scholarly journals Peripheral Blood CD4/CD8 Ratio Is More Predictive of Progression-Free Survival Than TNM Stage in Nasopharyngeal Cancer Treated With Intensity Modulated Radiation Therapy

2016 ◽  
Vol 96 (2) ◽  
pp. E328
Author(s):  
H. Wong ◽  
J. Yi ◽  
X.D. Huang ◽  
J.W. Luo ◽  
K. Wang ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Peripheral Blood ◽  
Nasopharyngeal Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Progression Free Survival ◽  
Tnm Stage ◽  
Free Survival ◽  
Intensity Modulated

scholarly journals Prognostic value of plasma EBV DNA for nasopharyngeal cancer patients during treatment with intensity-modulated radiation therapy and concurrent chemotherapy

2018 ◽  
Vol 52 (2) ◽  
pp. 195-203 ◽  
Author(s):  
Chawalit Lertbutsayanukul ◽  
Danita Kannarunimit ◽  
Anussara Prayongrat ◽  
Chakkapong Chakkabat ◽  
Sarin Kitpanit ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Value ◽  
Radiation Treatment ◽  
Nasopharyngeal Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Progression Free Survival ◽  
Concurrent Chemotherapy ◽  
Free Survival ◽  
Intensity Modulated ◽  
Ebv Dna

Abstract Background Plasma EBV DNA concentrations at the time of diagnosis (pre-EBV) and post treatment (post-EBV) have significant value for predicting the clinical outcome of nasopharyngeal cancer (NPC) patients. However, the prognostic value of the EBV concentration during radiation therapy (mid-EBV) has not been vigorously studied. Patients and methods This was a post hoc analysis of 105 detectable pre-EBV NPC patients from a phase II/III study comparing sequential (SEQ) versus simultaneous integrated boost (SIB) intensity-modulated radiation therapy (IMRT). Plasma EBV DNA concentrations were measured by PCR before commencement of IMRT, at the 5th week of radiation therapy and 3 months after the completion of IMRT. The objective was to identify the prognostic value of mid-EBV to predict overall survival (OS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). Results A median pre-EBV was 6880 copies/ml. Mid-EBV and post-EBV were detectable in 14.3% and 6.7% of the patients, respectively. The median follow-up time was 45.3 months. The 3-year OS, PFS and DMFS rates were 86.0% vs. 66.7% (p = 0.043), 81.5% vs. 52.5% (p = 0.006), 86.1% vs. 76.6% (p = 0.150), respectively, for those with undetectable mid-EBV vs. persistently detectable mid-EBV. However, in the multivariate analysis, only persistently detectable post-EBV was significantly associated with a worse OS (hazard ratio (HR) = 6.881, 95% confident interval (CI) 1.699-27.867, p = 0.007), PFS (HR = 5.117, 95% CI 1.562–16.768, p = 0.007) and DMFS (HR = 129.071, 95%CI 19.031–875.364, p < 0.001). Conclusions Detectable post-EBV was the most powerful adverse prognostic factor for OS, PFS and DMFS; however, detectable mid-EBV was associated with worse OS, PFS especially Local-PFS (LPFS) and may facilitate adaptive treatment during the radiation treatment period.

scholarly journals Cisplatin plus capecitabine concomitant with intensity-modulated radiation therapy in non-metastatic anal squamous cell carcinoma: the experience of a single research cancer center

2020 ◽  
Vol 12 ◽  
pp. 175883592094094 ◽  
Author(s):  
Maria Saveria Rotundo ◽  
Maria Giulia Zampino ◽  
Paola Simona Ravenda ◽  
Vincenzo Bagnardi ◽  
Giulia Peveri ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Retrospective Study ◽  
Cell Carcinoma ◽  
Survival Rates ◽  
Intensity Modulated Radiation Therapy ◽  
Curative Intent ◽  
Anal Squamous Cell Carcinoma ◽  
Free Survival ◽  
Intensity Modulated

Background and Aims: The standard treatment of non-metastatic anal squamous cell carcinoma (ASCC) consists of chemotherapy with mitomycin (MMC) plus 5-fluorouracil (5FU) for 1–2 cycles concomitant with pelvic radiotherapy. Subsequent studies introduced cisplatin (CDDP) combined with 5FU, with unclear results. We evaluated the doublet capecitabine (C) and CDDP as a possible alternative to MMC-5FU regimen concomitant with intensity-modulated radiation therapy (IMRT). Patients and Methods: We carried out a retrospective study on 67 patients affected by stage I–III ASCC, treated with CDDP (60–70 mg/m2 every 21 days for two courses) plus C (825 mg/m2 twice daily for 5 days/week) chemotherapy concomitant with IMRT for curative intent. Results: At a median follow up of 41 months, the clinical complete response calculated at the 6-month time-point (6-moCR), the 6-month objective response rate and the 6-month disease control rate were 93%, 94%, and 99%, respectively. Disease-free survival rates at 1, 2, and 3 years were 89%, 87%, and 85%, while the overall survival rates at 1 and 2 years were 100% and 95%. The colostomy-free survival rates were 90% at 1 year and 88% at 2 years. Grade 3–4 acute adverse events were reported in 61% of patients; predominantly skin toxicity (46%) and limited hematological toxicity (12%). Conclusion: In this retrospective study, chemotherapy with C plus CDDP concomitant with IMRT proved safe and effective, and may represent a possible alternative option to standard MMC-containing regimen for curative intent.

Phase II study of consolidative intensity-modulated radiation therapy following first-line palliative systemic chemotherapy for de novo previously untreated metastatic (M1) nasopharyngeal carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6524-6524
Author(s):  
Victor Ho-Fun Lee ◽  
Ann SY Chan ◽  
Dora LW Kwong ◽  
To-Wai Leung ◽  
Sherry CY Ng ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Progressive Disease ◽  
De Novo ◽  
Phase Ii Study ◽  
Intensity Modulated Radiation Therapy ◽  
Relapse Free Survival ◽  
First Line ◽  
Free Survival ◽  
Intensity Modulated ◽  
Line Chemotherapy

6524 Background: The prognosis of de novo previously untreated metastatic (M1) nasopharyngeal carcinoma (NPC) at diagnosis is poor, and the role of consolidative intensity-modulated radiation therapy (IMRT) to the primary tumor and the neck following first-line palliative chemotherapy remains unknown. We report a phase II study of consolidative IMRT after first-line chemotherapy in previously untreated M1 NPC. Methods: Consolidative IMRT was given in prospectively recruited patients whose previously untreated M1 NPC did not progress after 6 cycles of first-line chemotherapy with gemcitabine and cisplatin. The primary study objective was overall survival (OS). Secondary objectives included progression-free survival (PFS), local relapse-free survival (LRFS), regional relapse-free survival (RRFS), response and toxicity. Results: Sixty-nine consecutive patients were enrolled. Sixty-four (92.8%) patients received first-line chemotherapy, of which 8 (12.5%) developed progressive disease and another 8 (12.5%) did not receive IMRT despite non-progression to first-line chemotherapy. The remaining 48 patients whose disease controlled after chemotherapy received IMRT, including 18 (37.5%) who received concurrent chemoradiation. OS was significantly better in those who received IMRT (35.1 versus 14.2 months; P < 0.001), after a median follow-up duration of 3.40 years (range 0.43 years to 12.14 years). PFS, LRFS, and RRFS were also significantly longer in those who received IMRT. Multivariable analyses revealed that IMRT was the only prognostic factor of all survival endpoints. Grade 3 adverse events were observed in 10 (20.8%) patients, mainly mucositis, dysphagia and desquamation. Conclusions: Consolidative IMRT was associated with an OS benefit and favorable tolerability among previously untreated M1 NPC patients who had non-progressive disease following first-line chemotherapy. These results support the rationale to further investigate IMRT as part of the initial treatment in this setting. Clinical trial information: NCT02476669 .

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