Retrospective analysis of 934 primary nasopharyngeal carcinoma (NPC) patients treated with conventional external beam radiotherapy alone

Lu, Tai‐Xiang; Cui, Nian Ji; Luo, Wei; Zhao, Chong; Wu, Shaoxiong; Liu, X.; Chen, Y.; Xie, Fang‐Yun; Chen, M.; Hu, Wei; Cao, Xuejun; Xia, Yunfei

doi:10.1016/j.ijrobp.2004.07.451

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies based on 2D-RT, 46.9% to 59.2% of all failure sites after definitive radiotherapy included at least one distant site [ 10 – 13 ], which was lower than the result (68.2%) observed in our study. The main treatment failure patterns in the 2D-RT era included both locoregional recurrence and DM with similar occurrence rates [ 10 , 11 , 13 , 14 ]. However, DM alone accounted for 56.1% of all treatment failures and became the predominant pattern, while locoregional failure alone accounted for less than a third of failures.…”

Section: Discussioncontrasting

confidence: 96%

Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy

Xiao

Shen

et al. 2015

Oncotarget

View full text Add to dashboard Cite

Purpose: To report the distant metastasis (DM) risk and patterns for nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) and to analyze the benefits of chemotherapy based on DM risk.Materials and Methods: 576 NPC patients were analyzed. The DM rates were calculated using the Kaplan-Meier method, and the log-rank test was used to compare differences. The patients were divided into different risk subclassifications according to DM hazard ratios.Results: 91 patients developed DM after treatment, with bone as the most common metastatic sites. 82.4% of DMs occurred within 3 years of treatment. Patients were classified as low-risk, intermediate-risk and high-risk, and the corresponding 5-year DM rates were 5.1%, 13.1% and 32.4%, respectively (P < 0.001). Chemotherapy failed to decrease the DM rate in the low-risk subclassification, but decreased the DM risk in the intermediate-risk subclassification (P = 0.025). In the high-risk subclassificaiton, the DM rate was 31.9% though chemotherapy was used, which was significantly higher than that of other two subclassifications.Conclusions: DM is the dominant treatment failure in NPC treated by IMRT, with similar occurrence times and distributions to those that occurred in the era of conventional radiotherapy. Further studies on treatment optimization are needed in high-risk patients.

show abstract

Section: Discussioncontrasting

confidence: 96%

Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy

Xiao

Shen

et al. 2015

Oncotarget

View full text Add to dashboard Cite

show abstract

“…In addition, management of local failure remains a challenge. Lee et al and others 5,6,22 reported a recurrence rate of 8.2% for lymph nodes of the nasopharynx and neck during the first 5 years following the completion of radiotherapy for NPC. In 70% to 90% of these cases, tumor recurrence was diagnosed within 2 to 3 years, and the recurrent sites were focused in the nasopharynx, the nasal pharyngeal space, and the carotid sheath.…”

Section: Discussionmentioning

confidence: 98%

Refractory Nasopharyngeal Carcinoma: Positron Emission Tomography Combined with Computed Tomography–Guided ¹²⁵I Seed Implantation Therapy after Repeated Traditional Radiochemotherapy

Zhang

Gao

et al. 2013

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

show abstract

The current status of the delineation and determination of the targets and the radiation protocols for nasopharyngeal cancer with intensity-modulated radiotherapy

Zhu

2007

Chin. J. Clin. Oncol.

View full text Add to dashboard Cite

IMRT has increased the local-regional control and decreased the complications from treating nasopharyngeal cancer (NPC). Therefore studying IMRT is important. CT and MRI are complementary, and their joint use is currently considered to be the optimal modality to delineate the extent of the primary spread of NPC. The key problem in delineation of the neck nodes is how to translate anatomic node regions into the CT boundaries. The consensus guideline which narrowed the gap among different cancer centers is recommended in delineating the boundary of the cervical lymph node regions. The definition of the NPC GTV is clear and almost the same among the main cancer centers in their IMRT planning protocols.The suggested biological dose to the GTV is close to or more than 80 Gy; the main differences are the definitions of the CTVs and their schemes for the prescribed dose, and also the dosage to the high cervical region is different among those centers. According to their long-term follow-up results, it is suggested that, besides adding 5~10 mm margins to the primary lesions, the immediate high-risk structures (including the entire nasopharyngeal cavity, retropharyngeal space, clivus, base of the skull, pterygoid plates and muscles, parapharyngeal space, the sphenoid and partial ethmoid sinuses, the posterior third of the maxillary sinuses and the nasal cavity) should also be included with a prescription of more than 60 Gy, and the bilateral Ib, II and Va node levels should be ranked as high-risk regions and differentially prescribed for treatment with no less than 60 Gy.According to the large-case reports on the traditional treatment of nasopharyngeal cancer (NPC) with the facial-cervical field as the main irradiation field, the 5-year locoregional controls were 81.7%~85%, and the 5-year overall survival was 59%~75%, but the complications induced by irradiation were relatively high [1][2][3][4] . Intensity-modulated radiotherapy (IMRT), which can not only improve the locoregional control, but also reduce the complication rates, is currently deemed as the optimal means to treat NPC. Experience from the University of California at San Francisco (UCSF) indicated that the 4-year local control was 98% with a 4-year survival of 88%. The accumulating complication rates above level III were 11.9% [5] . The Cancer Center of the Sun YatSen University in China recently reported a 3-year locoregional control of 93.2% and a 3-year overall survival of 85.1% [6] . Those results were superior to those treated with the traditional means. However when applying IMRT to the treatment of NPC, the displays of the extension of the primary lesions were not wholly in accordance with each other when using different image modali-

show abstract

Retrospective analysis of 934 primary nasopharyngeal carcinoma (NPC) patients treated with conventional external beam radiotherapy alone

Cited by 4 publications

References 0 publications

Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy

Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy

Refractory Nasopharyngeal Carcinoma: Positron Emission Tomography Combined with Computed Tomography–Guided ¹²⁵I Seed Implantation Therapy after Repeated Traditional Radiochemotherapy

The current status of the delineation and determination of the targets and the radiation protocols for nasopharyngeal cancer with intensity-modulated radiotherapy

Contact Info

Product

Resources

About

Retrospective analysis of 934 primary nasopharyngeal carcinoma (NPC) patients treated with conventional external beam radiotherapy alone

Cited by 4 publications

References 0 publications

Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy

Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy

Refractory Nasopharyngeal Carcinoma: Positron Emission Tomography Combined with Computed Tomography–Guided 125I Seed Implantation Therapy after Repeated Traditional Radiochemotherapy

The current status of the delineation and determination of the targets and the radiation protocols for nasopharyngeal cancer with intensity-modulated radiotherapy

Contact Info

Product

Resources

About

Refractory Nasopharyngeal Carcinoma: Positron Emission Tomography Combined with Computed Tomography–Guided ¹²⁵I Seed Implantation Therapy after Repeated Traditional Radiochemotherapy