Long-term outcomes of nasopharyngeal carcinoma patients with T1-2 stage in intensity-modulated radiotherapy era

Abstract

Objectives: To evaluate long-term outcomes and late toxicities of nasopharyngeal carcinoma (NPC) patients with T1-2N0-3M0 stage in intensity-modulated radiotherapy (IMRT) era. Materials and Methods: From June 2005 to October 2013, 276 patients confirmed T1-2N0-3M0 NPC treated with IMRT were reviewed, with 143 (51.8%) N0-1 disease and 133 (48.2%) N2-3 disease. Among them, 76.4% received chemotherapy. The prescribed doses given to the primary tumor and lymph nodes were 66Gy in 30 fractions. Results: After a median follow-up of 103 months, the 5-year and 10-year overall survival (OS) were 90.6% and 79.2%. The 5-year and 10-year local control (LC) rate, regional control (RC) rate and distant metastasis free survival (DMFS) were 97.0% and 91.9%, 94.1% and 92.2%, 89.4% and 87.0%, respectively. The 5-year and 10-year OS, RC rate and DMFS of N0-1 compared with those of N2-3 were 98.6% vs. 82.0% and 86.8% vs. 70.9% (P=0.000), 99.3% vs. 88.3% and 99.3% vs. 84.1% (P=0.000), 97.9% vs. 80.1% and 95.7% vs. 77.5% (P=0.000). The incidence of 3-4 late toxicities were low and mainly xerostomia and hearing deficit. The rates of radiation-induced cranial nerve palsy and temporal necrosis were 2.5% and 2.5%, respectively. Eighteen patients had the second primary tumor, of whom eight were lung cancer, six were head and neck cancer, four were others. Conclusions: Satisfactory locoregional control was achieved in T1-2N0-3M0 NPC treated with IMRT. Distant metastasis was the main failure cause and N2-3 was the main adverse prognostic factor. Second primary tumor occurred 6.5% and negatively impacted OS in NPC.

Effects of CIK Cell Therapy Combined with Camrelizumab on the Quality of Life in Patients with Nasopharyngeal Carcinoma and Analysis of Prognostic Factors

“…In recent years, the immunotherapy dominated by PD-1/PD-L1 immune checkpoint inhibitors has been gradually applied to the comprehensive treatment regimen for various types of tumors. Camrelizumab is the third PD-1 drug made in China after toripalimab and sintilimab and can activate T cells by blocking PD-1/PD-L1 binding, thereby weakening the immunosuppression within the patients' organism and enhancing the tumor-killing effect [ 7 , 8 ]. Zhou et al gave the patients with advanced nasopharyngeal carcinoma targeted therapy combined with immunotherapy (anrotinib + camrelizumab), and the patients' recheck showed that they had shrunken lesions, significantly relieved cough and active shortness of breath, and remarkably improved quality of life [ 9 ], suggesting that anrotinib + camrelizumab has treatment effect on the patients with nasopharyngeal carcinoma.…”

A Dosimetric Study on the Impact of Collimator Angles in Nasopharynx Carcinoma using VMAT Planning

“…The article comes to the conclusion that SC-VMAT with three full arcs was inferior in dosimetry to DC-VMAT with a single arc (15) . Colli-VMAT plans with smaller angular sections (16) have comparable target coverage and spare healthy tissues in comparison to Std-VMAT https://www.indjst.org/ plans (17) , according to analysis by Beom Seok Ahn et al In the same (16) , a precise substantial decrease in total MUs was also noted.…”

Changes in brain gray matter volume in nasopharyngeal carcinoma patients after radiotherapy in long-term follow-up

“…The incidence of radiation encephalopathy after radiotherapy for NPC is lower than that in conventional radiotherapy because of the use of IMRT technology 7 , 8 . However, functional MRI studies on NPC after IMRT have showed that the brain volume for patients without radiation encephalopathy have decreased compared to those of healthy persons, suggesting that although IMRT reduces the radiation dose in normal brain tissue, the effect of radiotherapy on brain tissue still exists 9 , 10 .…”