Comparing the Effectiveness of Endoscopic Surgeries With Intensity-Modulated Radiotherapy for Recurrent rT3 and rT4 Nasopharyngeal Carcinoma: A Meta-Analysis

Abstract

BackgroundThis meta-analysis aimed to compare the efficacy of intensity-modulated radiotherapy (IMRT) and endoscopic surgery (ES) for high T-stage recurrent nasopharyngeal carcinoma (NPC).MethodsRelevant studies were retrieved in six databases from 02/28,2011 to 02/28,2021. The 2-year, 3-year, 5-year overall survival (OS) rates and 2-year disease-free survival (DFS) rates were calculated to compare the survival outcomes of the two treatments of IMRT and ES. Combined odds ratios (ORs) and 95% confidence interval (C Is) were measured as effect size on the association between high T-stage and 5-year OS rates.ResultsA total of 23 publications involving 2,578 patients with recurrent NPC were included in this study. Of these, 1611 patients with recurrent rT3-4 NPC were treated with ES and IMRT in 358 and 1,253 patients, respectively. The combined 2-year OS and 5-year OS rates for the two treatments were summarized separately, and the 2-year OS and 5-year OS rate for ES were 64% and 52%, respectively. The 2-year OS and 5-year OS rate for IMRT were 65% and 31%, respectively. The combined 2-year DFS rates of IMRT and ES were 60% and 50%, respectively. Combined ORs and 95% confidence intervals for 5-year survival suggest that ES may improve survival in recurrent NPC with rT3-4. In terms of complications, ES in the treatment of high T-stage recurrent NPC is potentially associated with fewer complications.ConclusionsThe results of our study suggest that ES for rT3-4 may be a better treatment than IMRT, but the conclusion still needs to be sought by designing more studies.

Salvage Endoscopic Skull Base Surgery: Another Treatment Option After Immunotherapy for Recurrent Nasopharyngeal Carcinoma

“…Primary NPC is sensitive to radiotherapy, with intensity-modulated radiotherapy (IMRT) being the most widely used technique ( 5 , 6 ). Despite recent improvements in treatment techniques, approximately 10%–20% of patients with 70 Gy IMRT still experience local recurrence, which is a substantial challenge for clinicians ( 1 , 7 , 8 ). Immunotherapy has a role as a novel cancer treatment modality, especially immune checkpoint inhibitor (ICI) therapy.…”

Primary endodermal hemangiopericytoma/solitary fibrous tumor of the cervical spine: a case report and literature review

“…However, for patients at high risk for injury to the nerve root or dura mater, or those with type IB and III tumors [ 9 , 11 ], it is usually difficult to perform total tumor resection without significant impact on the limb function or nerve injury. Therefore, total resection should not be overemphasized [ 9 , 48 – 50 ]. Postoperative radiotherapy is necessary to prevent recurrence [ 4 , 16 , 18 , 36 , 40 , 50 – 55 ].…”

“…The HPC/SFT is often aggressive, with a high recurrence rate and distant metastasis [ 18 , 26 , 41 , 46 ]. Therefore, even if the primary lesion is well controlled, regular follow-up is necessary [ 9 , 13 , 18 , 23 , 48 , 53 ].…”

LINC00704 contributes to the proliferation and accelerates the cell cycle of nasopharyngeal carcinoma cells via regulating ETS1/CDK6 axis

“…1 NPC is a radiosensitive tumor, and radiotherapy is the main treatment strategy. 2,3 Although radiotherapy can improve the 5-year survival rate of NPC, due to lymph nodes metastasis and distant metastasis, the prognosis of some patients is still unfavorable. 4 Therefore, it is very important to further explore the mechanism of NPC pathogenesis and find valuable biomarkers and new therapeutic targets.…”

“…NPC is one of the most prevalent tumors in Southern China 1 . NPC is a radiosensitive tumor, and radiotherapy is the main treatment strategy 2,3 . Although radiotherapy can improve the 5‐year survival rate of NPC, due to lymph nodes metastasis and distant metastasis, the prognosis of some patients is still unfavorable 4 .…”