Locally recurrent nasopharyngeal carcinoma

Chang, Joseph Tung-Chieh; See, Lai‐Chu; Liao, Chun‐Ta; Ng, Shu‐Hang; Wang, Cheng‐Hsu; Chen, I-How; Tsang, Ngan‐Ming; Tseng, Chen‐Kan; Tang, Shuai; Hong, Ji-Hong

doi:10.1016/s0167-8140(99)00177-2

Cited by 129 publications

(110 citation statements)

References 31 publications

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“…Validating the results of the present study requires further biopsy collections to assess the expression of EGFR in patients with NPC and whether EGFR expression is associated with radiation resistance. The limitations of the present study were as follows: On one hand, the volume of nasopharyngeal tumor tissue was small (<0.5 cm 3 ), meaning that they were difficult to isolate under the nasopharyngeal microscope. Additionally, targeted treatment was not included as a part of the standard therapy: Only patients with local advanced NPC who could afford the treatment were able to select the targeted drugs.…”

Section: Discussionmentioning

confidence: 93%

“…Radiotherapy targeting the nasopharyngeal tumor and draining lymph node echelons remains a common treatment for NPC (2,3). Although early stage NPC may be effectively treated by radiotherapy alone, treatments of regional advanced NPC (Union for International Cancer Control Stage III/IV) require improvements; the incidence rate of a local residual tumor following radical radiotherapy is 7.0-13.0% and the local recurrent rate ranges from 16.8 to 23.0% (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

et al. 2018

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Abstract. The present study retrospectively analyzed the prognostic factors of 135 patients with locally advanced nasopharyngeal carcinoma (NPC) who received intensity modulated radiation therapy between August 2008 and January 2012 at Xiangya Hospital of Central South University. Patients were staged from III-IVA according to the 7th American Joint Committee on Cancer staging system. Using Statistical Analysis System 9.3 software, the present study demonstrated that, among these 135 patients, the 5-year overall survival, the 5-year local relapse-free survival, and the 5-year disease metastasis-free survival were 84, 82, and 78%, respectively. Multivariate Cox regression analysis identified that targeted treatment [hazard ratio (95% confidence interval), 2.642 (1.001, 6.972); P=0.0497] served as an independent negative prognostic factor in locally advanced NPC. The results of immunostaining revealed that the staining intensity of the radiation-resistant group was increased compared with that of the radiation-sensitive group. These results demonstrate that a high expression of EGFR may be associated with radiation resistance, and targeted treatment may not be effective in patients with locally advanced nasopharyngeal carcinoma with low expression of EGFR.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

et al. 2018

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“…Re-irradiation doses between 50-60Gy were able to obtain 100% LC rate for recurrent T1-3 lesions using IMRT techniques (Han et al, 2012). Other studies show retreatment total dose between 50-60Gy was associated with improved LRFS or OS (Chang et al, 2000;Leung et al, 2000). However, normalised total brachytherapy dose was not demonstrated to have a statistically significant effect on OS.…”

Section: Resultsmentioning

confidence: 94%

Treatment Outcome with Brachytherapy for Recurrent Nasopharyngeal Carcinoma

Cheah¹,

Lau²,

Yusof³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: To evaluate the treatment outcome and major late complications of all patients with recurrent nasopharyngeal carcinoma (NPC) treated with intracavitary brachytherapy (ICBT) in Hospital Kuala Lumpur. Materials and Methods: This retrospective study was conducted at the Department of Radiotherapy and Oncology, Hospital Kuala Lumpur, Malaysia. All patients with histologically confirmed recurrent NPC in the absence of distant metastasis treated in the period 1997-2010 were included in this study. These patients were treated with ICBT alone or in combination with external beam radiotherapy (EBRT). Treatment outcomes measured were local recurrence free survival (LRFS), disease free survival (DFS) and overall survival (OS). Results: Thirty three patients were eligible for this study. The median age at recurrence was 56 years with a median time to initial local recurrence of 27 months. Majority of patients were staged as rT1-2 (94%) or rN0 (82%). The proportion of patients categorised as stage III-IV at first local recurrence was only 9%. Twenty one patients received a combination of ICBT and external beam radiotherapy while 12 patients were treated with ICBT alone. Median interval of recurrence post re-irradiation was 32 months (range: 4-110 months). The median LRFS, DFS and OS were 30 months, 29 months and 36 months respectively. The 5 year LRFS, DFS and OS were 44.7%, 38.8% and 28.1% respectively. The N stage at recurrence was found to be a significant prognostic factor for LRFS and DFS after multivariate analysis. Major late complications occurred in 34.9% of our patients. Conclusions: Our study shows ICBT was associated with a reasonable long term outcome in salvaging recurrent NPC although major complications remained a significant problem. The N stage at recurrence was a significant prognostic factor for both LRFS and DFS.

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“…1 High incidence of disease recurrence, which ranges from 15 to 58%, [1][2][3] is an important clinical feature of this disease. 1 Recent advances in treatment techniques and strategies are providing an opportunity to potentially cure some patients with recurrent NPC.…”

Section: Introductionmentioning

confidence: 99%

Value of ¹⁸F-FDG heterogeneity for discerning metastatic from benign lymph nodes in nasopharyngeal carcinoma patients with suspected recurrence

Moon

Cho

Son

et al. 2016

BJR

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Objective: This study investigated the value of fluorine-18 fludeoxyglucose ( 18 F-FDG) heterogeneity as an indicator of metastatic lymph nodes (LNs) in patients with nasopharyngeal carcinoma (NPC). We further assessed whether addition of this parameter improves diagnostic performance beyond that provided by maximum standardized uptake value (SUV max ). Methods: We analyzed 74 LNs that were suspicious for metastasis. These LNs were measured for coefficient of variation (CV) of 18 F-FDG uptake, which was used as a parameter for 18 F-FDG heterogeneity. Results: Multivariate logistic regression analyses revealed that a high CV (hazard ratio, 20.97; 95% confidence interval, 2.26-194.62; p 5 0.007) was an independent predictor of metastatic LNs. However, receiveroperating characteristic curve analysis (p 5 0.278) and net reclassification (p 5 0.539) were unable to show improved diagnostic performance by addition of CV to SUV max . Conclusion: High CV of 18 F-FDG uptake is an independent risk factor for metastatic LNs in patients with NPC displaying suspicious LNs following treatment. Advances in knowledge: Heterogeneity of 18 F-FDG uptake has a potential as a biomarker of metastatic LNs.

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Locally recurrent nasopharyngeal carcinoma

Cited by 129 publications

References 31 publications

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

Treatment Outcome with Brachytherapy for Recurrent Nasopharyngeal Carcinoma

Value of ¹⁸F-FDG heterogeneity for discerning metastatic from benign lymph nodes in nasopharyngeal carcinoma patients with suspected recurrence

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Locally recurrent nasopharyngeal carcinoma

Cited by 129 publications

References 31 publications

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

Prognostic analysis of patients with locally advanced nasopharyngeal carcinoma following intensity modulated radiation therapy

Treatment Outcome with Brachytherapy for Recurrent Nasopharyngeal Carcinoma

Value of 18F-FDG heterogeneity for discerning metastatic from benign lymph nodes in nasopharyngeal carcinoma patients with suspected recurrence

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Value of ¹⁸F-FDG heterogeneity for discerning metastatic from benign lymph nodes in nasopharyngeal carcinoma patients with suspected recurrence