scholarly journals The impact of the cumulative dose of cisplatin during concurrent chemoradiotherapy on the clinical outcomes of patients with advanced-stage nasopharyngeal carcinoma in an era of intensity-modulated radiotherapy

BMC Cancer ◽  
2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Shan-Shan Guo ◽  
Lin-Quan Tang ◽  
Lu Zhang ◽  
Qiu-Yan Chen ◽  
Li-Ting Liu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Clinical Outcomes ◽  
Cumulative Dose ◽  
Concurrent Chemoradiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Advanced Stage ◽  
Intensity Modulated ◽  
The Impact

A phase II randomized, multicentric clinical trail comparing recombinant human endostatin plus intensity-modulated radiotherapy versus concurrent chemoradiotherapy in locally advanced low-risk nasopharyngeal carcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6063-6063
Author(s):  
Min Kang ◽  
Shaomin Lin ◽  
Haisheng Zhu ◽  
Sihui Liao ◽  
Haixin Huang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Adverse Effects ◽  
Phase Ii ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced ◽  
Intensity Modulated Radiotherapy ◽  
Low Risk ◽  
Short Term ◽  
Intensity Modulated ◽  
Term Efficacy

6063 Background: A prospective, randomized, and multicentric phase II study was performed to evaluate the short-term efficacy and safety of Endostar plus intensity-modulated radiotherapy (IMRT) versus concurrent chemoradiotherapy(CCRT) in locally advanced low-risk nasopharyngeal carcinoma(NPC). Methods: From September 2014 to August 2016, 120 patients with low-risk NPC at stages III-IVa from 9 centers were randomly divided into experimental group (Endostar plus radiotherapy (ERT); n = 60) and control group (CCRT; n = 60). ERT patients were given Endostar (7.5 mg/m2/day) by continuous intravenous infusion (CIV) from 5 days before radiotherapy for consecutive 10 days for 2 cycles with an interval of 14 days. Then, ERT patients received 2 cycles of 10 days of maintenance treatment with Endostar after radiotherapy. The CCRT patients were given cisplatin (100 mg/m2) on days 1, 22, and 43 for 3 cycles. Immediate and 3-month efficacy and adverse effects were evaluated between the two groups. ClinicalTrials registration number was NCT02237924. Results: All patients were eligible for toxicity and response analysis. Regarding immediate efficacy, the complete response(CR) rates were 45.0% for ERT arm and 33.3% for CCRT arm in nasopharynx (P = 0.190), and 43.3% for ERT arm and 36.7% for CCRT arm in regional nodes (P = 0.456). Three months after RT, the CR rates were 71.2% for ERT arm and 60.0% for CCRT arm in nasopharynx (P = 0.151), and 74.6% for ERT arm and 63.3% for CCRT arm in regional nodes (P = 0.172). The rate and severity of leukopenia, hemoglobin reduction and thrombocytopenia in ERT arm were significantly lower than CCRT arm (P < 0.01). The occurrence rates of Xerostomia, oral mucositis, nausea / vomiting, constipation and weight loss in ERT arm were significantly lower than those in CCRT arm (P < 0.01). Conclusions: The present study demonstrates that ERT has similar short-term efficacy on locally advanced low-risk NPC compared with CCRT, but the acute adverse effects of ERT are fewer, and the compliance and tolerability of patients are better. Clinical trial information: NCT02237924.

scholarly journals Irradiation-Induced Nasopharyngeal Necrosis in Newly Diagnosed Nasopharyngeal Carcinoma Treated by Intensity-Modulated Radiation Therapy: Clinical Characteristics and the Influence of Treatment Strategies

2021 ◽  
Author(s):  
Yi Xu ◽  
Yang Liu ◽  
Zekun Wang ◽  
Jingbo Wang ◽  
Jianghu Zhang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Clinical Characteristics ◽  
Propensity Scores ◽  
Treatment Strategies ◽  
Multivariate Logistic Regression Analysis ◽  
Intensity Modulated Radiotherapy ◽  
Progression Free Survival ◽  
Intensity Modulated ◽  
The Impact ◽  
Accumulated Dose

Abstract Purpose: To define the clinical characteristics of irradiation-induced nasopharyngeal necrosis (INN) after intensity-modulated radiotherapy (IMRT) and identify the influence of treatment strategies on INN in primary nasopharyngeal carcinoma (NPC) patients.Patients and methods: From 2008 to 2019, NPC patients pathologically diagnosed with INN after primary IMRT were reviewed. Those patients were matched with propensity scores for patients without INN in our center. The impact of treatment strategies on INN occurrence was assessed using univariate and multivariate logistic regression analysis. Results: The incidence rate of INN was 1.9% among the primary NPC population, and 53 patients with INN were enrolled. Headache and foul odor were the main symptoms, and 71.7% of cases had pseudomembrane during or at the end of radiotherapy. All patients were in early or middle stage INN, and no one presented with skull-based osteoradionecrosis. Then 212 non-INN patients were included based on propensity scores match. Overall survival (p=0.248) and progression-free survival (p=0.266) curves were similar between the INN and non-INN groups. Treatment strategies including combining chemotherapy or molecular targeted therapy with radiotherapy were not associated with INN occurrence, while boost dose (OR 7.360; 95% CI 2.301-23.547; P = 0.001) was a predictor factor for it. However, the optimal threshold for an accumulated dose to predict INN's occurrence was failed to determine.Conclusion: In the IMRT era, the severity of INN in primary NPC patients is lessened. This study showed that treatment strategies contributed little to develop INN, while the accumulated dose of radiation may relate to its occurrence.

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