Intensity-modulated radiotherapy with simultaneous modulated accelerated boost technique and chemotherapy in patients with nasopharyngeal carcinoma

Fareed, Muhammad Mohsin; Al-Amro, Abdullah S.; Bayoumi, Yasser; Tunio, Mutahir A.; Ismail, Abdul S; Akasha, R.; Mubasher, Mohamed; Asiri, Mushabbab Al

doi:10.1186/1471-2407-13-318

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…Our study is consistent with a previous case study, which showed that IMPT decreased feeding tube placement rates in patients with NPC [16]. However, a 65% rate of feeding tube usage in IMRT was reported, which is more than that reported in previous studies (i.e., 20-30% in grade 3-4 mucositis) [17][18][19]. In our study, occurrence of grade 3 mucositis (17.5%) was consistent with previous reports on IMRT, and we demonstrated that the NG tube placement rate reduced from 15% in VMAT to 7.8% in IMPT.…”

Section: Discussionsupporting

confidence: 91%

Intensity Modulated Proton Beam Therapy versus Volumetric Modulated Arc Therapy for Patients with Nasopharyngeal Cancer: A Propensity Score-Matched Study

Chou

Fan

Lin

et al. 2021

Cancers

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(1) Background: We compared the outcomes of patients with nasopharyngeal carcinoma treated with IMPT and VMAT. (2) Methods: We performed a retrospective propensity score matching analysis (1:1) of patients treated with IMPT (years: 2016–2018) and VMAT (2014–2018). Survival was estimated using the Kaplan–Meier method. Multivariate Cox proportional hazards regression analysis was used to identify the independent predictors of survival. Binary toxicity endpoint analyses were performed using a Cox model and logistic regression. (3) Results: Eighty patients who received IMPT and VMAT were included. The median follow-up time was 24.1 months in the IMPT group. Progression-free survival (PFS) and overall survival (OS) were not statistically different between the two groups but potentially better in IMPT group. In multivariate analysis, advanced N-stage and body weight loss (BWL; >7%) during radiotherapy were associated with decreased PFS. The IMPT group had significantly less requirement for nasogastric (NG) tube placement and BWL during treatment. The mean oral cavity dose was the only predictive factor in stepwise regression analysis, and IMPT required a significantly lower mean dose. However, IMPT increased the grade 3 radiation dermatitis. (4) Conclusions: IMPT is associated with reduced rates of NG tube insertion and BWL through reducing oral mean dose, potentially producing better oncologic outcomes.

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Section: Discussionsupporting

confidence: 91%

Intensity Modulated Proton Beam Therapy versus Volumetric Modulated Arc Therapy for Patients with Nasopharyngeal Cancer: A Propensity Score-Matched Study

Chou

Fan

Lin

et al. 2021

Cancers

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“…The proportion of patients with grade 1, 2 and 3 ARD after treatment with PBT was 0-64.3%, 25-67.4%, and 3.6-42.0%, respectively [3,4,14,20]. For XRT, it varies from 6.4-51.0% for grade 1, 31-69% for grade 2, and 8.8-23.6% for grade3 in selected reports [21][22][23][24]. In a clinical setting, the comparison of ARD between PBT and XRT remains inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Acute radiation dermatitis among patients with nasopharyngeal carcinoma treated with proton beam therapy: Prognostic factors and treatment outcomes

Fang

Lee

Chuang

et al. 2022

International Wound Journal

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BackgroundA high incidence of severe acute radiation dermatitis (ARD) has been reported for cancer patients treated by proton beam therapy (PBT). This prospective study investigated the prognostic factors and treatment outcomes of ARD among patients with nasopharyngeal carcinoma (NPC) treated with PBT. MethodsFifty-seven patients with newly diagnosed NPC and treated with PBT were enrolled. ARD was recorded weekly based on the criteria of Common Terminology Criteria for Adverse Events version 4.0 in a prospective fashion at treatment visits (1st to 7th weeks) and 1 week (8th week) and 1 month (11th week) after the completion of PBT. Topical corticosteroid was used when grade 1 ARD appeared, and silver sulfadiazine was added if ARD progressed to grade 2 or more. ResultsThe maximum ARD grade was 1, 2, and 3 in 26 (45.6%), 24 (42.1%), and 7 (12.3%) of the patients, respectively. The peak incidence of grade 2 and 3 ARD was observed during the period of the 6th to 8th weeks. Twenty-four (42.1%) patients received topical corticosteroid alone; 33 (57.9%) patients received the combination of topical corticosteroid and silver sulfadiazine. In the 11th week, most grade 2 and 3 ARD had disappeared and 93.0% of the patients had ARD of grade 1 or lower. In the binary logistic regression model, we identi ed habitual smoking [odds ratio (OR): 5.2, 95% con dence interval (CI): 1.3-18.8, P = 0.012] and N2 to N3 nodal status (OR: 4.9, 95% CI: 1.6-15.4, P = 0.006) as independent predictors of grade 2 and 3 ARD. ConclusionThe results show ARD is a major concern for patients with NPC treated with PBT, especially those with habitual smoking or advanced nodal status. Topical corticosteroid and silver sulfadiazine are effective for treating ARD induced by PBT.Author's contributions: KCF and CHL collected and interpreted the data, and was the major contributor in writing the manuscript. FMF conceived of the study and its design, supervised its conduct, carried out target delineation, and helped draft the manuscript. WLT assisted statistical analyses and interpretations of the data. HCC, TLH and CYC participated in recruitment and clinical care of subjects. All authors read and approved the nal manuscript. KCF and CHL had equal contribution to this work.

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“…Previously, we reported our experience of IMRT with simultaneous modulated accelerated boost technique and concurrent chemotherapy in Saudi patients with NPC 13. Herein, we report long-term follow-up of these patients, especially focusing on the pattern of failures (local, locoregional, and distant), after IMRT and concurrent chemotherapy, prognostic factors and outcomes of reirradiation, and systemic chemotherapy in Saudi patients with recurrent, metastatic NPC.…”

Section: Introductionmentioning

confidence: 99%

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy in Saudi Arabia

Maklad¹,

Bayoumi²,

Hassan³

et al. 2016

OTT

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BackgroundWe aimed to investigate the patterns of failure (locoregional and distant metastasis), associated factors, and treatment outcomes in nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy (IMRT) combined with chemotherapy.Patients and methodsFrom April 2006 to December 2011, 68 nasopharyngeal carcinoma patients were treated with IMRT and chemotherapy at our hospital. Median radiation doses delivered to gross tumor volume and positive neck nodes were 66–70 Gy, 63 Gy to clinical target volume, and 50.4–56 Gy to clinically negative neck. The clinical toxicities, patterns of failures, locoregional control, distant metastasis control, disease-free survival, and overall survival were observed.ResultsThe median follow-up time was 52.2 months (range: 11–87 months). Epstein–Barr virus infection was positive in 63.2% of patients. Overall disease failure developed in 21 patients, of whom 85.8% belonged to stage III/IV disease. Among these, there were seven locoregional recurrences, three regional recurrences with distant metastases, and eleven distant metastases. The median interval from the date of diagnosis to failure was 26.5 months (range: 16–50 months). Six of ten (60%) locoregional recurrences were treated with reirradiation ± concurrent chemotherapy. The 5-year locoregional control, distant metastasis control, disease-free survival, and overall survival rates of whole cohort were 81.1%, 74.3%, 60.1%, and 73.4%, respectively. Cox regression analyses revealed that neoadjuvant chemotherapy, age, and Epstein–Barr virus were independent predictors for disease-free survival.ConclusionNeoadjuvant chemotherapy followed by IMRT with or without chemotherapy improves the long-term survival of Saudi patients with nasopharyngeal carcinoma. Distant metastasis was the main pattern of treatment failure. Neoadjuvant chemotherapy, age, and Epstein–Barr virus status before IMRT were important independent prognostic factors.

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Intensity-modulated radiotherapy with simultaneous modulated accelerated boost technique and chemotherapy in patients with nasopharyngeal carcinoma

Cited by 9 publications

References 16 publications

Intensity Modulated Proton Beam Therapy versus Volumetric Modulated Arc Therapy for Patients with Nasopharyngeal Cancer: A Propensity Score-Matched Study

Intensity Modulated Proton Beam Therapy versus Volumetric Modulated Arc Therapy for Patients with Nasopharyngeal Cancer: A Propensity Score-Matched Study

Acute radiation dermatitis among patients with nasopharyngeal carcinoma treated with proton beam therapy: Prognostic factors and treatment outcomes

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy in Saudi Arabia

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