Comparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis

Chua, Daniel T.T.; Wu, San‐Gang; Lee, Victor; Tsang, Janice

doi:10.1186/1758-3284-1-13

Cited by 58 publications

(28 citation statements)

References 35 publications

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“…In patient with local failure of nasopharyngeal cancer, Chua et al reported that incidence of severe late complications was 33% in SRS group vs. 21% in hSRT group, including brain necrosis (16% vs. 12%) and hemorrhage (5% vs. 2%) and they preferred use of fractionated treatment [15]. Cengiz et al reported a high incidence (15%) of bleeding after hSRT using the CyberKnife system [11]; this value was similar to that (9.5%) reported by us in a previous study [10].…”

Section: Discussionmentioning

confidence: 96%

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Yamazaki

Ogita²,

Kodani

et al. 2013

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 96%

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Yamazaki

Ogita²,

Kodani

et al. 2013

Radiotherapy and Oncology

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“…Assuming an α/β ratio of 3 Gy and estimating that a bed-σ (summated bed) of 143 Gy would induce 20% more toxicity than a bed-1 (primary course) of 111 Gy, they found that 58 found that a total equivalent dose of 50 Gy or more improved local control. A study by Chua et al 48 compared single-fraction (srs) and multiple-fraction (srm) stereotactic radiotherapy in a matched-pair design. Compared with srs, srm led to better local control in npc (p = 0.003), but os was not significantly different (p = 0.31).…”

Section: What Is the Optimal Dose And Fractionation When Delivering Rmentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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Recurrent nasopharyngeal carcinoma, which represents a small proportion of head-and-neck cancers, has a unique set of patho-clinical characteristics. The management of recurrent nasopharyngeal carcinoma remains a challenging clinical problem. Traditional treatments offer limited local control and survival benefits; more seriously, they frequently induce severe late complications. Recently, novel treatment techniques and strategies—including precision radiotherapy, endoscopic surgery or transoral robotic resection, third-generation chemotherapy regimens, and targeted therapies and immunotherapy—have provided new hope for patients with recurrent nasopharyngeal carcinoma. Some of these patients can potentially be cured with modern treatments. However, a lack of adequate evidence makes it difficult for clinicians to apply these powerful techniques and strategies. Individualized management guidelines, full evaluation of quality of life in these patients, and a further understanding of the mechanisms underlying recurrence are future directions for research into recurrent nasopharyngeal carcinoma.

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“…Chua and Wu et al compared their treatment results in a matched cohort analysis [29]. Patients were matched individually for the following prognostic factors: persistent versus recurrent disease, rT stage, and tumor volume.…”

Section: Treatmentmentioning

confidence: 99%

Current Treatment Options for Local Residual Nasopharyngeal Carcinoma

Stoker

Diessen

Boer

et al. 2013

Curr. Treat. Options in Oncol.

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Opinion statementLocal residual disease occurs in 7-13 % after primary treatment for nasopharyngeal carcinoma (NPC). To prevent tumor progression and/or distant metastasis, treatment is indicated. Biopsy is the “gold standard” for diagnosing residual disease. Because late histological regression frequently is seen after primary treatment for NPC, biopsy should be performed when imaging or endoscopy is suspicious at 10 weeks. Different modalities can be used in the treatment of local residual disease. Interestingly, the treatment of residual disease has better outcomes than treatment of recurrent disease. For early-stage disease (rT1-2), treatment results and survival rates are very good and comparable to patients who had a complete response after the first treatment. Surgery (endoscopic or open), brachytherapy (interstitial or intracavitary), external or stereotactic beam radiotherapy, or photodynamic therapy all have very good and comparable response rates. Choice should depend on the extension of disease, feasibility of the treatment, and doctor’s and patient’s preferences and experience, as well as the risks of the adverse events. For the more extended tumors, choice of treatment is more difficult, because complete response rates are poorer and severe side effects are not uncommon. The results of external beam reirradiation and stereotactic radiotherapy are better than brachytherapy for T3-4 tumors. Photodynamic therapy resulted in good palliative responses in a few patients with extensive disease. Also, chemotherapeutics or the Epstein-Barr virus targeted therapies can be used when curative intent treatment is not feasible anymore. However, their advantage in isolated local failure has not been well described yet. Because residual disease often is a problem in countries with a high incidence of NPC and limited radiotherapeutic and surgical facilities, it should be understood that most of the above mentioned therapeutic modalities (radiotherapy and surgery) will not be readily available. More research with controlled, randomized trials are needed to find realistic treatment options for residual disease.

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Comparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis

Cited by 58 publications

References 35 publications

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Current Treatment Options for Local Residual Nasopharyngeal Carcinoma

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