Current Role of Chemotherapy in Nonmetastatic Nasopharyngeal Cancer

Nasopharyngeal carcinoma is highly radio- and chemosensitive tumor with its unique clinical and biological behavior. Treatment of stage I disease is radical radiotherapy alone. For stage II disease treatment is radiotherapy with or without chemotherapy. The standard of care for locally advanced nasopharyngeal cancer (stages III-IVB) is concurrent chemoradiation. Optimum timing and sequence of chemotherapy are not yet well-defined. The role of adjuvant and induction chemotherapy is debatable. Here we are going to highlight the role of chemotherapy in nasopharyngeal carcinoma, its benefit, and controversies regarding timing and sequences.

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Role of Pretreatment Hemoglobin-to-Platelet Ratio in Predicting Survival Outcome of Locally Advanced Nasopharyngeal Carcinoma Patients

Journal of Cancer Epidemiology ◽

10.1155/2021/1103631 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Cosphiadi Irawan ◽

Andhika Rachman ◽

Puji Rahman ◽

Arif Mansjoer

Keyword(s):

Nasopharyngeal Carcinoma ◽

Cancer Patients ◽

Cox Regression ◽

Locally Advanced ◽

Nasopharyngeal Cancer ◽

Bivariate Analysis ◽

Kaplan Meier ◽

Cell Components ◽

Negative Predictor

Background. The three-year survival rate of locally advanced nasopharyngeal carcinoma (NPC) patients in Indonesia is lower than in other Asian countries. Calculation of hemoglobin-to-platelet ratio (HPR) may become a more practical predictor than the ratios using leukocyte cell components. Yet, no study has been conducted to investigate the potential of HPR in predicting survival outcomes in locally advanced nasopharyngeal cancer patients. Objective. To determine the role of pretreatment hemoglobin-to-platelet ratio in predicting the three-year overall survival (OS) of locally advanced NPC. Method. A retrospective cohort study followed up on 289 locally advanced NPC patients who had undergone therapy at the Dr. Cipto Mangunkusumo National General Hospital between January 2012 and October 2016. HPR cut-off was determined using ROC. Subjects were classified into two groups according to the HPR value. Kaplan-Meier curve was utilized to illustrate patients’ three-year survival, and Cox regression test analyzed confounding variables to yield an adjusted hazard ratio (HR). Results. The optimal cut-off for HPR was 0.362 (AUC 0.6228, 95% CI: 0.56-0.69, sensitivity 61.27%, specificity 60.34%). Of the subjects, 48.44% had HPR ≤ 0.362 , and they had a higher three-year mortality rate than those with HPR > 0.362 (50% vs. 31.54%). In bivariate analysis, HPR ≤ 0.362 and age ≥ 60 significantly showed a worse three-year OS ( p value = 0.003 and 0.075, respectively). In multivariate analysis, we concluded that a pretreatment HPR ≤ 0.362 was an independent negative predictor of three-year OS in locally advanced NPC patients (adjusted HR 1.82; 95% CI: 1.25–2.65). Conclusion. Pretreatment HPR ≤ 0.362 was a negative predictor of three-year OS in locally advanced nasopharyngeal cancer patients.

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Role of Organ Preservation in Locally Advanced Hypopharyngeal Carcinoma

10.5772/intechopen.98906 ◽

2021 ◽

Author(s):

Farida Nazeer ◽

Rejnish Ravi Kumar ◽

Malu Rafi ◽

Lekha M. Nair ◽

Kainickal Cessal Thommachan ◽

...

Keyword(s):

Organ Preservation ◽

Locally Advanced ◽

Standard Of Care ◽

Response Assessment ◽

Hypopharyngeal Carcinoma ◽

Radical Radiotherapy ◽

Postoperative Radiation ◽

Larynx Preservation ◽

Poor Treatment

Hypopharyngeal carcinoma is relatively rare and has the worst prognosis of all head and neck cancers. Initially, surgery followed by postoperative radiation was the standard of care for locally advanced disease. In the recent years, various organ sparing approaches have evolved. There are mainly two schools of thought regarding larynx preservation in hypopharyngeal cancers which include either induction chemotherapy followed by response assessment for radical radiotherapy or concurrent chemoradiation. An ongoing trial is comparing the effectiveness between these two established approaches. The role of anti-EGFR therapy and immunotherapy is still being evaluated. Despite all the advancements in treatment, hypopharyngeal cancers are still associated with poor treatment outcomes.

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P0112 Role of neoadjuvant chemotherapy in locally advanced nasopharyngeal carcinoma

European Journal of Cancer ◽

10.1016/j.ejca.2014.03.156 ◽

2014 ◽

Vol 50 ◽

pp. e40-e41

Author(s):

M. Qasim Buriro ◽

R. Abdullah ◽

H. Nisar

Keyword(s):

Nasopharyngeal Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Locally Advanced

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Induction gemcitabine cisplatin followed by chemoradiation in locally advanced nasopharyngeal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.6027 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 6027-6027 ◽

Cited By ~ 1

Author(s):

Sadaf Usman ◽

Sara Rasheed ◽

Ali Raza ◽

Raza Hussain ◽

Arif Jamshed

Keyword(s):

Nasopharyngeal Carcinoma ◽

Randomized Clinical Trials ◽

Locally Advanced ◽

Nasopharyngeal Cancer ◽

Stage Iv ◽

Attractive Alternative ◽

Current Standard ◽

Alternative Approach ◽

Recent Addition ◽

Gemcitabine And Cisplatin

6027 Background: The current standard of treatment in locally advanced nasopharyngeal cancer is concurrent chemoradiation, however recent addition of induction chemotherapy in the already established regimen has presented an attractive alternative approach. We report on survival with induction Gemcitabine and Cisplatin (GC) followed by chemoradiation (CRT) in the treatment of advanced nasopharyngeal carcinoma. Methods: Between 2005 and 2015, 300 patients (M 70%: F 30%) with histologically confirmed nasopharyngeal carcinoma. Histological subtypes WHO I 4% (13) and WHO III 96% (287). AJCC (7th edition) stage was Stage III 28% (85) and Stage IV 72% (215) patients. IC included a 2 drug combination; intravenous gemcitabine 1000 mg/m2 on day 1 and 8 and cisplatin 75 mg/m2 on day 1 only. Radiotherapy was given as a phase treatment to a total dose of 70 Gy in 35 fractions. Concurrent three weekly cisplatin (75 mg/m2) was administered to all patients. Results: Median follow up time was 30 months. The 5-year overall survival (OS), loco regional control (LRC) and relapse free survival (RFS) rates were 70% (95% CI 6.43 – 7.52), 69% (95% CI 6.52 – 7.64) and 52% (95% CI 5.25 – 6.34) respectively. One hundred and seven patients failed treatment; local or loco-regional 39% (42), regional 16% (17) and distant 45% (48). Conclusions: We conclude that induction gemcitabine and cisplatin followed by chemo-radiation is an effective regimen in management of nasopharyngeal carcinoma, meriting further investigation in randomized clinical trials.

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Current Role of Magnetic Resonance Imaging in Evaluation and Radiotherapy in Locally Advanced Carcinoma Cervix

Indian Journal of Gynecologic Oncology ◽

10.1007/s40944-016-0063-3 ◽

2016 ◽

Vol 14 (2) ◽

Author(s):

Saikat Das ◽

Santanu Samanta ◽

Manu Mathew ◽

Reetu John ◽

Abraham Peedicayil ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Locally Advanced ◽

Resonance Imaging ◽

Carcinoma Cervix ◽

Current Role ◽

Advanced Carcinoma

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The role of MRI in staging and radiotherapy treatment planning in locally advanced nasopharyngeal carcinoma – case report

International Bulletin of Otorhinolaryngology ◽

10.14748/orl.v14i2.6769 ◽

2018 ◽

Vol 14 (2) ◽

pp. 10

Author(s):

Hr. Ivanovska ◽

E. Encheva ◽

G. Iliev ◽

R. Georgiev ◽

B. Chaushev ◽

...

Keyword(s):

Case Report ◽

Nasopharyngeal Carcinoma ◽

Treatment Planning ◽

Locally Advanced ◽

Radiotherapy Treatment Planning ◽

Radiotherapy Treatment

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Successful treatment of nasopharyngeal cancer using radiotherapy with concurrent cetuximab in a patient with Charcot-Marie-Tooth disease

BMJ Case Reports ◽

10.1136/bcr-2018-228956 ◽

2019 ◽

Vol 12 (7) ◽

pp. e228956 ◽

Cited By ~ 1

Author(s):

Alexandra Nicoleta Budure ◽

Eric Winquist ◽

David Palma ◽

Rohann Jonathan Mark Correa

Keyword(s):

Nasopharyngeal Carcinoma ◽

Successful Treatment ◽

Nasopharyngeal Cancer ◽

Treatment Strategies ◽

Radical Radiotherapy ◽

Charcot Marie Tooth ◽

Charcot Marie Tooth Disease ◽

Antineoplastic Treatment ◽

Disease Free ◽

Tooth Disease

Herein we present a case of a patient with Charcot-Marie-Tooth (CMT) disease who was diagnosed with locally invasive nasopharyngeal carcinoma. In the context of CMT, the use of standard platinum-based radio-sensitising chemotherapy would have been neurotoxic and is contraindicated in patients with CMT. However, no alternate antineoplastic treatment strategies for patients with CMT have been described in the literature. In this case, an innovative approach was taken using radical radiotherapy concurrently with the biological agent cetuximab. The patient did not suffer any neurotoxicity, though he did experience several expected toxicities commonly associated with this regimen. The patient nonetheless completed treatment and has experienced an excellent response both clinically and radiographically and remains disease free.

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Immunotherapy Strategies for Gastrointestinal Stromal Tumor

Cancers ◽

10.3390/cancers13143525 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3525

Author(s):

Junaid Arshad ◽

Philippos A. Costa ◽

Priscila Barreto-Coelho ◽

Brianna Nicole Valdes ◽

Jonathan C. Trent

Keyword(s):

Monoclonal Antibodies ◽

Soft Tissue ◽

Kinase Inhibitors ◽

Checkpoint Inhibitors ◽

Locally Advanced ◽

Soft Tissue Sarcomas ◽

Standard Of Care ◽

Current Standard ◽

Molecular Alterations

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal soft tissue sarcoma of the gastrointestinal tract. The management of locally advanced or metastatic unresectable GIST involves detecting KIT, PDGFR, or other molecular alterations targeted by imatinib and other tyrosine kinase inhibitors. The role of immunotherapy in soft tissue sarcomas is growing fast due to multiple clinical and pre-clinical studies with no current standard of care. The potential therapies include cytokine-based therapy, immune checkpoint inhibitors, anti-KIT monoclonal antibodies, bi-specific monoclonal antibodies, and cell-based therapies. Here we provide a comprehensive review of the immunotherapeutic strategies for GIST.

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The rationale for and the current role of chemoradiotherapy

Journal of Radiotherapy in Practice ◽

10.1017/s1460396907005055 ◽

2007 ◽

Vol 6 (1) ◽

pp. 11-19 ◽

Cited By ~ 4

Author(s):

R. J. Prestwich ◽

D. Shakespeare ◽

S. Waters

Keyword(s):

Disease Control ◽

Solid Tumour ◽

Concurrent Chemoradiotherapy ◽

Standard Of Care ◽

Combined Modality Treatment ◽

Current Role ◽

Therapeutic Ratio ◽

Combined Modality

AbstractCombined-modality treatment using chemotherapy and radiotherapy, particularly concurrently, has now become the standard of care for many solid tumour sites on the basis of improvements in locoregional disease control and in some cases survival. The rationale for combined-modality treatment, potential mechanisms of interaction, the therapeutic ratio and the current place of sequential and concurrent chemoradiotherapy are discussed.

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