only one patients maintained a complete remission for 30 months; 3 patients have partial remission for a median 15 months and 4 patients with stationary disease for 12 months. The total local recurrence, rates of both groups of patients were 21.4% [3/14] and 87.5% [7/8], respectively. Local recurrence was relatively high among patients with primary well to moderately differentiated epitheliomas than poorly to un-differentiated ones, even in boosted patients. The disease-free survival rate for the whole study group was 50% at 36 months with a median follow-up period and overall survival of 27 and 14.5 months for the patients with and without primary boosting, respectively. Disease free-survival rate was significantly higher for the boosted than non-boosted patients [80% and 13% at 20 months, respectively], and with 73% disease free-survival at 36 months for the boosted patients. From this-study, we believe that booster dose for residual lesion in the nasopharynx [better pathologically proved] is necessary to improve the local control and the disease-free survival of patients