A phase II study of adaptive two-step intensity-modulated radiation therapy (IMRT) with chemotherapy for loco-regionally advanced nasopharyngeal cancer (JCOG1015)

Nishimura, Yasumasa; Ishikura, Satoshi; Shibata, Taro; Kodaira, Takeshi; Ito, Yoshiaki; Tsuchiya, Kunihiko; Murakami, Yuji; Saitoh, Jun; Akimoto, Tetsuo; Nakata, Kensei; Yoshimura, Masataka; Teshima, Teruki; Toshiyasu, Takashi; Ota, Yosuke; Ishikawa, Kazuki; Shimizu, Hidetoshi; Minemura, Toshiyuki; Nakamura, Kenichi; Hiraoka, Masahiro

doi:10.1007/s10147-020-01665-2

Cited by 15 publications

(11 citation statements)

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“…All 101 patients were treated using a two‐step intensity‐modulated RT (IMRT) technique. At our institution, a two‐step method is used for head and neck cancers instead of the simultaneous integrated boost method 20 . The procedure of two‐step IMRT has been previously described in detail 8 .…”

Section: Methodsmentioning

confidence: 99%

“…At our institution, a two‐step method is used for head and neck cancers instead of the simultaneous integrated boost method. 20 The procedure of two‐step IMRT has been previously described in detail. 8 In short, whole neck RT of 44.0–50.0 Gy/22–25 fractions was delivered, followed by boost doses to the high‐risk clinical target volume (CTV) up to a total dose of 70.0 Gy/35 fractions.…”

Section: Methodsmentioning

confidence: 99%

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Serum lactate dehydrogenase is a predictive biomarker in patients with oropharyngeal cancer undergoing radiotherapy: Retrospective study on predictive factors

et al. 2021

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Background The present study aimed to evaluate the prognostic factors in human papillomavirus (HPV)‐positive and HPV‐negative oropharyngeal cancer (OPC) treated with definitive radiotherapy. Methods We retrospectively evaluated 101 patients with OPC who underwent definitive radiotherapy between 2008 and 2018. Results The median follow‐up period of the surviving patients was 68 months (range, 8–164 months). The 5‐year overall survival rate was 69.8%. Univariate analyses revealed that poor survival was associated with male sex, smoking ≥30 pack‐years, Eastern Cooperative Oncology Group performance status ≥1, tumor‐node‐metastasis (TNM) stage III‐IV (8th edition), HPV‐negativity, serum lactate dehydrogenase (LDH) ≥202, C‐reactive protein/albumin ratio ≥0.15, and lymphocyte‐to‐monocyte ratio <2.90. In multivariate analyses, poor survival was independently correlated with smoking ≥30 pack‐years (p < 0.01) and LDH ≥202 (p = 0.02). Conclusions The present study suggested that high LDH levels predicted poor survival after definitive radiotherapy for patients with both HPV‐positive and HPV‐negative OPC.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Serum lactate dehydrogenase is a predictive biomarker in patients with oropharyngeal cancer undergoing radiotherapy: Retrospective study on predictive factors

et al. 2021

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“…IMRT/VMAT will be utilized in various JCOG clinical trials not only in the JCOG-RTSG but also in other JCOG study groups using radiotherapy. The multicenter clinical trials that are representative of the JCOG-RTSG are JCOG1015 [ 9 ], JCOG1208 for head and neck, and JCOG1402 (a joint study with the JCOG Gynecologic Cancer Study Group) for the uterus and cervix. In JCOG1008, JCOG1212, JCOG1303, JCOG1703 and JCOG1910, which are representative of the JCOG Head and Neck Cancer Study Group and Brain Tumor Study Group, IMRT/VMAT is used.…”

Section: Dosimetry Audit System For Imrt/vmat Clinical Trials: Jcog10mentioning

confidence: 99%

An overview of the medical-physics-related verification system for radiotherapy multicenter clinical trials by the Medical Physics Working Group in the Japan Clinical Oncology Group–Radiation Therapy Study Group

Nishio

Nakamura

Okamoto

et al. 2020

Journal of Radiation Research

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The Japan Clinical Oncology Group–Radiation Therapy Study Group (JCOG-RTSG) has initiated several multicenter clinical trials for high-precision radiotherapy, which are presently ongoing. When conducting multi-center clinical trials, a large difference in physical quantities, such as the absolute doses to the target and the organ at risk, as well as the irradiation localization accuracy, affects the treatment outcome. Therefore, the differences in the various physical quantities used in different institutions must be within an acceptable range for conducting multicenter clinical trials, and this must be verified with medical physics consideration. In 2011, Japan’s first Medical Physics Working Group (MPWG) in the JCOG-RTSG was established to perform this medical-physics-related verification for multicenter clinical trials. We have developed an auditing method to verify the accuracy of the absolute dose and the irradiation localization. Subsequently, we credentialed the participating institutions in the JCOG multicenter clinical trials that were using stereotactic body radiotherapy (SBRT) for lungs, intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) for several disease sites, and proton beam therapy (PT) for the liver. From the verification results, accuracies of the absolute dose and the irradiation localization among the participating institutions of the multicenter clinical trial were assured, and the JCOG clinical trials could be initiated.

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“…This was a prospective clinical study (JCOG1015) based on an original study by Nishimura et al in Japan with IMXT. 9,21 That protocol was based on practical standard IMXT in Japan for nasopharyngeal carcinoma. Our IMPT study was designed to be compatible with that protocol.…”

Section: B | Target Volume Oars and Dose Prescriptionmentioning

confidence: 99%

Potential benefits of adaptive intensity‐modulated proton therapy in nasopharyngeal carcinomas

Minatogawa

Yasuda

Dekura

et al. 2020

J Applied Clin Med Phys

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Purpose: To investigate potential advantages of adaptive intensity-modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity-modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC).Methods: Ten patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46 Gy in 23 fractions (46Gy/23Fx.) was prescribed using the initial plan and 24Gy/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT. Results:The means of the D mean of the right parotid gland (P < 0.001), right TM joint (P < 0.001), left TM joint (P < 0.001), oral cavity (P < 0.001), supraglottic larynx (P = 0.001), glottic larynx (P < 0.001), , middle PCM (P = 0.0371), interior PCM (P < 0.001), cricopharyngeal muscle (P = 0.03643), and thyroid gland (P = 0.00216), in A-IMPT are lower than those of A-IMXT, with statistical significance. The means of, D 0.03cc , and D mean of each sub portion of auditory apparatus and D 30% for Eustachian tube and D 0.5cc for mastoid volume in A-IMPT are significantly lower than those of A-IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 Gy (RBE = 1.1).

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A phase II study of adaptive two-step intensity-modulated radiation therapy (IMRT) with chemotherapy for loco-regionally advanced nasopharyngeal cancer (JCOG1015)

Cited by 15 publications

References 38 publications

Serum lactate dehydrogenase is a predictive biomarker in patients with oropharyngeal cancer undergoing radiotherapy: Retrospective study on predictive factors

Serum lactate dehydrogenase is a predictive biomarker in patients with oropharyngeal cancer undergoing radiotherapy: Retrospective study on predictive factors

An overview of the medical-physics-related verification system for radiotherapy multicenter clinical trials by the Medical Physics Working Group in the Japan Clinical Oncology Group–Radiation Therapy Study Group

Potential benefits of adaptive intensity‐modulated proton therapy in nasopharyngeal carcinomas

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