scholarly journals Short-term efficacy comparison between helical tomotherapy and intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma

2020 ◽  
Author(s):  
Zhen Cui ◽  
Jia Liu ◽  
Qiaoyu Sun ◽  
Chaoge Wang ◽  
Meifang Fang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Planning Target Volume ◽  
Helical Tomotherapy ◽  
Locally Advanced ◽  
Intensity Modulated Radiotherapy ◽  
Target Volume ◽  
Short Term ◽  
Intensity Modulated ◽  
Significant Difference ◽  
Better Than

Abstract Background: To evaluate short-term safety and efficacy of helical tomotherapy (HT) versus intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).Methods: Retrospective analysis of locally advanced nasopharyngeal carcinoma treated with radiotherapy and concurrent platinum based neoadjuvant chemotherapy (cisplatin 80 mg/m2 every 3 weeks for 1 cycle) in our hospital from February 2017 to October 2019, including 70 patients in HT group and 70 in IMRT group. The target area of ​​the tumor was delineated by magnetic resonance (MRI) imaging. The prescription doses delivered to the gross tumor volume (pGTVnx) and positive lymph nodes (pGTVnd), the high risk planning target volume (PTV1), and the low risk planning target volume (PTV2), were 69.96 Gy, 66-70 Gy, 60 Gy and 50-54 Gy, in 33 fractions, respectively. Acute reactions were evaluated according to the RTOG/EORTC criteria, whereas the therapeutic efficacy was assessed according to RECTST version 1.1 criteria in a 3-months period.Results: The CI of PGTVnx, PGTVnd, PTV1 and PTV2, and HI of PGTVnx, PTV1 and PTV2 in HT group was significantly better than those in IMRT group. The OAR Dmax and Dmean in HT group were better than those in IMRT group with a significant difference (all p <0.05). Patients in the HT group were significantly better than those in the IMRT group in the protection of acute parotid gland injury and hearing damage (p <0.05), but not other acute adverse reaction. No significant difference was found on the short-term efficacy illustrated by ORR between HT group and IMRT group (x2 = 0.119; p = 0.730).Conclusions: Compared with IMRT, HT has better radiophysical-related dosimetric advantages in radiotherapy for locally advanced nasopharyngeal carcinoma. Despite similar on short-term effects, HT has lower incidence of adverse reactions than IMRT.

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.

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