Intensity-Modulated Radiation Therapy in the Salvage of Locally Recurrent Nasopharyngeal Carcinoma

Qiu, Sufang; Shen, Lin; Tham, Ivan; Pan, Jianji; Lü, Jun; Lu, Jiade J.

doi:10.1016/j.ijrobp.2011.07.006

Cited by 115 publications

(115 citation statements)

References 29 publications

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“…Compared with non-imrt techniques, imrt leads to better local control and os rates in head-and-neck cancer. A series of imrt studies have been reported in rnpc, with satisfactory preliminary results 36,[43][44][45] . Table i summarizes those studies.…”

Section: Is Imrt a Superior Technique Compared With Other Radiotherapmentioning

confidence: 97%

“…Clinical target volumes are similar at various institutions; the most recommended clinical target volume was a 0.2-1.5 cm expansion of the gross target volume 36,[43][44][45][46] . In 239 rnpc patients treated with imrt, Han et al 36 recently reported 5-year rates of local relapse-free survival, disease-free survival, and os as 85.8%, 45.4%, and 44.9% respectively.…”

Section: Is Imrt a Superior Technique Compared With Other Radiotherapmentioning

confidence: 99%

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Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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Recurrent nasopharyngeal carcinoma, which represents a small proportion of head-and-neck cancers, has a unique set of patho-clinical characteristics. The management of recurrent nasopharyngeal carcinoma remains a challenging clinical problem. Traditional treatments offer limited local control and survival benefits; more seriously, they frequently induce severe late complications. Recently, novel treatment techniques and strategies—including precision radiotherapy, endoscopic surgery or transoral robotic resection, third-generation chemotherapy regimens, and targeted therapies and immunotherapy—have provided new hope for patients with recurrent nasopharyngeal carcinoma. Some of these patients can potentially be cured with modern treatments. However, a lack of adequate evidence makes it difficult for clinicians to apply these powerful techniques and strategies. Individualized management guidelines, full evaluation of quality of life in these patients, and a further understanding of the mechanisms underlying recurrence are future directions for research into recurrent nasopharyngeal carcinoma.

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Section: Is Imrt a Superior Technique Compared With Other Radiotherapmentioning

confidence: 97%

Section: Is Imrt a Superior Technique Compared With Other Radiotherapmentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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“…Radiotherapy targeting the nasopharyngeal tumor and draining lymph node echelons remains a common treatment for NPC (2,3). Although early stage NPC may be effectively treated by radiotherapy alone, treatments of regional advanced NPC (Union for International Cancer Control Stage III/IV) require improvements; the incidence rate of a local residual tumor following radical radiotherapy is 7.0-13.0% and the local recurrent rate ranges from 16.8 to 23.0% (4)(5)(6)(7)(8). To reduce the rate of local recurrence and distant metastasis, combination treatments, including chemoradiotherapy and molecular targeted therapy are particularly important for cases of locally advanced head and neck squamous-cell carcinoma (HNSCC) (9).…”

Section: Introductionmentioning

confidence: 99%

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

et al. 2018

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Abstract. The present study retrospectively analyzed the prognostic factors of 135 patients with locally advanced nasopharyngeal carcinoma (NPC) who received intensity modulated radiation therapy between August 2008 and January 2012 at Xiangya Hospital of Central South University. Patients were staged from III-IVA according to the 7th American Joint Committee on Cancer staging system. Using Statistical Analysis System 9.3 software, the present study demonstrated that, among these 135 patients, the 5-year overall survival, the 5-year local relapse-free survival, and the 5-year disease metastasis-free survival were 84, 82, and 78%, respectively. Multivariate Cox regression analysis identified that targeted treatment [hazard ratio (95% confidence interval), 2.642 (1.001, 6.972); P=0.0497] served as an independent negative prognostic factor in locally advanced NPC. The results of immunostaining revealed that the staining intensity of the radiation-resistant group was increased compared with that of the radiation-sensitive group. These results demonstrate that a high expression of EGFR may be associated with radiation resistance, and targeted treatment may not be effective in patients with locally advanced nasopharyngeal carcinoma with low expression of EGFR.

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“…High incidence of acute grade 3-4 toxicities can be attributed to high volume of local recurrences and planning target volume The 5-year DFS and OS rates of NPC patients, especially with locoregional and distant failures in our cohort, were found in agreement with international data. 15,18,19 In recurrent NPC cases, rT stage and rN stage were found important prognostic factors for OS in our study cohort. Age was found to be an important independent prognostic factor in this study, which is also in agreement with reported literature.…”

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confidence: 50%

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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Intensity-Modulated Radiation Therapy in the Salvage of Locally Recurrent Nasopharyngeal Carcinoma

Cited by 115 publications

References 29 publications

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

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

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