Overview
The purpose of this study is to explore whether 18F-FDG PET/CT guided reduced-dose radiotherapy would maintain survival outcomes in nasopharyngeal carcinoma (NPC) patients.
Description
Enrolled patients with complete metabolic response (CMR) and more than 70% partial metabolic response (PMR) according to PERCIST criteria at the 25th fraction will receive intensity modulated radiation therapy (IMRT) of reduced-dose (prescribed dose, 63.6 Gy, 2.12 Gy per fractions, 30 fractions), for those who with ≤70% PMR will receive conventional dose (prescribed dose, 70Gy, 2.12 Gy per fractions, 33 fractions).
Eligibility
Inclusion Criteria:
- Pathology confirmed nasopharyngeal squamous cell carcinoma.
- Stage I-IVA（8thAJCC/UICC staging system).
- Aged 18-80 years.
- KPS≥70.
- Have measurable lesions on 18F-FDG PET/CT before treatment.
- HGB≥90 g/L，ANC≥1.5×109 /L，PLT≥80×109 /L.
- ALT,AST<2.5 fold of ULN；TBIL<2.0×ULN.
- CCR≥60ml/min or Cr<1.5×ULN.
- Signed informed consent.
- Have follow up condition.
Exclusion Criteria:
- Past malignancies history (except for stage I non-melanoma skin cancer or cervical carcinoma in situ).
- Age <18 or >80years.
- Pregnancy or lactation.
- History of previous radiotherapy (except for non-melanomatous skin cancers outside intended RT treatment volume).
- Prior chemotherapy or surgery (except diagnostic) to primary tumor or nodes.
- With sever infection and internal disease.
- Major organ dysfunction, such as decompensated cardiopulmonary, kidney, liver failure, cannot tolerate surgical treatment.