Uno studio di riferimento su 883 pazienti affetti da neoplasia della rinofaringe trattati in due Centri italiani dal 1977 al 2000. Parte I: evoluzione delle scelte tecniche e sopravvivenza

PurposE. The authors sought to define treatment results according to the different accrual periods and clinical- therapeutic features in a large series of nasopharyngeal cancer (NPC) patients treated in two Italian centres over more than two decades. Materials and methods. A total of 883 patients consecutively treated with radiotherapy between 1977 and 2000 at the Florence (FLO) and Brescia (IRA) Radiation Oncology centres were studied. Five-year overall (OS) and disease-specific (DSS) actuarial survival rates in the different pathological, clinical and therapeutic subgroups were calculated, along with the actuarial local-regional control (LRC) probabilitY. Results. At univariate analysis, survival and local control rates were significantly better in the more recent accrual periods and in the more favourable disease presentations; treatment-related parameters mainly affect LRC. At multivariate analysis, patient- and disease-related factors had a more evident prognostic effect than did therapeutic factors, although dose to the nasopharynx and treatment technique had a marginally significant impact on DSS and OS. Conclusions. Results of this benchmark study may be useful for understanding the development of new radio- therapy techniques for NPC, such as three-dimensional conformal radiotherapy (3D-CRT) and particularly intensity- modulated radiotherapy (IMRT). © Springer-Verlag 2011.