CT-Guided 125 I Brachytherapy for Locally Recurrent Nasopharyngeal Carcinoma

Yan, Huzheng; Zhang, Fujun

doi:10.1016/j.brachy.2017.04.026

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…As such, based on the treatment strategy, 101 cohorts underwent data collection. Among these, 24 cohorts reported on IMRT, 26–49 17 on CRT, 34,49–64 11 on SRS, 34,57,65–73 9 on brachytherapy, 13,47,51,74–79 18 on open nasopharyngectomy, 41,80–95 and 22 on endoscopic nasopharyngectomy 39,40,48,49,62,92,96–112 …”

Section: Resultsmentioning

confidence: 99%

Salvage treatments for locally recurrent nasopharyngeal cancer: Systematic review and meta‐analysis

Wang

Liao

et al. 2022

Head & Neck

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The present study aimed to evaluate the effectiveness and safety of various salvage treatments to treat locally recurrent nasopharyngeal carcinoma (IrNPC). A comprehensive search was conducted to gather relevant research publications on salvage treatment for IrNPC. Specifically, 2‐, 3‐, and 5‐year overall survival were the primary outcome. A total of 89 studies with 101 cohorts were collected. Endoscopic nasopharyngectomy was found to be associated with a significantly improved 5‐year OS compared with CRT (p = 0.027) and IMRT (p = 0.016). Moreover, based on recurrence T classification, the 2‐, 3‐, and 5‐year OS were similar across different treatments. Endoscopic nasopharyngectomy was associated with a significant reduction in treatment‐related complications (grade ≥ 3) compared with IMRT (p < 0.001) and open nasopharyngectomy (p = 0.028). Endoscopic nasopharyngectomy may provide comparable treatment outcomes to re‐irradiation, while offering a better safety profile for selective patients with resectable IrNPC.

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Section: Resultsmentioning

confidence: 99%

Salvage treatments for locally recurrent nasopharyngeal cancer: Systematic review and meta‐analysis

Wang

Liao

et al. 2022

Head & Neck

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“…Some recent studies showed that 125 I brachytherapy was a feasible, safe, and effective treatment for locally recurrent NPC, and the 3D high‐definition endoscopic system improves the precision of endoscopic nasopharyngectomy, particularly when dissection of the internal carotid artery and dura is required . With advances in technology, the appropriate treatment protocol for patients with detected pre EBV DNA may need further study.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognostic value of pre‐retreatment plasma epstein‐barr virus DNA in locoregional recurrent nasopharyngeal carcinoma

et al. 2019

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Purpose To define the clinical characteristics and prognostic value of pre‐retreatment plasma Epstein‐Barr virus (EBV) DNA, we investigated EBV status in locoregional recurrent nasopharyngeal carcinoma (lrNPC) patients. Methods Between April 2008 and August 2016, the data of patients with nonmetastatic lrNPC were retrospectively reviewed. The survival indexes of patients between different pre‐retreatment EBV status groups were compared. Results A total of 401 patients with nonmetastatic lrNPC were enrolled, and 197 (49.1%) patients had detectable pre‐retreatment plasma EBV DNA. Treatment included radiotherapy alone (n = 37 patients), surgery alone (n = 105), radiotherapy (n = 208), surgery combined with radiotherapy (n = 20), chemotherapy and targeted therapy (n = 31). Median follow‐up was 32 months. The 3‐year locoregional relapse‐free survival (LRRFS), distant metastasis‐free survival (DMFS), and overall survival (OS) rates for the entire cohort were 64.8%, 89.4%, and 58.8%, respectively. The estimated 3‐year LRRFS, DMFS, and OS rates for the pre EBV‐positive group vs the pre EBV‐negative group were 54.2% vs 75.0% ( P < 0.001), 86.6% vs 91.9% ( P = 0.05), 51.6% vs 65.9% ( P = 0.01), respectively. Among patients in the clinical stage rI/II, there were 17 patients in the radiotherapy alone group and 49 patients in the surgery alone group. And there was no significant difference in overall survival between radiotherapy and surgery, even among the different pre‐EBV statuses ( P > 0.05). In terms of long‐term toxic and side effects, the incidence of radioactive temporal lobe injury in the radiotherapy group was higher than that in the surgery group (35.3% vs 8.2%, P < 0.001), and no statistically significant difference was found in other long‐term toxic and side effects. Conclusions The positive rate of pre‐retreatment plasma EBV DNA in lrNPC is lower than primary NPC. The prognosis of EBV DNA negative group is better than positive group. For locally early‐stage lrNPC, regardless of EBV DNA status, radiotherapy and surgery are available options and both can achieve better long‐term survival.

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“…In the consideration of cosmetic and functional outcomes, I-125 BT is an appropriate alternative ( 110 ). A clinical trial (n = 81) evaluating the efficacy of I-125 BT in locally recurrent NPC when compared with external beam re-radiotherapy reported a higher median local tumor PFS (LTPFS; 21 vs. 17 months, p = 0.015), without meaningfully impacting OS ( 85 ). Another study reported that the median LTPFS time (14 vs. 9 months, p < 0.001) of I-125 BT in treating distant metastases in the oral and maxillofacial region compared to EBRT was also higher ( 86 ).…”

Section: I-125 Brachytherapy In Solid Tumorsmentioning

confidence: 99%

Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions

Wei

Mengyuan

et al. 2021

Front. Oncol.

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Radioactive iodine-125 (I-125) is the most widely used radioactive sealed source for interstitial permanent brachytherapy (BT). BT has the exceptional ability to deliver extremely high doses that external beam radiotherapy (EBRT) could never achieve within treated lesions, with the added benefit that doses drop off rapidly outside the target lesion by minimizing the exposure of uninvolved surrounding normal tissue. Spurred by multiple biological and technological advances, BT application has experienced substantial alteration over the past few decades. The procedure of I-125 radioactive seed implantation evolved from ultrasound guidance to computed tomography guidance. Compellingly, the creative introduction of 3D-printed individual templates, BT treatment planning systems, and artificial intelligence navigator systems remarkably increased the accuracy of I-125 BT and individualized I-125 ablative radiotherapy. Of note, utilizing I-125 to treat carcinoma in hollow cavity organs was enabled by the utility of self-expandable metal stents (SEMSs). Initially, I-125 BT was only used in the treatment of rare tumors. However, an increasing number of clinical trials upheld the efficacy and safety of I-125 BT in almost all tumors. Therefore, this study aims to summarize the recent advances of I-125 BT in cancer therapy, which cover experimental research to clinical investigations, including the development of novel techniques. This review also raises unanswered questions that may prompt future clinical trials and experimental work.

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CT-Guided 125 I Brachytherapy for Locally Recurrent Nasopharyngeal Carcinoma

Cited by 3 publications

References 10 publications

Salvage treatments for locally recurrent nasopharyngeal cancer: Systematic review and meta‐analysis

Salvage treatments for locally recurrent nasopharyngeal cancer: Systematic review and meta‐analysis

Clinical characteristics and prognostic value of pre‐retreatment plasma epstein‐barr virus DNA in locoregional recurrent nasopharyngeal carcinoma

Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions

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