Nasopharyngeal Carcinoma Treated With Reduced-Volume Intensity-Modulated Radiation Therapy: Report on the 3-Year Outcome of a Prospective Series

Zong

Shen

et al. 2014

Intl Journal of Cancer

Self Cite

101

More than 75% of nasopharyngeal carcinoma (NPC) patients have already developed local or regional spread at diagnosis, which hampers effective treatment and results in a poor prognosis. It is essential to characterize more sensitive and specific biomarkers for screening of high risk individuals and assessment of NPC treatment effectiveness. NPC is an Epstein-Barr virus (EBV) associated tumor in which only a few viral proteins but more than 20 BamHI A rightward transcripts (BART) microRNAs are detected, at abundant levels. We hypothesized that these BART microRNAs may be novel biomarkers for NPC. Systematic analysis of EBV BART microRNA expression profiles in EBV latently infected Mutu I and Mutu III cell lines, EBV-harboring NPC and noncancerous NP cells found that miR-BART3, miR-BART7 and miR-BART13 microRNAs are highly expressed and regularly secreted into the extracellular environment of NPC cells. These BART microRNAs were evaluated for used as potential NPC biomarkers. Analysis of plasma specimens obtained from NPC patients (n 5 89), and healthy (n 5 28) and non-NPC tumor patient controls (n 5 18) found levels of both miR-BART7 and miR-BART13, but not miR-BART3, to be distinctly presence among NPC patients, with elevated levels being particularly apparent among patients with advanced disease. Receiver operating characteristic curve analysis combining miR-BART7 and miR-BART13 levels produces a 90% predictive value for the presence of NPC. Analysis of 41 NPC patients before and after radiotherapy showed that miR-BART7 and miR-BART13, but not miR-BART3, were diminished after treatment. These results indicate that EBV microRNAs, miR-BART7 and miR-BART13, may constitute useful new serological biomarkers for diagnosis of NPC and prediction of treatment efficacy.

Section: Discussionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Circulating Epstein–Barr virus microRNAs miR‐BART7 and miR‐BART13 as biomarkers for nasopharyngeal carcinoma diagnosis and treatment

Zong

Shen

et al. 2014

Intl Journal of Cancer

Self Cite

101

Asian Pacific Journal of Cancer Prevention

“…Initial therapeutic outcome: Radical radiotherapy was given to all patients, in which 399 with routine radiotherapy and 205 with IMRT; the total radiotherapeutic dosage on nasopharynx was 66.00~85.60 Gy with average one of (70.87±3.10) Gy, and ratiotherapeutic times were 30~40 times with average ones being (34.01±2.38) times; the maximum radiotherapeutic dosage for lymph node was 50.00~79.00 Gy with average one of (65.44±5.19) Gy, and the radiotherapeutic times for neck were 25~39 times with average ones being (32.00±2.46) times. The detailed techniques referred to the previously reported research by Cancer Hospital of Fujian Medical University (Lin et al, 2009;Xu et al, 2010). Additionally, emergency treatments, including surgery, dimensional conformal radiation therapy (3D-CRT), chemotherapy, intracavitary brachytherapy and intensity modulated radiation therapy (IMRT) were given to patients who had persistent or relapse diseases.…”

Section: Methodsmentioning

confidence: 99%

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

Zheng

Xu²,

Qiu³

et al. 2015

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.

“…Currently, intensity‐modulated radiation therapy (IMRT) or comprehensive treatment based on IMRT is the main treatment method for NPC, and it can improve tumor control and decrease radiation induced complications (1) . However, the reproducibility of patient positioning with accurate immobilization devices is the key to ensure the efficacy of IMRT (2) .…”

Section: Introductionmentioning

confidence: 99%

Analysis of setup error based on CTVision for nasopharyngeal carcinoma during IGRT

Zhou

J Applied Clin Med Phys

et al. 2016

The aim of the present study was to investigate the role of CTVision in interfractional setup errors during intensity‐modulated radiation therapy (IMRT) in 12 nasopharyngeal carcinoma (NPC) patients. The trend of setup errors as a function of time during a fractionated radiotherapy course was investigated, and the influence of reconstructive thickness on image reconstruction for setup errors was analyzed. The appropriate planning target volume (PTV) margin and planning risk volume (PRV) margin were defined to provide a reference for the design of IMRT for NPC. Based on CTVision, online CT was performed weekly for each patient. Setup errors were measured by registration between the CT reconstructed image and reference image. Mean of setup errors, estimated population systematic (:), and population random (σ) errors were calculated using SPSS (v15.0). Optimum PTV and PRV margins were calculated. In the clinical data, for the LR (left–right), SI (superior–inferior), and AP (anterior–posterior) directions, : was 0.8, 0.8, and 1.0 mm, respectively, and σ was 1.0, 1.3, and 0.8 mm, respectively. In the LR, SI, and AP directions, PTV margins were at least 2.7, 2.9, and 3.0 mm, respectively, and PRV margins were at least 1.5, 1.7, and 1.7 mm, respectively. No significant differences in setup errors were observed during the fractionated radiotherapy course false(p>0.05false). However, CT image reconstruction with different thicknesses affected the accuracy of measurements for setup errors, particularly in the SI direction. The application of CTVision to correct setup errors is important and can provide reasonable margins to guarantee the coverage of PTVs and spare organs at risk. A thickness of 3 mm in the reconstructed image is appropriate for the measurement of setup errors by image registration.PACS number(s): 87.55.Qr