Evolution of treatment for nasopharyngeal cancer – Success and setback in the intensity-modulated radiotherapy era

Lee, Anne W.M.; Ng, Wai Tong; Chan, Lucy; Hung, Wai Man; Chan, Connie; Sze, Henry C.K.; Chan, Oscar S.H.; Chang, Amy; Yeung, Richie

doi:10.1016/j.radonc.2014.02.003

Cited by 320 publications

(270 citation statements)

References 26 publications

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“…Nasopharyngeal carcinoma (NPC) is a cancer of the epithelial cells of the nasopharynx and is associated with a high incidence of treatment failure and overall poor prognosis (1,2). The prevalence of NPC is skewed geographically with South-East Asia, the middle East, and Northern Africa being disproportionately affected (3).…”

Section: Introductionmentioning

confidence: 99%

Genomic Analysis of Nasopharyngeal Carcinoma Reveals TME-Based Subtypes

Zhang

MacIsaac

Zhou

et al. 2017

Molecular Cancer Research

134

115

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Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV) associated cancer characterized by a poor prognosis and a high level of lymphocyte infiltrate. Genetic hallmarks of NPC are not completely known but include deletion of the p16 (CDKN2A) locus and mutations in NF-kB pathway components, with a relatively low total mutational load. To better understand the genetic landscape, an integrated genomic analysis was performed using a large clinical cohort of treatment-na€ ve NPC tumor specimens. This genomic analysis was generally concordant with previous studies; however, three subtypes of NPC were identified by differences in immune cell gene expression, prognosis, tumor cell morphology, and genetic characteristics. A gene expression signature of proliferation was poorly prognostic and associated with either higher mutation load or specific EBV gene expression patterns in a subtype-specific manner. Finally, higher levels of stromal tumor-infiltrating lymphocytes associated with good prognosis and lower expression of a WNT and TGFb pathway activation signature.

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Section: Introductionmentioning

confidence: 99%

Genomic Analysis of Nasopharyngeal Carcinoma Reveals TME-Based Subtypes

Zhang

MacIsaac

Zhou

et al. 2017

Molecular Cancer Research

134

115

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“…Radiotherapy is the primary therapeutic method for locoregional advanced NPC (LANPC) because LANPC is sensitive to radiotherapy. In recent years, with the wide application of intensity modified radiation therapy (IMRT) and comprehensive therapies, the therapeutic efficacy for NPC patients has been further improved and the 5-year local recurrence free survival rate is up to 78.4%~80% Lee et al, 2014;. However, the therapeutic efficacy for LANPC patients is still unsatisfactory and the 5-year survival rate is only 70% .…”

Section: Introductionmentioning

confidence: 99%

Analysis on Clinical Characteristics and Influencing Factors of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

Zheng

Xu²,

Qiu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: To explore the independent prognostic factors for the recurrence/metastasis of patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods: A total of 604 patients initially diagnosed as LANPC by pathohistology in Fujian Provincial Cancer Hospital were selected to analyze the relationship between the clinical pathological patterns, therapeutic protocols and clinical stages with the recurrence/metastasis of LANPC. Results: The 1-, 3-and 5-year locoregionally recurrent rates of LANPC patients were 2.0%, 9.5% and 12.9% respectively, with average recurrent period being 78 months. Univariate analysis results indicated that clinical stages had certain influence on the recurrent period of LANPC patients. However, COX regression models showed that ages, genders and clinical stages were not the independent prognostic factors influencing the recurrence. The 1-, 3-and 5-year metastatic rates of LANPC patients were 6.6%, 17.5% and 18.8% respectively, with average metastatic period of 73 months. Univariate analysis results demonstrated that ages, N stages, clinical stages, locations of lymph node, retropharyngeal lymph node and extracapsular invasion of lymph node had certain influence on the metastatic period of LANPC patients. Additionally, further COX regression analysis results suggested that T stages, reduction protocols and extracapsular invasion of lymph node were the independent prognostic factors influencing the metastasis of patients with LANPC, in which T stages and extracapsular invasion of lymph node were the pestilent factors while reduction protocols the protective factor. Conclusions: Induction chemotherapy is beneficial to LANPC patients with initial treatment, and the metastatic rate decreases greatly after the application of reduction chemotherapy.

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“…1 Currently, the investigations for confirmation of NPC entail a nasopharyngeal endoscopy followed by an endoscopically directed biopsy at the site of an abnormality or sampling biopsies from an endoscopically normal nasopharynx. These methods may miss small nasopharyngeal carcinomas, however, because they are typically submucosal tumors or tumors located at the lateral aspect of the pharyngeal recess.…”

mentioning

confidence: 99%

Detection of Nasopharyngeal Carcinoma by MR Imaging: Diagnostic Accuracy of MRI Compared with Endoscopy and Endoscopic Biopsy Based on Long-Term Follow-Up

King¹,

Vlantis²,

Yuen³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Our previous nasopharyngeal carcinoma detection study, comparing MR imaging, endoscopy, and endoscopic biopsy, showed that MR imaging is a highly sensitive test that identifies nasopharyngeal carcinomas missed by endoscopy. However, at the close of that study, patients without biopsy-proved nasopharyngeal carcinoma nevertheless had shown suspicious abnormalities on endoscopy and/or MR imaging. The aim of this study was to determine whether there were any patients with undiagnosed nasopharyngeal carcinoma by obtaining long-term follow-up and to use these data to re-evaluate the diagnostic performance of MR imaging.

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Evolution of treatment for nasopharyngeal cancer – Success and setback in the intensity-modulated radiotherapy era

Cited by 320 publications

References 26 publications

Genomic Analysis of Nasopharyngeal Carcinoma Reveals TME-Based Subtypes

Genomic Analysis of Nasopharyngeal Carcinoma Reveals TME-Based Subtypes

Analysis on Clinical Characteristics and Influencing Factors of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

Detection of Nasopharyngeal Carcinoma by MR Imaging: Diagnostic Accuracy of MRI Compared with Endoscopy and Endoscopic Biopsy Based on Long-Term Follow-Up

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