Reduction of Target Volume and the Corresponding Dose for the Tumor Regression Field after Induction Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma

Wang, Lei; Zheng, Wei; Xie, Donglai; Zeng, Ruolan; Cheng, Wanqin; Hu, Jiang; Huang, Shaomin; Zhou, Shu; Zhong, Rui; Su, Yong

doi:10.4143/crt.2018.250

Cited by 27 publications

(25 citation statements)

References 25 publications

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“…Another study by Xue et al also indicated that contouring GTVnx based on the post‐IC images achieved satisfactory survival outcome and avoided overdosing of critical neurological structures 22 . Similar results have been reported by several other studies 23,24 . If the post‐IC GTVnx is adopted as the final GTVnx in future practice, the potential influence of tumor volume enlargement on subsequent radiotherapy should not be ignored, as the volume of the final GTVnx between the enlargement group and the reduction group would be significantly different.…”

Section: Discussionsupporting

confidence: 61%

“…22 Similar results have been reported by several other studies. 23,24 If the post-IC GTVnx is adopted as the final GTVnx in future practice, the potential influence of tumor volume enlargement on subsequent radiotherapy should not be ignored, as the volume of the final GTVnx between the enlargement group and the reduction group would be significantly different.…”

Section: Discussionmentioning

confidence: 99%

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Impact of tumor volume enlargement after induction chemotherapy on subsequent radiotherapy in locally advanced nasopharyngeal carcinoma: A propensity‐score matching analysis

Shen

2020

Cancer Medicine

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A small proportion of nasopharyngeal carcinoma (NPC) patients show resistance to induction chemotherapy (IC). This study sought to investigate the impact of tumor volume enlargement after IC on the dosimetric parameters of subsequent radiotherapy. The records of a total of 240 locally advanced NPC patients who received IC followed by concurrent chemoradiotherapy were retrospectively reviewed. Patients with a tumor volume enlargement of ≥10% and patients with a tumor volume reduction of ≥10% after induction chemotherapy were classified as the enlargement group and the control group, respectively. The dosimetric parameters of the planning target volumes (PTVs) and the organs at risk (OARs) were compared between the matched groups after propensity score matching (PSM). For the gross tumor volume of nasopharynx (GTVnx), 21 patients and 127 patients were classified as the enlargement group and the control group, respectively. After matching, 20 sub‐pairs of 40 patients were generated in the post‐PSM cohort. The GTVnx enlargement group exhibited no significant disadvantages in all of the dosimetric parameters, except in the planning organ‐at‐risk volume (PRV) of contralateral lens (Dmax, 722 cGy vs. 634 cGy, p = 0.041). For the gross tumor volume of lymph nodes (GTVnd), 44 patients and 144 patients were classified as the enlargement group and the control group, respectively. After matching, 39 sub‐pairs of 78 patients were generated in the post‐PSM cohort. The GTVnd enlargement group exhibited no significant disadvantages in all of the dosimetric parameters. Univariate and multivariate analyses showed that the enlargement of GTVnx and the enlargement of GTVnd were not independently associated with any of the dosimetric parameters. A tumor volume enlargement of ≥10% in GTVnx or GTVnd after induction chemotherapy has no significant impact on the dosimetric parameters of subsequent radiotherapy in locally advanced NPC.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Impact of tumor volume enlargement after induction chemotherapy on subsequent radiotherapy in locally advanced nasopharyngeal carcinoma: A propensity‐score matching analysis

Shen

2020

Cancer Medicine

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“…The most common PROM collected has been QoL, with the majority of studies using the validated European Organization for Research and Treatment of Cancer quality of life core questionnaire (EORTC QLQ-C30) and the accompanying head and neck module (EORTC QLQ-H&N35) ( Table 1). The QLQ-C30 contains 30 items which map to a global health status/QoL score (composed of two items), five functional scales, three multiitem symptom scales, and six single symptom items (50); while the 35 items from the QLQ-H&N35 maps to seven symptom scales and 11 single items (51). Higher scores in the global QoL score and functional scales reflect better QoL or function, while on the symptom scales and items higher scores indicate an increased severity of symptomology.…”

Section: Toxicity and Quality Of Life Outcomesmentioning

confidence: 99%

Quality of Life, Toxicity and Unmet Needs in Nasopharyngeal Cancer Survivors

et al. 2020

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“…Nasopharyngeal carcinoma (NPC) is a malignancy arising from the epithelium of the nasopharynx and is prevalent in southern China (1–3). Radiotherapy (RT) with or without chemotherapy is the primary treatment for patients with NPC (4); however, despite considerable improvements in RT techniques and chemotherapy regimens for patients with NPC, treatment-related complications are still not uncommon in routine clinical practice. Radiation encephalopathy (RE) is one of the most severe complications in patients with NPC who have undergone RT, and has been a subject of attention for several decades.…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy Potentially Facilitates the Occurrence of Radiation Encephalopathy in Patients With Nasopharyngeal Carcinoma Following Radiotherapy: A Multiparametric Magnetic Resonance Imaging Study

Zhang

Gao

et al. 2019

Front. Oncol.

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Radiation encephalopathy (RE) is deemed to be a disease induced only by radiotherapy (RT), with the effects of chemotherapeutic agents on the brains of nasopharyngeal carcinoma (NPC) patients being largely overlooked. In this study, we investigated structural and functional brain alterations in NPC patients following RT with or without chemotherapy. Fifty-six pre-RT, 37 post-RT, and 108 post-CCRT (concomitant chemo-radiotherapy) NPC patients were enrolled in this study. A surface-based local gyrification index (LGI) was obtained from high resolution MRI and was used to evaluate between-group differences in cortical folding. Seed-based functional connectivity (FC) analysis of resting-state fMRI data was also conducted to investigate the functional significance of the cortical folding alterations. Compared with the Pre-RT group, patients in the Post-CCRT group showed LGI reductions in widespread brain regions including the bilateral temporal lobes, insula, frontal lobes, and parietal lobes. Compared with the Post-RT group, patients in the Post-CCRT group showed LGI reductions in the right insula, which extended to the adjacent frontal lobe. Seed-based FC analysis showed that patients in the Post-CCRT group had lower FC between the insula and the left middle frontal gyrus than patients in the Pre-RT group. The follow-up results showed that patients in the Post-CCRT group had a much higher RE incidence rate (20.4%) than patients in the Post-RT group (2.7%; P = 0.01). These findings indicate that chemotherapy potentially facilitated the occurrence of RE in NPC patients who underwent radiotherapy.

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Reduction of Target Volume and the Corresponding Dose for the Tumor Regression Field after Induction Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma

Abstract: After IC, contouring of GTVnx-residual/GTVnd-residual as residual tumor volume and distribution 60 Gy of radiation dose to the tumor regression field may be feasible and need further investigation.

Cited by 27 publications

References 25 publications

Impact of tumor volume enlargement after induction chemotherapy on subsequent radiotherapy in locally advanced nasopharyngeal carcinoma: A propensity‐score matching analysis

Impact of tumor volume enlargement after induction chemotherapy on subsequent radiotherapy in locally advanced nasopharyngeal carcinoma: A propensity‐score matching analysis

Quality of Life, Toxicity and Unmet Needs in Nasopharyngeal Cancer Survivors

Chemotherapy Potentially Facilitates the Occurrence of Radiation Encephalopathy in Patients With Nasopharyngeal Carcinoma Following Radiotherapy: A Multiparametric Magnetic Resonance Imaging Study

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