Journal ArticleDOI
Whole-Field Simultaneous Integrated-Boost Intensity-Modulated Radiotherapy for Patients With Nasopharyngeal Carcinoma
Frank C.S. Wong,A Ng,V. Lee,Collin M.M. Lui,Kwok-Keung Yuen,W.K. Sze,To-Wai Leung,Stewart Y. Tung +7 more
TLDR
Whole-field simultaneous integrated-boost intensity-modulated radiotherapy with a dose >70 Gy achieved excellent locoregional control, without an excess incidence of severe, acute mucositis/pharyngitis, in patients with newly diagnosed nondisseminated nasopharyngeal carcinoma treated with WF-SIB.Abstract:
Purpose: To retrospectively review the outcomes of our patients with newly diagnosed nondisseminated nasopharyngeal carcinoma treated with intensity-modulated radiotherapy using a whole-field simultaneous integrated-boost technique. Methods and Materials: A total of 175 patients treated with WF-SIB between mid-2004 and 2005 were eligible for study inclusion. The distribution of disease by stage was Stage IA in 10.9%, Stage IIA in 2.3%, Stage IIB in 21.7%, Stage III in 41.1%, Stage IVA in 14.9%, and Stage IVB in 9.1%. Of the 175 patients, 2 (1.2%), 10 (5.7%), and 163 (93.1%) had World Health Organization type I, II, and III histologic features, respectively. We prescribed 70 Gy, 60 Gy, and 54 Gy delivered in 33 fractions within 6.5 weeks at the periphery of three planning target volumes (PTV; PTV70, PTV60, and PTV54, respectively). Of the 175 patients, 46 with early T-stage disease received a brachytherapy boost, and 127 with advanced local or regional disease received chemotherapy. Results: The median follow-up period was 34 months. The overall 3-year local failure-free survival, regional failure-free survival, distant failure-free survival, and overall survival rate was 93.6%, 93.3%, 86.6%, and 87.2%, respectively. Cox regression analysis showed Stage N2-N3 disease (p = .029) and PTV (p = .024) tomore » be independent factors predicting a greater risk of distant failure and poor overall survival, respectively. Grade 3 acute mucositis/pharyngitis occurred in 23.4% of patients, and Stage T4 disease was the only significant predictor of mucositis/pharyngitis (p = .021). Conclusion: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy with a dose >70 Gy achieved excellent locoregional control, without an excess incidence of severe, acute mucositis/pharyngitis, in the present study. Strategies for using such highly conformal treatment for patients with a large tumor and late N-stage disease are potential areas of investigation for future studies.« lessread more
Citations
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Journal ArticleDOI
Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities.
Xueming Sun,Shengfa Su,Chun-yan Chen,Fei Han,Chong Zhao,Weiwei Xiao,Xiaowu Deng,Shaomin Huang,Chengguang Lin,Taixiang Lu +9 more
TL;DR: IMRT for NPC yielded excellent survival outcomes, and distant metastasis was the most commonly seen failure pattern after treatment, and concurrent chemotherapy failed to improve survival rates for patients with advanced locoregional disease.
Journal ArticleDOI
Current Management of Nasopharyngeal Cancer
TL;DR: The current consensus and controversies in the treatment strategy for different stages, the choice of chemotherapy regimen, and the key factors for improving the therapeutic ratio of radiotherapy will be discussed.
Journal ArticleDOI
Intensity-modulated radiotherapy prolongs the survival of patients with nasopharyngeal carcinoma compared with conventional two-dimensional radiotherapy: A 10-year experience with a large cohort and long follow-up.
Meng Xia Zhang,Jing Li,Guo Ping Shen,Xiong Zou,Jun Jie Xu,Rou Jiang,Rui You,Yi Jun Hua,Ying Sun,Jun Ma,Ming Huang Hong,Ming Yuan Chen +11 more
TL;DR: IMRT provided an improved LRFS, LRRFS and PFS in both the early and advanced T classifications and overall stage for non-disseminated NPC compared with 2D-CRT, however, no significant advantage was observed in NRFS, DMFS or OS when IMRT was used.
Journal ArticleDOI
The battle against nasopharyngeal cancer
TL;DR: This is a review of the evolving efforts to understand and combat nasopharyngeal carcinoma, a most peculiar cancer with a distinctly skewed geographic and ethnic distribution, which is one of the most fascinating successes in oncology.
Journal ArticleDOI
Long-Term Outcomes of Early-Stage Nasopharyngeal Carcinoma Patients Treated With Intensity-Modulated Radiotherapy Alone
TL;DR: IMRT alone for Stage T1-T2bN0, T1N1, and T2N1 yielded satisfactory survival outcomes with acceptable toxicity, and no differences were found in survival outcomes among these four subgroups.
References
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TL;DR: Part 1 General information on cancer staging and end-results reporting: purposes and principles of staging reporting of cancer survival and end results are explained.
Journal ArticleDOI
CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment.
Andy Trotti,A. Dimitrios Colevas,Ann Setser,Valerie W. Rusch,David P. Jaques,Volker Budach,Corey J. Langer,Barbara A. Murphy,Richard Cumberlin,C. Norman Coleman,Philip Rubin +10 more
TL;DR: Recent progress in the evolution of adverse effects grading systems is updated and the development of CTCAE v3.0 is reviewed, which represents an international collaboration and consensus of the oncology research community.
Journal ArticleDOI
Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099.
Muhyi Al-Sarraf,Michael LeBlanc,P.G. Giri,Karen K. Fu,Jay S. Cooper,T. Vuong,Arlene A. Forastiere,George L. Adams,Wael Sakr,David E. Schuller,John F. Ensley +10 more
TL;DR: It is concluded that chemoradiotherapy is superior to radiotherapy alone for patients with advanced nasopharyngeal cancers with respect to PFS and overall survival.
Journal ArticleDOI
Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience.
Nancy M. Lee,Ping Xia,Jeanne M. Quivey,Khalil Sultanem,Ian Poon,C. Akazawa,Pam Akazawa,Vivian Weinberg,Karen K. Fu +8 more
TL;DR: In this article, intensity-modulated radiotherapy (IMRT) was used in the treatment of nasopharyngeal carcinoma (NPC) using three different techniques: manually cut partial transmission blocks, computer-controlled auto-sequencing segmental multileaf collimator (SMLC), and sequential tomotherapy using a dynamic multivane intensity modulating collimators (MIMiC).
Journal ArticleDOI
Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients
Bertrand Baujat,Hélène Audry,Jean Bourhis,Anthony T.C. Chan,Haluk Onat,Daniel T.T. Chua,Dora L.W. Kwong,Muhyi Al-Sarraf,Kwan Hwa Chi,Masato Hareyama,Sing Fai Leung,Kullathorn Thephamongkhol,Jean Pierre Pignon +12 more
TL;DR: Chemotherapy led to a small, but significant, benefit for overall survival and event-free survival when chemotherapy was administered concomitantly with RT.