Soo Yoon Sung , MD 1 , Min Kyu Kang , MD 2 , Chul Seung Kay , MD 3 , Ki Chang Keum , MD 4 , Sung Hwan Kim , MD 5 , Yeon-Sil Kim , MD , 1 , Won Taek Kim , MD 6 , Ji-Yoon Kim , MD 7 , Jin-Hee Kim , MD 8 , Sung Ho Moon , MD 9 , Yong Chan Ahn , MD 10 , Young Taek Oh , MD 11 , Hong-Gyun Wu , MD 12 , Chang-Geol Lee , MD 4 , Woong-Ki Chung , MD 13 , Kwan Ho Cho , MD 9 , Moon-June Cho , MD 14 , Jin Hwa Choi , MD 15
30 September 2015
To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea.
A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions.
Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose.