Table of Contents
Journal of Radiotherapy
Volume 2014, Article ID 268340, 8 pages
Clinical Study

Late Toxicities after Conventional Radiotherapy for Nasopharyngeal Carcinoma: Incidence and Risk Factors

1Department of Radiation Oncology, Habib Bourguiba University Hospital, Majida Boulila Road 3029, Sfax 3029, Tunisia
2Department of Otolaryngology, Habib Bourguiba University Hospital, Sfax 3029, Tunisia
3Department of Radiology, Habib Bourguiba University Hospital, Sfax 3029, Tunisia
4Department of Medical Oncology, Habib Bourguiba University Hospital, Sfax 3029, Tunisia

Received 30 September 2013; Revised 30 November 2013; Accepted 29 December 2013; Published 10 February 2014

Academic Editor: Wai Tong Ng

Copyright © 2014 Wicem Siala et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. To determine the incidence and analyze the factors affecting late toxicity for nasopharyngeal carcinoma patients treated with conventional radiotherapy. Patients and Methods. Retrospective analysis was performed on 239 NPC patients treated between 1993 and 2004 in our institution. One hundred and fifty-seven patients were treated with conventional fractionation (2 Gy per fraction, 5 fractions per week) and eighty-two patients with hyperfractionated radiotherapy (1.6 Gy per fraction twice a day, 5 days per week). One hundred fifty nine patients underwent neoadjuvant cisplatin based chemotherapy. Late toxicity was evaluated according to the RTOG/EORTC score. Results. Xerostomia was the most common related complication (98.7%). Neoadjuvant chemotherapy and hyperfractionated radiotherapy did not increase late toxicities. Multivariate analyses showed that radiation dose was a significant factor for hearing impairment, younger age for trismus, initial node status for neck fibrosis, and initial dental hygiene for dental complications. Female gender was associated with significantly higher incidence of trismus and hearing impairment. Conclusion. Conventional radiotherapy was associated with a high rate of late toxicities which affect patients’ quality of life. With the development of three-dimensional conformal radiotherapy and intensity modulated radiotherapy, a reduced incidence of radiation related complications could be expected.