Concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma: A treatment paradigm also applicable to patients in Southeast Asia

Lu, Hongsheng; Peng, Luxing; Yuan, Xianbin; Hao, Yanrong; Lu, Zhongxin; Chen, Jiaxin; Cheng, Jiaojiao; Deng, Shan; Gu, Jingmin; Pang, Qiang; Qin, Jian

doi:10.1016/j.ctrv.2009.01.002

Cited by 49 publications

(36 citation statements)

References 77 publications

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“…Compared with conventional 2D techniques and 3D crt, imrt can provide superior dose coverage to the tumour and better sparing of surrounding tissues, potentially improving local control and long-term survival and, more importantly, enhancing qol for these patients 40,41 . Hisung et al 42 reported that, compared with 5-field 3D crt, 5-to 7-field imrt distinctly reduced radiation in the brain stem by about 16%.…”

Section: Is Imrt a Superior Technique Compared With Other Radiotherapmentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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Recurrent nasopharyngeal carcinoma, which represents a small proportion of head-and-neck cancers, has a unique set of patho-clinical characteristics. The management of recurrent nasopharyngeal carcinoma remains a challenging clinical problem. Traditional treatments offer limited local control and survival benefits; more seriously, they frequently induce severe late complications. Recently, novel treatment techniques and strategies—including precision radiotherapy, endoscopic surgery or transoral robotic resection, third-generation chemotherapy regimens, and targeted therapies and immunotherapy—have provided new hope for patients with recurrent nasopharyngeal carcinoma. Some of these patients can potentially be cured with modern treatments. However, a lack of adequate evidence makes it difficult for clinicians to apply these powerful techniques and strategies. Individualized management guidelines, full evaluation of quality of life in these patients, and a further understanding of the mechanisms underlying recurrence are future directions for research into recurrent nasopharyngeal carcinoma.

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Section: Is Imrt a Superior Technique Compared With Other Radiotherapmentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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“…Concurrent chemoradiotherapy has long been considered the standard treatment for advanced npc 2 . Some studies have shown that concurrent administration of chemotherapy and radiotherapy is superior to sequential therapy or radiotherapy alone for achieving locoregional control 2 . Chemoradiotherapy is therefore the standard regimen in the treatment of locoregionally advanced npc 3 .…”

Section: Introductionmentioning

confidence: 99%

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

Zeng

Xiao

et al. 2015

Current Oncology

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Background: We aimed to evaluate the association of serum C-reactive protein (crp) with prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. Methods: We retrospectively reviewed 79 patients with locoregionally advanced nasopharyngeal carcinoma (cT3–4N0–3M0) treated with chemoradiotherapy. Chemoradiotherapy consisted of external-beam radiotherapy to the nasopharynx (70–80 Gy), the lymph node–positive area (60–70 Gy), and the lymph node–negative area (50–60 Gy) combined with 3 cycles of various platinum-based regimens delivered at 3-week intervals. Elevated crp was defined as more than 8 mg/L. The survival rate was calculated using the Kaplan–Meier method, and univariate and multivariate analyses (Cox proportional hazards model) were used to identify factors significantly associated with prognosis. Results: During the median follow-up of 3.9 years (range: 1–5.5 years), 23 patients died from nasopharyngeal cancer. The 5-year cancer-specific survival (css) rate was 62.90%. Before chemoradiotherapy, 18 patients had high serum crp; the css rate in that subgroup was significantly worse than the rate in the remaining patients (p = 0.0002). Multivariate analysis showed that crp was an independent prognostic indicator of css, with a hazard ratio of 3.04 (95% confidence interval: 1.22 to 7.55; p = 0.017). Among the 18 patients with elevated serum crp, 9 achieved normal serum crp after chemoradiotherapy, of whom 5 remained living with no evidence of recurrence or metastasis during follow-up. By contrast, the remaining 9 patients in whom serum crp did not normalize after chemoradiotherapy died within 4.2 years. Conclusions: Elevated serum crp before treatment predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.

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“…Nasopharyngeal carcinoma (NPC) is highly prevalent in southern China, especially in Guang Dong and Hong Kong, due to its insidious location of tumorigenesis and various clinical symptoms, most patients has been in locally advanced stage before diagnosed (Lu et al, 2009). Main causes of failure in treatment of high T staged nasopharyngeal carcinoma are residual or recurrence (Dimery et al, 1993;Johnson et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Preliminary Results of a Phase I/II Study of Simultaneous Boost Irradiation Radiotherapy for Locally Advanced Nasopharyngeal Carcinoma

Xiang

Wang²,

Xu³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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7%) showing partial remission.The most frequently observed acute toxicities during the concurrent chemoradiotherapy were mucositis and leucopenia. Four patients (6.9%) had RTOG grade 3 mucositis, whereas four patients (6.9%) had grade 3 leucopenia. No patient had grade 4 acute toxicity. Three (5.17%) of the patients exhibited injury to the brain on routine MRI examination, with a median observation of 32 months (range, 25-42months). All of them were RTOG grade 0. The 3-year overall, regional-free and distant metastasis-free survival rates were 85%, 94% and 91%, respectively. Conclusion: Simultaneous boost irradiation radiotherapy is feasible in patients with locally advanced nasopharyngeal carcinoma. The results showed excellent local control and overall survival, with no significant increase the incidence of radiation brain injury or the extent of damage. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

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Concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma: A treatment paradigm also applicable to patients in Southeast Asia

Cited by 49 publications

References 77 publications

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

Preliminary Results of a Phase I/II Study of Simultaneous Boost Irradiation Radiotherapy for Locally Advanced Nasopharyngeal Carcinoma

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