The relations of dosimetric parameters with long‐term outcomes and late toxicities in advanced T‐stage nasopharyngeal carcinoma with IMRT

Gou, Xiaoxia; Duan, Baoxing; Shi, Huashan; Qin, Lei; Xiao, Jianghong; Chen, Nianyong

doi:10.1002/hed.25986

Cited by 10 publications

(5 citation statements)

References 28 publications

(45 reference statements)

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“…Specifically, increased access to supportive services may have better equipped high‐volume facilities to care for patients with radiotherapy‐related toxicities, thereby reducing interruptions to planned radiation treatment regimens 37 . Recent studies have also suggested that lower radiation dose/volume, when delivered in a more targeted setting, may also improve outcomes and survival due to lower toxicity and side effects, 38,39 which may be another contributing factor for improved outcomes at high‐volume facilities.…”

Section: Discussionmentioning

confidence: 99%

The influence of facility volume on patient treatments and survival outcomes in nasopharyngeal carcinoma

et al. 2021

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Background This study evaluates the influence of facility case‐volume on nasopharyngeal carcinoma (NPC) treatments and overall survival (OS). Methods The 2004–2015 National Cancer Database was queried for patients with NPC receiving definitive treatment. Results A total of 8260 patients (5‐year OS: 63.4%) were included. The 1114 unique facilities were categorized into 854 low‐volume (treating 1–8 patients), 200 intermediate‐volume (treating 9–23 patients), and 60 high‐volume (treating 24–187 patients) facilities. Kaplan–Meier log‐rank analysis demonstrated significantly improved OS with high‐volume facilities (p < 0.001). On cox proportional‐hazard multivariate regression after adjusting for age, sex, income, insurance, comorbidity index, histology, AJCC clinical stage, and treatment type, high‐volume facilities were associated with lower mortality risk than low‐volume (HR = 0.865, p = 0.019) and intermediate‐volume facilities (HR = 0.916, p = 0.004). Propensity score matching analysis confirmed this association (p < 0.001). Conclusion Higher facility volume was an independent predictor of improved OS in NPC, suggesting a possible survival benefit of referrals to high‐volume medical centers.

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Section: Discussionmentioning

confidence: 99%

The influence of facility volume on patient treatments and survival outcomes in nasopharyngeal carcinoma

et al. 2021

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“…2,3 The 5-year local regional control rates for T3 and T4 NPC are estimated to be 90% and 75-80%, respectively. 4,5 However, about 5-30% of patients develop local recurrence or distant metastasis. 6 Approximately 50% of patients show local recurrence with distant metastases.…”

Section: Introductionmentioning

confidence: 99%

Expression and Biological Functions of EPC1 in Nasopharyngeal Carcinoma

et al. 2021

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Background: Comb homolog enhancer 1 (EPC1) gene is one of the important members of epigenetic inhibitor PCG family. It shows carcinogenic potential in a variety of malignant tumors, but the expression and role of EPC1 in nasopharyngeal carcinoma are unclear. The aim of this study was to explore the expression and function of enhancer of polycomb homolog 1 (EPC1) in nasopharyngeal carcinoma (NPC). Methods: The differential expression of EPC1 in the cancer tissues and cell lines of NPC was examined by quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR). EPC1 expression, cell proliferation, and apoptosis were detected in NPC cell lines after EPC1 silencing, and the levels of the epithelial-mesenchymal transition (EMT)-related proteins E-cadherin and vimentin were detected in NPC cells after EPC1 silencing. The study was performed at Fujian Provincial Hospital, Fujian, China, from 2018 to 2019. Results: We found that EPC1 was significantly upregulated in the cancer tissues and cell lines of NPC (P<0.001). Furthermore, knockdown of EPC1 inhibited the growth and metastasis of NPC cells. E-cadherin and vimentin were detected in NPC cells after EPC1 was knocked out. It was confirmed that inhibition of EPC1 resulted in increased E-cadherin expression (P<0.001) and decreased vimentin expression (P<0.001), suggesting that inhibition of EPC1 could inhibit the EMT in NPC cells. Conclusion: EPC1 expression was upregulated in NPC tissues and cell lines. Knockout of EPC1 effectively inhibited the growth of NPC cells, induced apoptosis, and inhibited invasion and metastasis. Inhibition of EPC1 could inhibit the EMT in NPC cells. All of the above findings support the viewpoint that EPC1 plays a pro-cancer role in NPC.

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“…Dosimetric inadequacy of the primary tumor volume constricted by the critical organs may contribute to the recurrence. 16 In the study reported by Ng et al, an under-dose GTVp of 3.4 cm 3 was associated with high rate of local failure. 17 Our previous studies indicated that patients with the early local recurrence still had the chance to achieve long-term survival after salvage treatment.…”

Section: Discussionmentioning

confidence: 91%

The Failure Patterns of Nasopharygeal Carcinoma After Intensity-Modulated Radiotherapy and Implications for Surveillance

Tian¹,

Huang²,

Zeng³

et al. 2022

CMAR

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Objective To investigate the treatment outcomes, failure patterns and surveillance strategy in patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT). Methods A cohort of patients with NPC who had received the full course of IMRT between 2008 and 2012 were retrospectively analyzed. The failure patterns, time to recurrence, and detection methods were recorded. The survival was calculated using the Kaplan–Meier method. Multivariate proportional hazard regression models were used to test the prognostic factors. Results In total, 2607 patients with NPC treated with IMRT were recruited. After the median follow-up of 112 months, 402 (15.4%) patients experienced distant metastasis, 225 (8.6%) patients had local recurrence, and 77 (3.0%) patients had regional recurrences. The 10-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 74.5%, 90.1%, and 79.3%, respectively. The factors of male sex, age >50 years, lactate dehydrogenase >245 IU/L, advanced T classification, and advanced N classification were associated with poor OS. The N disease classification was the most important factor in predicting distant metastasis, and advanced T disease classification for high risk of local recurrence. For patients with T1 disease, the incidence of local recurrence was less than 2%, and the incidence of distant metastasis was less than 5% for patients with N0 disease. About 83% of the recurrence occurred in the first 5 years, and 20% of the recurrences showed no symptoms. Conclusion High rate of local-regional control can be achieved for patients with NPC after IMRT, while distant metastasis remains as the major cause of failures. Patients with advanced N classification has high risk to develop distant metastasis, and most occurred within 5 years. Developing rational and individualized surveillance strategies based on the high risk factors of recurrence is helpful to balance the survival benefit and medical cost.

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The relations of dosimetric parameters with long‐term outcomes and late toxicities in advanced T‐stage nasopharyngeal carcinoma with IMRT

Cited by 10 publications

References 28 publications

The influence of facility volume on patient treatments and survival outcomes in nasopharyngeal carcinoma

The influence of facility volume on patient treatments and survival outcomes in nasopharyngeal carcinoma

Expression and Biological Functions of EPC1 in Nasopharyngeal Carcinoma

The Failure Patterns of Nasopharygeal Carcinoma After Intensity-Modulated Radiotherapy and Implications for Surveillance

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