Improved long-term survival with combined modality therapy for pediatric nasopharynx cancer

Wolden, Suzanne L.; Steinherz, Peter G.; Kraus, Dennis H.; Zeléfsky, Michael J.; Pfister, David G.; Wollner, Norma

doi:10.1016/s0360-3016(99)00493-9

Cited by 59 publications

(60 citation statements)

References 25 publications

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“…NPC and in particular undifferentiated NPC is known to be a very radiosensitive tumor [4], thus the main treatment strategy for all the cases of locoregional NPC has been high-dose radiotherapy to the nasopharynx and involved lymph nodes of the neck, and a moderate dose of radiation to uninvolved nodes and surrounding tissue. Concerning radiation's dose, doses greater than 65 Gy have been shown to yield a better local control in a few studies [11,18,19], but other reports have not shown any correlation between the dose of radiation, rate of local relapse, and survival time [20][21][22]. Currently, the optimum dose for a secure control of NPC in children is not yet established.…”

Section: Discussionmentioning

confidence: 99%

Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review

Gioacchini

Tulli

Kaleci

et al. 2016

Eur Arch Otorhinolaryngol

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To systematically review and discuss the published data about treatments and outcomes for children and adolescents affected by nasopharyngeal carcinoma. In April 2015, an appropriate string was run on PubMed to retrieve all relevant articles. A cross-check was performed by two of the authors on abstracts and full-text articles found using the selected inclusion and exclusion criteria. A meta-analysis concerning the rate of reported disease-free survival and overall survival was performed. Fifteen studies were identified comprising a total of 865 subjects affected by nasopharyngeal carcinoma. According to the American Joint Committee for Cancer Staging system, the majority of tumors were classified as Stage IV (57.3 %). All included patients underwent radiotherapy, while 687 (79.4 %) received also some regimen of chemotherapy. On the basis of our statistical analysis, the mean (95 % CI) rate of disease-free survival was 66 % (95 % CI 56-76). The mean (95 % CI) rate of the overall survival resulted 68 % (95 % CI 58-78). On the basis of our analysis, it may be affirmed that the prognosis of juvenile nasopharyngeal carcinoma is still unsatisfactory. New reports on homogeneous populations are needed to better define the most influencing prognostic factors and to evaluate the introduction of possible alternative therapeutic protocols.

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Section: Discussionmentioning

confidence: 99%

Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review

Gioacchini

Tulli

Kaleci

et al. 2016

Eur Arch Otorhinolaryngol

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“…However, such high doses may cause significant long-term complications. 15,40 To minimize the radiation dose to normal tissues, high-dose-rate brachytherapy is a good option to increase radiation to the nasopharynx, although to our knowledge it remains an unexplored method. Only four articles published in the literature to date have reported on boost doses to the nasopharynx with brachytherapy in childhood, and only a few patients from the reported series underwent this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The final dose of radiotherapy is Ϸ 65-70 grays (Gy), which, combined with chemotherapy, improves survival and local control rates. 15 Unfortunately, significant acute and late effects due to high-dose external radiation always are present in survivors. Efforts to reduce the external radiotherapy dose include the use of brachytherapy in the nasopharynx after 50 -55 Gy.…”

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confidence: 99%

High‐dose‐rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood

Nakamura

Novaes

Antoneli

et al. 2005

Cancer

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Neuropeptide‐containing hippocampal interneurons and dentate granule cell inhibition were investigated at different periods following electrical stimulation‐induced, self‐sustaining status epilepticus (SE) in rats. Immunohistochemistry for somatostatin (SOM), neuropeptide Y (NPY), parvalbumin (PV), cholecystokinin (CCK), and Fluoro‐Jade B was performed on sections from hippocampus contralateral to the stimulated side and studied by confocal laser scanning microscopy. Compared to paired age‐matched control animals, there were fewer SOM and NPY‐immunoreactive (IR) interneurons in the hilus of the dentate gyrus in animals with epilepsy (40–60 days after SE), and 1, 3, and 7 days following SE. In the hilus of animals that had recently undergone SE, some SOM‐IR and NPY‐IR interneurons also stained for Fluoro‐Jade B. Furthermore, there was electron microscopic evidence of the degeneration of SOM‐IR interneurons following SE. In contrast, the number of CCK and PV‐IR basket cells in epileptic animals was similar to that in controls, although it was transiently diminished following SE; there was no evidence of degeneration of CCK or PV‐IR interneurons. Patch‐clamp recordings revealed a diminished frequency of inhibitory postsynaptic currents in dentate granule cells (DGCs) recorded from epileptic animals and animals that had recently undergone SE compared with controls. These results confirm the selective vulnerability of a particular subset of dentate hilar interneurons after prolonged SE. This loss may contribute to the reduced GABAergic synaptic inhibition of granule cells in epileptic animals. J. Comp. Neurol. 500:876–893, 2007. © 2006 Wiley‐Liss, Inc.

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“…However, there is no clear evidence for a loss of tumor control so far. Additionally, regarding optimal effective dose, there is a controversy in the optimal radiation dose, as, for example, in pediatric NPC, presenting mainly with WHO type 3 histology, it has been shown that radiation doses > 60 Gy appear necessary to achieve a high rate of locoregional control [41]. Table 6 shows the DVH statistics for the critical normal structures organized in series, while Table 7 outlines the DVH statistics for the normal tissues organized in parallel.…”

Section: Late Toxicitymentioning

confidence: 99%

Simultaneous Integrated Boost Intensity‑Modulated Radiotherapy (SIB‑IMRT) in Nasopharyngeal Cancer

et al. 2010

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Improved long-term survival with combined modality therapy for pediatric nasopharynx cancer

Cited by 59 publications

References 25 publications

Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review

Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review

High‐dose‐rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood

Simultaneous Integrated Boost Intensity‑Modulated Radiotherapy (SIB‑IMRT) in Nasopharyngeal Cancer

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