A Prospective 10-Year Observational Study of Reduction of Radiation Therapy Clinical Target Volume and Dose in Early-Stage Nasopharyngeal Carcinoma

Long-term Survivals, Toxicities and the Role of Chemotherapy in Early-Stage Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy: A Retrospective Study with 15-Year Follow-up

“…Compared with primary tumor in nasopharynx, metastatic CLNs have a higher radio-sensitivity, so lower dose was given to GTVnd. In our practical application, 60–62 Gy/30 fr was performed to the equivocal lymph nodes (LNs), 62–64 Gy/30 fr to involved LNs with maximal axial diameter < 3 cm, and 64–66 Gy/30 fr to involved LNs, with maximal axial diameter ≥ 3 cm or central necrosis or extracapsular extension [ 14 , 16 , 21 ]. In this study, the 5-year LRRFS of whole cohort was 95.1% and 10-year LRRFS still reaching 93.3%, which indicating an excellent long-term tumor control with the use of IMRT.…”

“…The prescribed doses were 68–70 Gy/30 fractions (fr) to the gross tumor volume of nasopharynx (GTVnx), 60–66 Gy/30 fr to the gross tumor volume of metastatic lymph nodes (GTVnd), 60 Gy/30 fr to the high-risk clinical target volume (CTV1), and 54 Gy/30 fr to the low-risk clinical target volume (CTV2), respectively. All of the following information has been detailed described in our previous published study: the IMRT technique, delineation method of the target volumes, dose limitation to the target volumes and organs at risk [ 21 ].…”

Efficacy and Safety of Endoscopic Nasopharyngectomy Combined With Low-Dose Radiotherapy for Primary T1-2 Nasopharyngeal Carcinoma

“…Miao and colleagues treated NPC patients with LDRT, and found this treatment could achieve long-term tumor control with mild late toxicities, but the rate of recurrence and metastasis was relatively high. 5 With the development of the endoscopic technique, ENPG was widely used in the recurrent NPC patients, and it showed fewer invasions, better treatment effect and QoL than re-radiotherapy. 16 In a recent study, researchers tried to utilize single ENPG to treat localized stage I NPC patients and found ENPG exhibited encouraging survival results, better QoL and less medical cost.…”

“… 4 Recently, several studies reported that low-dose radiotherapy (LDRT) can achieve long-term tumor control with mild late toxicities for T1-2 NPC patients, but the rate of reoccurrence is relatively high. 5 , 6 With the popularity of health education and the development of early cancer screening methods such as narrow band imaging technique, plasma Epstein-Barr virus (EBV) DNA screening and nasopharyngeal brushing samples detection, the detection rate of early-stage NPC in high-risk groups has been greatly improved, making it possible to perform endoscopic nasopharyngectomy (ENPG) for these NPC patients. 7 , 8 Previous publications have observed that salvage ENPG were successfully conducted in recurrent NPC patients and resulted in better survival outcomes and less occurrence of complications than IMRT.…”

Development of web-based quality-assurance tool for radiotherapy target delineation for head and neck cancer: quality evaluation of nasopharyngeal carcinoma

“…The recommended coverage for microscopic involvement included the entire nasopharynx, retropharyngeal nodal regions, skull base, clivus, pterygoid fossae, parapharyngeal space, sphenoid sinus, the posterior third of the nasal cavity/maxillary sinuses and the pterygopalatine fossae. 2 The extent of IR-CTV in NPC treatment is related to marginal local recurrences 3 and development of radiation toxicity including xerostomia and swallowing difficulty, 4 yet inter-observer variation in delineating IR-CTV can be substantial. 5 With advancement of conformal radiotherapy (RT) techniques and reduction of target margins, adequate target coverage has become a critical issue, and consensus guidelines for delineation of neck node levels 6 and CTVs for conformal RT for nasopharynx and other head and neck tumor sites have been published.…”