Induction Chemotherapy Followed by Chemo-intensity-modulated Radiotherapy for Locally Advanced Nasopharyngeal Cancer

Miah, Aisha; Bhide, Shreerang A.; Rosario, Lyra Del; Matthews, Jennifer; Nicol, R.; Tanay, MaryAnne; Gupta, Samta; Zaidi, Shane; Newbold, Kate; Harrington, Kevin; Nutting, Chris

doi:10.1016/j.clon.2016.01.012

Cited by 14 publications

(14 citation statements)

References 19 publications

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“…Two studies regarding the completion of adjuvant chemotherapy in patients with colon cancer found social and demographic factors to be associated with treatment completion, whereas hospital and physician characteristics were not. 12,19,20 However, in the current study, patients with incomplete CRT did not appear to experience more toxicity than those with complete CRT. 14,15 To the best of our knowledge, similar studies in patients with HNSCCa have not been performed to date, but could provide valuable information regarding which patients are likely to complete nonsurgical therapy and which patients might be better served by surgery.…”

Section: Discussioncontrasting

confidence: 62%

“…In addition, acute toxicity experienced during CRT would play a major role in treatment incompletion. 12,19,20 However, in the current study, patients with incomplete CRT did not appear to experience more toxicity than those with complete CRT. Instead, we observed that many patients with incomplete CRT underwent salvage total laryngectomy after discontinuing their CRT treatment cycle.…”

Section: Discussioncontrasting

confidence: 62%

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Comparative effectiveness of surgical and nonsurgical therapy for advanced laryngeal cancer

Lin

Fedewa

Prickett

et al. 2016

Cancer

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Patients with advanced laryngeal cancer who underwent complete CRT were found to have overall and cause-specific survival rates similar to those of patients undergoing surgery. However, a substantial percentage of patients who initiated CRT did not complete the course. Although CRT provides organ preservation, the benefits and trade-offs of CRT and total laryngectomy should be discussed fully with patients. The importance of completing the full course of CRT should be emphasized. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2845-2856. © 2016 American Cancer Society.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussioncontrasting

confidence: 62%

Comparative effectiveness of surgical and nonsurgical therapy for advanced laryngeal cancer

Lin

Fedewa

Prickett

et al. 2016

Cancer

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“…Severe acute dysphagia models were generated and internally validated using a training dataset of 335 patients with DICOM RT data available, enrolled in one of six different clinical trials [29] , [30] , [31] , [32] , [33] , with institutional review board approval and signed patient consent ( Table 1 ). Patients for whom clinical data (age, sex, primary disease site, use of chemotherapy) were unavailable (13 patients) were excluded from the analyses.…”

Section: Methodsmentioning

confidence: 99%

Incorporating spatial dose metrics in machine learning-based normal tissue complication probability (NTCP) models of severe acute dysphagia resulting from head and neck radiotherapy

Dean

Wong

Welsh

et al. 2018

Clinical and Translational Radiation Oncology

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Severe acute dysphagia commonly results from head and neck radiotherapy (RT). A model enabling prediction of severity of acute dysphagia for individual patients could guide clinical decision-making. Statistical associations between RT dose distributions and dysphagia could inform RT planning protocols aiming to reduce the incidence of severe dysphagia. We aimed to establish such a model and associations incorporating spatial dose metrics. Models of severe acute dysphagia were developed using pharyngeal mucosa (PM) RT dose (dose-volume and spatial dose metrics) and clinical data. Penalized logistic regression (PLR), support vector classification and random forest classification (RFC) models were generated and internally (173 patients) and externally (90 patients) validated. These were compared using area under the receiver operating characteristic curve (AUC) to assess performance. Associations between treatment features and dysphagia were explored using RFC models. The PLR model using dose-volume metrics (PLRstandard) performed as well as the more complex models and had very good discrimination (AUC = 0.82) on external validation. The features with the highest RFC importance values were the volume, length and circumference of PM receiving 1 Gy/fraction and higher. The volumes of PM receiving 1 Gy/fraction or higher should be minimized to reduce the incidence of severe acute dysphagia.

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“…3 In a clinical trial published recently, incidence of fatigue $ Grade 2 was 99% in locally advanced NPC patients undergoing chemoradiotherapy. 4 Therefore, the effective management of CRF is of much significance for improving quality of life in NPC patients undergoing chemoradiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Effects of Tai Chi Exercise on Cancer-Related Fatigue in Patients With Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy: A Randomized Controlled Trial

Zhou

Wan

Chen

et al. 2018

Journal of Pain and Symptom Management

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Context. Tai Chi exercise has been shown to improve cancer-related fatigue (CRF) and autonomic nervous system (ANS) balance in some cancer patients or survivors; however, such effects are yet to be verified in nasopharyngeal carcinoma (NPC) patients undergoing chemoradiotherapy. Objectives. To explore the effects of Tai Chi exercise on CRF in NPC patients undergoing chemoradiotherapy and then to evaluate ANS information indicated by heart rate variability parameters and their association with CRF. Methods. A randomized controlled trial of Tai Chi exercise was conducted from January 2014 to August 2015. Participants in the Tai Chi group practiced Tai Chi a one-hour session, five sessions/week during chemoradiotherapy. Participants in the control group received usual care. The primary end points were scores of the multidimensional fatigue symptom inventoryeshort form (MFSI-SF). Secondary end points were heart rate variability parameters, including normalized lowfrequency (nLF) power, normalized high-frequency (nHF) power, and the nLF/nHF ratio, and their association with CRF. Results. One hundred fourteen patients were recruited in this study, and 83 patients completed the trial. The Tai Chi group and the control group had comparable baseline characteristics. After chemoradiotherapy, the Tai Chi group exhibited lower MFSI-SF total score and three negative subscale (general, physical, and emotional fatigue) scores and higher vigor score compared with the control group (P < 0.01 for all). The nLF/nHF ratio was significantly lower in the Tai Chi group compared to the control group after chemoradiotherapy. The MFSI-SF total score was markedly correlated with the nLF/nHF ratio. Conclusion. Tai Chi exercise is conducive to alleviate CRF in NPC patients undergoing chemoradiotherapy. The improvement in ANS balance might fit into the process of Tai Chi for CRF management in this population.

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Induction Chemotherapy Followed by Chemo-intensity-modulated Radiotherapy for Locally Advanced Nasopharyngeal Cancer

Cited by 14 publications

References 19 publications

Comparative effectiveness of surgical and nonsurgical therapy for advanced laryngeal cancer

Comparative effectiveness of surgical and nonsurgical therapy for advanced laryngeal cancer

Incorporating spatial dose metrics in machine learning-based normal tissue complication probability (NTCP) models of severe acute dysphagia resulting from head and neck radiotherapy

Effects of Tai Chi Exercise on Cancer-Related Fatigue in Patients With Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy: A Randomized Controlled Trial

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