10-Year Results of Therapeutic Ratio by Intensity-Modulated Radiotherapy Versus Two-Dimensional Radiotherapy in Patients with Nasopharyngeal Carcinoma

Chen, Lei; Zhang, Yuan; Lai, Shu Zhen; Li, Wen Fei; Hu, Wei; Sun, Rui; Liu, Li Zhi; Zhang, Fan; Peng, Hao; Du, Xiao Jing; Lin, Ai Hua; Sun, Ying

doi:10.1634/theoncologist.2017-0577

Cited by 67 publications

(47 citation statements)

References 23 publications

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“…Over the years, radiotherapy technology has evolved from two-dimensional radiotherapy (2DRT) to intensity-modulated radiotherapy (IMRT) and this has resulted in longer survival and milder toxicity in NPC patients (4). Chen et al reported that NPC patients with IMRT had better failure-free survival and overall survival than patients with 2DRT, and the incidence of toxicity in the IMRT group, such as dry mouth, was lower than in the 2DRT group (5). Deutsch et al also reported that IMRT had reduced the risk of long-term sequelae, such as xerostomia in patients with head and neck carcinoma (6).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

et al. 2020

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Inflammation and nutritional status have significant effects on the prognosis of cancer patients. This study investigated the predictive value of clinical biochemistry-based indexes in nasopharyngeal carcinoma (NPC). This retrospective study included 559 NPC patients and 500 patients with chronic rhinitis. Continuous variables were measured by t-test. The area under curves (AUC) was used to determine the diagnostic and prognostic value for NPC. Kaplan-Meier methods and the log-rank test were used to analyze overall survival (OS) and disease-free survival (DFS) of the patients. Cox and logistic regression analysis were used to analyze the independent prognostic risk factors for survival and influencing factors of side effects after treatment, respectively. The study results revealed that most indexes of NPC and rhinitis were significantly different between the two groups. In the survival analysis, the systemic inflammation score (SIS), prognostic nutritional index (PNI), albumin/globulin ratio (AGR), albumin (ALB), urea nitrogen (BUN) and creatinine (CREA) had significant influence on the OS and DFS. AGR was the optimal prognostic indicator for NPC. Among these indexes, SIS, AGR, BUN and CERA were independent prognostic factors of OS, AGR and PNI were independent prognostic factors of DFS. Most indexes were risk factors of side effects occurred in radiotherapy. In conclusion, the clinical biochemistry-based indexes, are reliable and of low-cost, therefore, they can be used in predicting diagnosis, prognosis and treatment plans of NPC.

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Section: Introductionmentioning

confidence: 99%

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

et al. 2020

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“…As we mentioned above, IMRT could lead to ideal local control. Large‐scale retrospective studies showed that advent of IMRT made the 10‐year LR rate of NPC decrease to only 3.5%‐5.0% . It is superior to conventional 2‐dimensional radiotherapy in precise dose delivery, which simultaneously realizes maximal tumor killing and protection of adjacent normal tissue.…”

Section: Discussionmentioning

confidence: 99%

Necessity of concurrent chemotherapy in N2‐3 nasopharyngeal carcinoma treated with neoadjuvant chemotherapy of ≥3 cycles followed by intensity‐modulated radiotherapy

et al. 2019

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Concurrent chemotherapy (CCT) is used in locally advanced nasopharyngeal carcinoma (NPC) for improved local control, which could also be achieved by intensity‐modulated radiotherapy (IMRT). And for N2‐3 NPC, distant metastasis is the more important cause of death. This study aims to evaluate the value of CCT in N2‐3 NPC when neoadjuvant chemotherapy (NACT) of sufficient cycles is performed to eradicate distant metastasis. It enrolled 959 patients diagnosed with TxN2‐3M0 NPC from July 2011 to December 2015 and treated with NACT of 3‐4 cycles and IMRT. A propensity score matching (PSM) was made between patients treated with and without CCT (called the CCT and non‐CCT groups, respectively), using a series of clinical characteristics (age, gender, T stage, N stage, NACT regimen, and EBV DNA) as covariates. After PSM, the two groups of patients were compared on survivals and acute toxicities. The results indicated that no difference was seen in the overall, disease‐free, recurrence‐free or metastasis‐free survivals between the two groups. But compared with the CCT group, the non‐CCT group had a lower patient proportion of myelosuppression, nausea/vomiting, oral mucositis, cervical dermatitis, xerostomia, and grade 3/4 myelosuppression and oral mucositis (all P values were <0.001). Hence, CCT appeared to bring more acute toxicities, instead of survival benefit, to N2‐3 NPC patients treated with NACT of ≥3 cycles and IMRT. It should be used with cautions in these patients.

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“…With the increasing application of intensity-modulated radiotherapy (IMRT), the incidence significantly decreased to 5% [3]. IMRT enables the delivery of the prescribed RT dose to the planning target volumes (PTV), and allows for the reduction the dose for organs at danger, such as the temporal lobe, brainstem, and optic chiasm [4]. The IMRT technology is able to create precision delivery of dosage to tumors by using beam collimation techniques (Multileaf Collimators) and feedback controlled intensity distribution through computation [5].…”

Section: Introductionmentioning

confidence: 99%

Temporal lobe microstructural abnormalities in patients with nasopharyngeal carcinoma quantitatively evaluated by high-resolution DWI and DKI after concurrent chemoradiotherapy

Balasubramanian

et al. 2020

Clinical and Translational Radiation Oncology

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To investigate temporal lobe microstructural abnormalities and neurocognitive function impairment after concurrent chemoradiotherapy (CCRT) in patients with nasopharyngeal carcinoma (NPC). Methods: NPC patients who underwent CCRT were enrolled. High-resolution diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) and diffusion-kurtosis imaging (DKI) MRI, were performed 5 times per patient (once pre-CCRT, 1 week post-CCRT, 3 months post-CCRT, 6 months post-CCRT, and 12 months post-CCRT). Neurocognitive function was evaluated by Montreal Neurocognitive Assessment (MoCA) twice per patient, once pre-CCRT, and once 12-months after CCRT. Results: Of 111 patients, 56 completed the entire protocol. The MRI derived apparent diffusion coefficient (ADC), mean of diffusion coefficient (Dmean) and fractional anisotropy (FA) values were significantly decreased (p < 0.05) over the 0-3 month period following CCRT and significantly increased (p < 0.05) over the 3-12 month period following CCRT. The mean of kurtosis coefficient (Kmean) continued to decline over a year post-CCRT. All parameters reveal more pronounced changes in white matter (WM) than in grey matter (GM). MoCA also declined after CCRT (p < 0.001). MoCA showed significant positive correlation with Kmean-WM-6 m, Kmean-WM-12 m and DKmean-WM. Conclusions: High-resolution DWI and DKI should be considered as a promising method for the investigation of temporal lobe microstructural change in NPC patients after CCRT.

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10-Year Results of Therapeutic Ratio by Intensity-Modulated Radiotherapy Versus Two-Dimensional Radiotherapy in Patients with Nasopharyngeal Carcinoma

Cited by 67 publications

References 23 publications

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

Necessity of concurrent chemotherapy in N2‐3 nasopharyngeal carcinoma treated with neoadjuvant chemotherapy of ≥3 cycles followed by intensity‐modulated radiotherapy

Temporal lobe microstructural abnormalities in patients with nasopharyngeal carcinoma quantitatively evaluated by high-resolution DWI and DKI after concurrent chemoradiotherapy

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