Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma

Lu, Tai Xiang; Yuan, Wei; Teh, Bin S.; Zhao, Chong; Han, Fei; Yin, Hui; Deng, Xiao Wu; Lu, Li Xia; Huang, Shao Min; Zeng, Zhi Fan; Lin, Cheng; Lu, Haiquan; Chiu, J. Kam; Carpenter, L. Steven; Grant, Walter H.; Woo, Shiao Y.; Cui, Nan; Butler, E. Brian

doi:10.1016/s0360-3016(03)01508-6

Cited by 132 publications

(80 citation statements)

References 29 publications

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“…[7][8][9]14 rT4 (especially with intracranial extension via the foramen lacerum and foramen ovale) was the predominant manifestation of locoregional recurrence, which is also in agreement with international data. 15 Recurrence with intracranial extension was found to have poor DFS and OS Note: Bold data indicate significant P-values.…”

Section: Discussionsupporting

confidence: 90%

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy in Saudi Arabia.

Maklad¹,

Bayoumi²,

Senosy³

et al. 2016

JCO

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Background:We aimed to investigate the patterns of failure (locoregional and distant metastasis), associated factors, and treatment outcomes in nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy (IMRT) combined with chemotherapy. Patients and methods: From April 2006 to December 2011, 68 nasopharyngeal carcinoma patients were treated with IMRT and chemotherapy at our hospital. Median radiation doses delivered to gross tumor volume and positive neck nodes were 66-70 Gy, 63 Gy to clinical target volume, and 50.4-56 Gy to clinically negative neck. The clinical toxicities, patterns of failures, locoregional control, distant metastasis control, disease-free survival, and overall survival were observed. Results: The median follow-up time was 52.2 months (range: 11-87 months). Epstein-Barr virus infection was positive in 63.2% of patients. Overall disease failure developed in 21 patients, of whom 85.8% belonged to stage III/IV disease. Among these, there were seven locoregional recurrences, three regional recurrences with distant metastases, and eleven distant metastases. The median interval from the date of diagnosis to failure was 26.5 months (range: 16-50 months). Six of ten (60%) locoregional recurrences were treated with reirradiation ± concurrent chemotherapy. The 5-year locoregional control, distant metastasis control, disease-free survival, and overall survival rates of whole cohort were 81.1%, 74.3%, 60.1%, and 73.4%, respectively. Cox regression analyses revealed that neoadjuvant chemotherapy, age, and Epstein-Barr virus were independent predictors for disease-free survival. Conclusion: Neoadjuvant chemotherapy followed by IMRT with or without chemotherapy improves the long-term survival of Saudi patients with nasopharyngeal carcinoma. Distant metastasis was the main pattern of treatment failure. Neoadjuvant chemotherapy, age, and Epstein-Barr virus status before IMRT were important independent prognostic factors.

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Section: Discussionsupporting

confidence: 90%

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy in Saudi Arabia.

Maklad¹,

Bayoumi²,

Senosy³

et al. 2016

JCO

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“…Reirradiation is more feasible with IMRT than with conventional techniques for the many reasons stated above. Lu et al [37] have recently reported on their experience with reirradiation using IMRT for recurrent nasopharyngeal cancer. Acute toxicity of the skin, mucosa, and salivary glands was acceptable according to RTOG criteria.…”

Section: Imrt For Nasopharyngeal Carcinomamentioning

confidence: 99%

“…At a median follow-up of 9 months, the locoregional control rate was 100%. Although longer follow-up is necessary, the preliminary toxicity and local control data for these recurrent cases are promising [37].…”

Section: Imrt For Nasopharyngeal Carcinomamentioning

confidence: 99%

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

et al. 2007

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After completing this course, the reader will be able to:1. Outline innovations related to targeted radiation therapy.2. Describe trials proving an advantage using IMRT.3. Assess treatment planning modalities and how IMRT fields are designed.4. Evaluate when there is a toxicity advantage for IMRT.5. Discern when conventional radiotherapy should be used instead of IMRT.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACT Intensity-modulated radiation therapy (IMRT) for head and neck tumors refers to a new approach that aims at increasing the radiation dose gradient between the target tissues and the surrounding normal tissues at risk, thus offering the prospect of increasing the locoregional control probability while decreasing the complication rate. As a prerequisite, IMRT requires a proper selection and delineation of target volumes. For the latter, recent data indicate the potential of functional imaging to complement anatomic imaging modalities. Nonrandomized clinical series in paranasal sinuses and pharyngolaryngeal carcinoma have shown that IMRT was able to achieve a very high rate of locoregional control with less morbidity, such as dry-eye syndrome, xerostomia, and swallowing dysfunction. The promising results of IMRT are likely to be achieved when many treatment conditions are met, for example, optimal selection and delineation of the target volumes and organs at risk, appropriate physical quality control of the irradiation, and accurate patient setup with the use of onboard imaging. Because of the complexity of the various tasks, it is thus likely that these conditions will only be

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“…In the reported reirradiation studies except those with BT alone, the majority of the recurrences are at advanced stage with a ratio of 15-73.3% and 8-53% for rT3-4 tumor and rStage-4 diseases, respectively (Lee et al, 1997;Xiao et al, 2001;Lu et al, 2004;Chua et al, 2005;Wu et al, 2007;Seo et al, 2009;Koutcher et al, 2010;Ozyigit et al, 2011). In our series the 41.7% of the cases were with rT3-4 and 29.2% were with rStage-4 disease.…”

Section: Discussionmentioning

confidence: 46%

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

Dizman¹,

Coskun-Breuneval²,

Altinisik-Inan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma

Cited by 132 publications

References 29 publications

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy in Saudi Arabia.

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy in Saudi Arabia.

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

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