High locoregional control for nasopharyngeal carcinoma was achieved with multisegmental intensity-modulated radiotherapy. Distant metastases are still the main impact on survival. More effective chemotherapy regimens and other systemic agents are needed to decrease the rate of distant metastasis.
3DCRT induced a substantial tumor response rate of 61.4% with survival rates at 1, 2 and 3 years of 60.5%, 40.3% and 32.0%, respectively, and a median survival time of 15.2 months in patients with unresectable HCC who had either failed with or were unsuited for TACE. The complications are acceptable and can be managed with conservative treatment. Although we do not know whether there is a survival benefit through the use of this treatment, 3DCRT seems to be a practical method of salvage for this subset of patients. Further study is warranted to evaluate the survival of such patients with and without this treatment.
In advanced T-staged (T3 and T4) nasopharyngeal tumors, a substantial variation of primary tumor volume was present within the same T stage, and primary tumor volume represented a more important prognostic factor for treatment outcome. Volumetric measurements of primary tumors in advanced nasopharyngeal tumors would refine the TNM staging system. Patients with large primary tumor volume should be treated more aggressively.
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