IMRT improves local control in patients with nasopharyngeal carcinoma compared with conventional radiotherapy: propensity score-matched analysis

Abstract

Background It is still controversial whether intensity-modulated radiotherapy has an obvious advantage over conventional radiotherapy. The purposes of this study were to evaluate prognostic factors in pre-treatment characteristics for nasopharyngeal carcinoma and to compare treatment outcomes in patients who received intensity-modulated radiotherapy and patients who received two-dimensional radiotherapy or three-dimensional radiotherapy. Methods We reviewed patients with nasopharyngeal carcinoma who received chemoradiotherapy in our hospital during the period from 2000 to 2017, and we excluded patients who had a history of surgery for nasopharyngeal carcinoma and those who had distant metastases before treatment. A total of 72 patients who were treated by radiotherapy with concurrent chemotherapy were enrolled. All of the patients were irradiated with a total dose of 58–70 Gy. Overall survival, locoregional control and progression-free survival rates were compared in the groups treated by intensity-modulated radiotherapy and two-dimensional/three-dimensional radiotherapy. Propensity score matching was performed to homogenize the two groups. Results The median follow-up period was 62.5 months. After propensity score matching, in patients treated with intensity-modulated radiotherapy, the 5-year rate of overall survival, locoregional control and progression-free survival were 73.5, 95.2 and 72.7%, respectively. In patients treated with two-dimensional/three-dimensional radiotherapy, the 5-year rate of overall survival, locoregional control and progression-free survival were 69.1, 67.7 and 51.8%, respectively. There was a significant difference between the groups only in locoregional control. Late toxicities of grade 2 or higher were occurred in 38.5 and 24.2% of the patients treated by two-dimensional/three-dimensional radiotherapy and intensity-modulated radiotherapy, respectively. Conclusions Our results suggested that intensity-modulated radiotherapy is more effective than two-dimensional/three-dimensional radiotherapy in patients with nasopharyngeal carcinoma, especially in locoregional control.

Cytoplasmic poly(A)-binding protein 1 (PABPC1) is a prognostic biomarker to predict survival in nasopharyngeal carcinoma regardless of chemoradiotherapy

“…RT or RT-based comprehensive treatment is the most effective curative NPC treatment. With the extensive application of RT, especially IMRT, the local control and survival rates of NPC have been significantly improved, despite some failures primarily due to distant metastasis [ 3 , 32 , 33 ]. The present study investigated much higher five-year OS and DFS survival rates in the IMRT-treated group than in the untreated group (87.5% vs. 40.5% for OS and 84.2% vs. 37.8% for DFS).…”

Current status of self-management efficacy and its correlation with post-traumatic growth、resilience in nasopharyngeal carcinoma patients treated with radiotherapy:A cross-sectional study

“…Considering the 20% ine ciency, the calculated sample size was 75-296 cases, and 205 cases were actually included. The inclusion criteria of this study were as follows: (1) NPC patients were con rmed by pathology; (2) patients receiving radiotherapy; (3) patients ≥ 18 years old; (5) Voluntary participation in this study and informed consent. Exclusion criteria are as follows: Patients with other tumors, mental illness or serious organic disease.…”

“…Because nasopharyngeal tumors show a high sensitivity to ionizing radiation [4] , patients with different disease stages should receive radiotherapy in their treatment plan in order to achieve the best therapeutic effect.Intensity Modulated Radiotherapy (IMRT) is the recommended radiotherapy method for NPC. Compared with traditional two-dimensional (2D) or three-dimensional (3D) radiotherapy, IMRT can provide high-dose radiation to NPC while protecting the adjacent important tissue structures [5] .Although with the continuous improvement of radiotherapy technology, the effect of IMRT can reduce the toxicity related to radiotherapy, the incidence of common toxic and side effects such as radiation dermatitis, oral mucositis and mouth di culty in patients receiving radiotherapy is still as high as 85%-100% [6][7][8][9] .Relevant studies have shown that the high incidence and aggravation of toxic and side effects will signi cantly affect the quality of life of patients and lead to the imbalance of treatment mentality and emotional anxiety of patients, thus affecting the degree of cooperation and enthusiasm of treatment [6] .…”

A machine learning approach for predicting radiation-induced hypothyroidism in patients with nasopharyngeal carcinoma undergoing tomotherapy

“…The increased adoption of IMRT, coupled with the systematic implementation of concurrent chemoradiotherapy, has greatly enhanced the treatment outcomes for nasopharyngeal carcinoma. As a result, the 5-year overall survival rate now stands at approximately 80% 5 , 6 .…”