Vagina Carotica

Vagina Carotica

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1 Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Feng Liu et al.

Chin Med J (Engl) .

2012 Jul .

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1 Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Liu F, Xiao JP, Xu GZ, Gao L, Xu YJ, Zhang Y, Jiang XS, Yi JL, Luo JW, Huang XD, Huan FK, Fang H, Wan B, Li YX.
Liu F, et al.
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Wu SX, Chua DT, Deng ML, Zhao C, Li FY, Sham JS, Wang HY, Bao Y, Gao YH, Zeng ZF.
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Background:

Local failure of nasopharyngeal carcinoma (NPC) after radiotherapy (RT) remains one of the major treatment failures. This study aimed to evaluate the clinical efficacy and complications of fractionated stereotactic radiotherapy (FSRT) with vagina carotica protection technique for local residual of NPC patients after the primary RT.

Methods:

From August 2006 to August 2010, FSRT with vagina carotica protection technique was applied to 36 patients in our department, the patients aged between 13 and 76 years with a median of 41.3 years, 25 of them were male and 11 were female. According to 2002 Union for International Cancer Control (UICC) Staging System, the stages before primary radiotherapy were: IIa 2, IIb 5, III 18, IVa 7, IVb 4. In the first course of radiotherapy, 9 patients received conventional RT, 27 patients received intensity modulated radiotherapy (IMRT) and 20 out of the 36 patients received concurrent chemoradiotherapy. The total dose in the first course of RT was 69.96 - 76.90 Gy (median, 72.58 Gy). The intervals between the primary RT and FSRT ranged from 12 to 147 days (median, 39.8 days). Target volumes ranged from 1.46 to 32.98 cm(3) (median, 14.94 cm(3)). The total FSRT doses were 10.0 - 24.0 Gy (median, 16.5 Gy) with 2.0 - 5.0 Gy per fraction. The most common regimen was 15 Gy in 5 fractions of 3 Gy, the irradiation dose to vagina carotica was less than 2 Gy per fraction.

Results:

The median follow-up time was 34 months (range, 12 - 59 months). The 3-year local control rate was 100%; the 3-year overall survival rate was 94.4%; the 3-year disease-free survival rate was 77.8%. In this study, we had one case of cranial nerve injury, two cases of temporal lobe necrosis, and no nasopharyngeal massive hemorrhage was observed.

Conclusion:

FSRT with vagina carotica protection technique is an effective and safe RT regimen for local residual of NPC with reduction of radiation-related neurovascular lesions.

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doi: 10.3760/cma.j.issn.0366-6999.2012.14.024

Isodose distribution using FSRT for persistent disease at nasopharynx occurring after the primary RT. Prescribed dose (90% isodose line) of FSRT was 15 Gy in five fractions to cover the target volume. The red line is the margin of target volume, the other lines are different levels of isodose line.
Survival rate (%) of 36 residual NPC patients after FSRT

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Chinese Medical Journal125(14):2525-2529, July 2012.

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LIU, Feng; XIAO, Jian-ping; XU, Ying-jie; ZHANG, Ye; XU, Guo-zhen; GAO, Li; YI, Jun-lin; LUO, Jing-wei; HUANG, Xiao-dong; HUAN, Fu-kui; FANG, Hao; WAN, Bao; LI, Ye-xiong
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China (Liu F, Xiao JP, Xu YJ, Zhang Y, Xu GZ, Gao L, Yi JL, Luo JW, Huang XD, Huan FK, Fang H, Wan B and Li YX)
Correspondence to: Dr. XIAO Jian-ping, Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China (Tel: 86-10-87788664. Fax: 86-10-67706153. Email: jpxiao8@yahoo.com.cn )
Local failure of nasopharyngeal carcinoma (NPC) after radiotherapy (RT) remains one of the major treatment failures. This study aimed to evaluate the clinical efficacy and complications of fractionated stereotactic radiotherapy (FSRT) with vagina carotica protection technique for local residual of NPC patients after the primary RT.
From August 2006 to August 2010, FSRT with vagina carotica protection technique was applied to 36 patients in our department, the patients aged between 13 and 76 years with a median of 41.3 years, 25 of them were male and 11 were female. According to 2002 Union for International Cancer Control (UICC) Staging System, the stages before primary radiotherapy were: IIa 2, IIb 5, III 18, IVa 7, IVb 4. In the first course of radiotherapy, 9 patients received conventional RT, 27 patients received intensity modulated radiotherapy (IMRT) and 20 out of the 36 patients received concurrent chemoradiotherapy. The total dose in the first course of RT was 69.96-76.90 Gy (median, 72.58 Gy). The intervals between the primary RT and FSRT ranged from 12 to 147 days (median, 39.8 days). Target volumes ranged from 1.46 to 32.98 cm 3 (median, 14.94 cm 3 ). The total FSRT doses were 10.0-24.0 Gy (median, 16.5 Gy) with 2.0-5.0 Gy per fraction. The most common regimen
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