(4) Dr. Inoue, Japan, Rep. of Korea, presented on the recommended target volume and planning strategy by the Japanese College of Radiology (JCR) and various American institutions. Discussion was centered on the best patient position and field arrangement in the treatment of NPC. Central to the discussion was the tolerance dose of various structures especially optic nerve and chiasm, pituitary gland and temporal lobe. The reported data indicates that the tolerance of the optic nerve / chiasm is 50 - 65 Gy (Emami et al 1991). However the participants felt that the incidence of blindness among NPC survivors was rare in their respective practices. A review of the treatment plans and radiation doses to the optic nerve / chiasm on these survivors was recommended.

Dr. Cho gave a short lecture on the utility of a Positron Emission Tomography (PET) in tumour staging and a review of data from his institution on the use of PET/CT scan in NPC.

It was agreed that, for staging of NPC, CT scan is essential but MRI is optional. PET may be a useful modality, but is not available in all participating countries and therefore will not be used for staging.

Session3: Radiotherapy for NPC

The field margins and shaping blocks especially around the oral cavity and optic nerve were discussed in depth. A dose of 40 - 50 Gy to the optic nerve was deemed acceptable, but this structure should be excluded from the treatment fields thereafter if possible.

Session4: Acute Toxicity Criteria

(6) At the beginning of the session, Dr. Tsujii, Japan, gave a short presentation on the NIRS data on optic neuropathy and a short literature review. Dr. T. Ohno, Japan, presented on the standard radiation toxicity criteria based on CTCAE version 3 and RTOG/EORTC. There was extensive discussion on the slides on clinical cases presented especially with borderline cases. The CTCAE would be used for this study.

Session5: Chemotherapy for NPC

(7) Dr. Kullathorn, Thailand, gave a review of clinical trials on the use of chemotherapy in NPC especially in the adjuvant setting. This was followed on by Dr. Kobayashi, Japan, who emphasized on the benefit of concurrent chemo-radiotherapy and on the need to improve distant metastases control. He also gave a short review on other drugs for NPC including newer agents and possible directions for future trials.

Session 6: Drafting the Workshop Minutes

(8) The draft minutes was discussed, amended and adopted.

Closing ceremony

(9) Participants expressed appreciation to MEXT, NIRS, local staff organizing the meeting and JAIF. The participants also expressed their gratitude for the continuing support from the Government of Japan for this project. Closing Remarks were given by Dr. H. Tsujii, who expressed his appreciation to the organizing committee members and participants.

Thursday, July 22

        Arrive at Tokyo International Airport

Saturday, July 24