Effect of relevant factors on radiation‐induced nasopharyngeal ulcer in patients with primary nasopharyngeal carcinoma treated with intensity‐modulated radiation therapy

Abstract

Objective: To analyze the correlation between relevant factors and radiation-induced nasopharyngeal ulcer (RINU) in primary nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT).Methods: Clinical data were collected for 599 patients with newly diagnosed NPC who had completed IMRT. The entire cohort was randomly divided into two subgroups. The relationship between RINU and IMRT dose-volume were statistically analyzed with ROC curves and the Chi-square test. Nutritional status during and after treatment was compared between patients with vs without RINU. Results:The results obtained showed that dose-volume had no effect on the incidence of RINU (P > .05). Nutrition-related parameters differed significantly between patients with vs without RINU (P < .05).

Irradiation-induced nasopharyngeal necrosis (INN) in newly diagnosed nasopharyngeal carcinoma treated by intensity-modulated radiation therapy: clinical characteristics and the influence of treatment strategies

“…The crude incidence rate of INN was 1-2.9% among the NPC population [11,12,14], and 3.3% in patients treated with IMRT while 2.3% with 2D radiotherapy [11]. Compared to 2D radiation therapy, IMRT enables target volumes to receive higher doses, which may increase the incidence of INN.…”

“…Quite a few studies have been reported risk factors to predict INN. The accumulated total dose of radiation, malnutrition, and infection are generally recognized as predictive factors [7,[10][11][12]. Yu developed a model including gender, pretreatment necrosis, accumulated total prescription dose, and recurrent tumor volume to predict INN in NPC patients with re-irradiation [13].…”

Irradiation-Induced Nasopharyngeal Necrosis in Newly Diagnosed Nasopharyngeal Carcinoma Treated by Intensity-Modulated Radiation Therapy: Clinical Characteristics and the Influence of Treatment Strategies

“…Therefore, we aimed to investigate whether the intensive treatment strategies would increase the risk of INN occurrence. A propensity-score matching methodology was used to balance other potential risk factors, such as T stage, gender, age, pathological type, biomarkers of nutritional status (hemoglobin, albumin, body mass index), and in ammation status (C-reactive protein, necrosis before re-irradiation), which were reported by published researches 11,12,13,17 . As a result, our study noted that adding chemotherapy or targeted therapy did not increase the risk of developing INN, as in line with other studies 11,23 .…”

“…Quite a few studies have been reported risk factors to predict INN. The accumulated total dose of radiation, malnutrition, and infection are generally recognized as predictive factors 10,11,7,12 . Yu developed a model including gender, pretreatment necrosis, accumulated total prescription dose, and recurrent tumor volume to predict INN in NPC patients with re-irradiation 13 .…”

“…Li et al indicated that the D3cc was an independent predictor for INN in primary NPC patients, which should be limited under 73.67 Gy 26 . On the contrary, Fei et al reported that dose-volume (tumor volume and ratio of tumor volume exposed to 74 Gy to GTV) did not affect the incidence of INN, neither did boost doses, which seems incompatible with clinical experience12 . Given the small sample (only nine patients developed INN in this study), the result should be hardly de nitive.…”