A Single Institution Experience With Pediatric Nasopharyngeal Carcinoma: High Incidence of Toxicity Associated With Platinum-based Chemotherapy Plus IMRT

Louis, Chrystal U.; Paulino, Arnold dela Cruz; Gottschalk, Stephen; Bertuch, Alison A.; Chintagumpala, Murali; Heslop, Helen E.; Russell, Heidi V.

doi:10.1097/mph.0b013e3180959af4

Cited by 27 publications

(51 citation statements)

References 23 publications

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“…Eighteen studies reported data on salivary gland hypofunction (13 salivary flow rate and five scintigraphy), and 44 studies assessed xerostomia. Finally, only one study assessed IMRT and xerostomia in a pediatric population [109].…”

Section: D Conformal Radiotherapymentioning

confidence: 99%

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Jensen

Pedersen

Vissink

et al. 2010

Support Care Cancer

379

297

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Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse literature included pediatric cancer populations, cancer chemotherapy, radioactive iodine treatment, total body irradiation/hematopoietic stem cell transplantation, and immunotherapy.

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Section: D Conformal Radiotherapymentioning

confidence: 99%

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Jensen

Pedersen

Vissink

et al. 2010

Support Care Cancer

379

297

View full text Add to dashboard Cite

show abstract

“…Eighteen studies reported data on salivary gland hypofunction (13 salivary flow rate, five by scintigraphy), and 44 studies assessed xerostomia. One study included a pediatric population [24]. General consen- RCT randomized controlled trial, IMRT intensity-modulated radiation therapy, RT radiation therapy, HBO hyperbaric oxygen a One study included both IMRT and amifostine b One study included pilocarpine both during and after RT c One study included both saliva substitutes and pilocarpine sus from the randomized controlled trials, cohort, casecontrol, and cross-sectional studies provided supporting evidence that parotid-sparing IMRT has the potential to decrease the prevalence and severity of salivary gland hypofunction and xerostomia .…”

Section: Assessment Of Management Strategiesmentioning

confidence: 99%

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact

Jensen

Pedersen

Vissink

et al. 2010

Support Care Cancer

226

180

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There is evidence that salivary gland hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree, depending on the type of cancer treatment. Management guideline recommendations are provided for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. Fields of sparse literature identified included effects of gustatory and masticatory stimulation, specific oral mucosal lubricant formulas, submandibular gland transfer, acupuncture, hyperbaric oxygen treatment, management strategies in pediatric cancer populations, and the economic consequences of salivary gland hypofunction and xerostomia.

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“…To the best of our knowledge, only one study has examined the use of IMRT in pediatric and adolescent NPC, and this study reported a high incidence of acute and late toxicities associated with platinum-based chemotherapy plus IMRT in 5 patients[11]. Compared with the effects of IMRT in adults, these poor outcomes make it essential to improve the application of IMRT in pediatric and adolescent NPC.…”

mentioning

confidence: 99%

Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma

Chang¹,

Liu²,

TANG³

et al. 2013

Chin J Cancer

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The application of simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in pediatric and adolescent nasopharyngeal carcinoma (NPC) is underevaluated. This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy. Thirty-four patients (aged 8–20 years) with histologically proven, non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study. The disease stage distribution was as follows: stage I, 1 (2.9%); stage III, 14 (41.2%); and stage IV, 19 (55.9%). All patients underwent SIB-IMRT and 30 patients also underwent cisplatin-based chemotherapy. The prescribed dose of IMRT was 64–68 Gy in 29–31 fractions to the nasopharyngeal gross target volume. Within the median follow-up of 52 months (range, 9–111 months), 1 patient (2.9%) experienced local recurrence and 4 (11.8%) developed distant metastasis (to the lung in 3 cases and to multiple organs in 1 case). Four patients (11.8%) died due to recurrence or metastasis. The 5-year locoregional relapse–free survival, distant metastasis–free survival, disease-free survival, and overall survival rates were 97.1%, 88.2%, 85.3%, and 88.2%, respectively. The most common acute toxicities were grades 3–4 hematologic toxicities and stomatitis. Of the 24 patients who survived for more than 2 years, 16 (66.7%) and 15 (62.5%) developed grades 1–2 xerostomia and ototoxicity, respectively. Two patients (8.3%) developed grade 3 ototoxicity; no grade 4 toxicities were observed. SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC, with mild incidence of late toxicities. Distant metastasis is the predominant mode of failure.

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A Single Institution Experience With Pediatric Nasopharyngeal Carcinoma: High Incidence of Toxicity Associated With Platinum-based Chemotherapy Plus IMRT

Abstract: We did not observe a significant decrease in long-term toxicities with IMRT plus chemotherapy in our small cohort of pediatric NPC patients.

Cited by 27 publications

References 23 publications

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact

Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma

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