Advanced T Stage is the Sole Determining Factor of Survival in Patients with Nasopharyngeal Carcinoma: The Outcomes of the Multi-Modality Management

2021 ◽  
Vol 104 (1) ◽  
pp. 79-87
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Treatment Time ◽  
Locally Advanced ◽  
Real Life ◽  
Disease Free Survival ◽  
Primary Objective ◽  
Stage I ◽  
International Studies ◽  
Serious Adverse Events ◽  
Undifferentiated Histology

Background: Thailand is an endemic area of nasopharyngeal carcinoma (NPC). Multi-modality treatment results in significant improvement in survivals. Objective: The overall survival (OS) of patients with early and locally-advanced (E and LA, stage I-IVa and IVb) diseases was the primary objective. Materials and Methods: The present study was a retrospective cohort study of patients with NPC treated at Vajira Hospital between 2013 and 2016. Baseline characteristics including age, gender, histopathology, staging, modality of treatment, time to radiotherapy completion, serious adverse events, treatment responses, patterns of recurrence, and metastasis were collected. Results: One hundred patients with mostly undifferentiated histology that presented with LA disease were included in this study. Stage III, IVa, and IVb accounted for 28%, 18%, and 22%, respectively. After median follow-up of 41.1 months, the median OS of patients E/LA diseases (stage I, II, III, IVa, and IVb) was not reached. Neither induction chemotherapy (IC) nor adjuvant chemotherapy (AC) was associated with superior disease-free survival (DFS) compared to definitive concurrent chemoradiotherapy (CRT) alone across all stage subgroups. Only T3 and T4 disease were significantly related to worse OS. Conclusion: With the standard CCRT, patients with E and LA diseases had excellent survival outcomes compared to the results from international studies. Keywords: Nasopharyngeal carcinoma, Multi-modality treatment, Outcomes, Real-life practice

The influence of overall treatment time to the efficiency of chemo-radiotherapy for locally advanced cervical cancer

2017 ◽  
Vol 17 (1) ◽  
pp. 124-130
Author(s):  
Ekkasit Tharavichitkul ◽  
Panupat Rugpong ◽  
Nisa Chawapun ◽  
Razvan M. Galalae
Keyword(s):  
Cervical Cancer ◽  
Treatment Time ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Intracavitary Brachytherapy ◽  
Treatment Results ◽  
Overall Treatment Time ◽  
Free Survival ◽  
Significant Difference ◽  
The Mean

AbstractPurposeThis study aims to clarify the influence of overall treatment time (OTT) on the efficiency of combined chemo-radiotherapy in cervical cancer.Material and methodsThis retrospective study enrolled 122 cervical cancer patients who had squamous cell carcinoma and had undergone definitive chemo-radiotherapy from 2009 to 2013. All patients received whole pelvic radiotherapy (WPRT) with the dose of 50 Gy in 25 fractions (with central shielding after 44 Gy) plus intracavitary brachytherapy with the dose of 28 Gy in four fractions. During WPRT, all patients received concurrent chemotherapy with weekly platinum-based regimen. The data of patient characteristics, OTT, treatment results and toxicities were collected and evaluated.ResultsThe mean follow-up time was 36 months. The mean age of patients was 52 years old; 68% of patients were stage IIB related to International Federation of Gynaecology and Obstetrics staging. Pelvic control (PC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates did not differ significantly in the data-derived cut points of 55·8 and 53 days. No statistically significant difference in treatment results between the two groups of OTT<49 and OTT≥62 days was observed.ConclusionsIn our data-derived cut point, OTT did not influence to PC, DMFS, DFS and OS. The influence of OTT on treatment results may be found in longer periods.

scholarly journals Clinical Profile and Treatment Outcomes in Patients Treated with Intensity-Modulated Radiotherapy (IMRT) for Carcinoma Nasopharynx: A Retrospective Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Farida Nazeer ◽  
R. Rejnish Kumar ◽  
Malu Rafi ◽  
Tapesh Bhattacharya ◽  
Aparna Mullangath Prakasan ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Distant Metastasis ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Pattern Of Failure ◽  
Free Survival

Objective. To retrospectively evaluate the clinical outcome of carcinoma nasopharynx patients treated with the IMRT technique. Methods. Eighty-one nasopharyngeal carcinoma patients who were treated with IMRT with or without chemotherapy between the period January 2011 and December 2014 at a comprehensive tertiary cancer center, Kerala, India, were included in the study. The mean age was 43 years (range 13–77 years), and majority of the patients were males (67.9%). The stagewise distribution of disease at presentation was 2 (2.5%) in stage I, 19 in stage II (23.5%), 31 (38.3%) in stage III, and 29 (35.8%) in stage IV. All patients were treated using simultaneous integrated boost (SIB) schedule using IMRT with 6 MV photon to a dose of 66 Gy in 30 fractions, 2.2 Gy per fraction prescribed to high-risk PTV; 60 Gy in 30 fractions, 2 Gy per fraction to intermediate risk PTV; and 54 Gy in 30 fractions, 1.8 Gy per fraction to low-risk PTV. Concurrent chemotherapy with cisplatin was offered to patients with stage II and above disease. Neoadjuvant chemotherapy with cisplatin and 5FU was given to patients with initially advanced disease (T3, T4, N2, and N3). Survival estimates were generated using the Kaplan–Meier method. The univariate analysis was performed using log-rank tests. Results. The 5-year locoregional control (LRC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) rates were 87.5%, 87%, 61.6%, and 62.5%, respectively. The 5-year OS was 100% for stage I (n = 2), 67% for stage II (n = 19), 70.4% for stage III (n = 31), and 68.1% for stage IV (n = 29). The DFS at 5 years was 100% for stage I, 61.1% for stage II, 56.2% for stage III, and 84.8% for stage IV disease. The univariate analysis showed that age, nodal stage, and use of induction chemotherapy showed an improved trend towards OS, though the results were not statistically significant. The predominant pattern of failure in the present study was distant metastasis. Most patients who developed distant metastasis in our study had either an advanced T stage or N3 disease at presentation. Conclusion. The present study shows our initial experience with IMRT for nasopharyngeal carcinoma. The compliance to RT was good in this study. The 5-year LRC and OS rate of nasopharyngeal carcinoma patients treated with IMRT were 87.5% and 62.5%. Distant metastasis was the main pattern of failure.

Childhood nasopharyngeal carcinoma: A 4-year single institution experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9069-9069
Author(s):  
A. A. Patel ◽  
P. M. Shah ◽  
K. M. Patel ◽  
S. N. Shukla ◽  
B. J. Parikh ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Complete Remission ◽  
Induction Chemotherapy ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Disease Extent ◽  
Free Survival ◽  
Major Response ◽  
Disease Free

9069 Background: Pediatric nasopharyngeal carcinoma (PNC) represents a locally advanced undifferentiated tumor. In this study, clinical experience and therapeutic results of 24 children with newly diagnosed PNC, treated in a single oncology institution in India over a period of 5 years, are analyzed. Methods: 24 patients (23 males and 1 female) 7–14 years old (median = 12) from Jan 2000 to Sep 2005 with PNC were retrospectively evaluated. 18/24 patients were evaluable. 16 patients received induction chemotherapy followed by radiotherapy while 1 patient was offered concurrent chemoradiotherapy, 1 patient received radiotherapy alone. 15/16 patients received postradiation chemotherapy. The agents used in induction and adjuvant therapy were cisplatin (100 mg/m2) on day 1 and 5-fluorouracil 750 mg/m2 for 5 days. The dose of radiotherapy used was 60 gray in 30 fractions. Results: The time of onset of symptoms to diagnosis ranged from 1 month to 9 months with a median of 5.5 months. Histopathology was lymphoepithelioma in 5 patients (27.7%) while 13 patients (72.2%) had poorly differentiated carcinoma. Disease extent was T2 (n = 7), T3 (n = 6), and T4 (n = 5); N1 (n = 5), N2 (n = 7), and N3 (n = 5). 7 patients had intracranial invasion. None had metastatic disease on presentation. 13 patients (72.2%) achieved major response which included 7 (38.8%) complete remission and 6 (33.3%) partial remission after the induction chemotherapy and radiotherapy. 4 (22.2%) had progressive disease. Another 3 (16.6%) attained complete remission after post radiation chemotherapy which consisted of two cycles of cisplatin and 5-flourouracil. The follow up ranged from 5 months to 84 months with a median follow up of 35 months. The disease free survival ranged from 10 months to 53 months with a median of 33 months. The patients who had a better response to induction chemotherapy had a better disease free survival. Out of 7 patients who attained complete remission 2 relapsed with a median time to first relapse of 9.5 months. Toxicity to therapy was modest. Only one patient had grade 4 neutropenia and mucositis. There was no therapy related mortality. Conclusion: Chemoradiotherapy for nasopharyngeal carcinoma in children is an effective treatment modality with minimal toxicity. No significant financial relationships to disclose.

A phase II study of preoperative chemotherapy with irinotecan(CPT) and cisplatin(CIS) for gastric cancer(NCI 5917): FDG-PET/CT predicts patient outcome

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4502-4502 ◽  
Author(s):  
M. A. Shah ◽  
H. Yeung ◽  
D. Coit ◽  
R. Trocola ◽  
D. Ilson ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Treatment Response ◽  
Preoperative Chemotherapy ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Primary Objective ◽  
Pathologic Response ◽  
Pet Ct ◽  
Fdg Pet Ct

4502 Introduction: Preoperative chemotherapy is a standard option for the treatment of locally advanced gastric cancer(GC). FDG-PET scans have been examined to identify early treatment response in esophagus and GEJ adenocarcinoma. We evaluated the utility of an early change in FDG-PET/CT at several time points in predicting response to preoperative chemotherapy in gastric cancer. Methods: 42 pts with locally advanced GC(preoperative stage T2N+M0 or T3–4NanyM0) were treated with CPT 65 mg/m2 and CIS 30mg/m2 on day(d)1 and d8, every 21 days for 4 cycles. FDG-PET/CT scans were performed at baseline, and in FDG avid patients, again on d15 and d35. The primary objective was to demonstrate that a decrease in FDG-SUV discriminates treatment response. Response was defined pathologically based on microscopic inspection for residual cancer cells and fibrosis(Mandard, Cancer 1994). Disease free survival(DFS) and overall survival(OS) were secondary endpoints. Results: Pt characteristics are as follows: median age 59(35–77), KPS 90%(70–100%), 27 male, gastric:GEJ 31:11. Median follow up is 23.3 months, with median DFS 23.8 months(95%CI 14-infinity) and median OS 39.1 months(95%CI 31–39months). Surgical resection occurred at a median of 101 days from study initiation. Pathologic response correlates significantly with DFS(p=0.005) and with OS(p=0.01). Amongst 31 FDG avid pts, a drop in SUV from baseline to d35 significantly predicts pathologic response(p=0.007) and DFS(p=0.01), whereas the change at d15 does not. 45% decrease in SUV at d35 best distinguishes good from poor pathologic response. With this cutoff, median DFS has not been reached(eg.>23.3 months) for patients with good PET response, and is 14.4 months(95%CI 8.3-infinity) for poor PET responders, p=0.03. Conclusions: Following preoperative chemotherapy, pathologic response at the time of resection significantly correlates with DFS and OS. We confirm that FDG-PET/CT response predicts both pathologic response and DFS following preoperative chemotherapy for locally advanced GC, although at d35. An early PET response assessment provides an opportunity to change therapy in non responding patients, and is currently under investigation(supported by ASCO CDA). No significant financial relationships to disclose.

An overview of SELECTTION: Survey of European lung cancer evaluating choice of treatment and tolerability in observed second-line non-small cell lung cancer (NSCLC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18204-18204
Author(s):  
E. F. Smit ◽  
A. Vergnenegre ◽  
J. Arellano ◽  
K. Kraaij ◽  
A. Kral ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Treatment Options ◽  
Locally Advanced ◽  
Real Life ◽  
Primary Objective ◽  
Treatment Discontinuation ◽  
Line Treatment ◽  
Second Line ◽  
Significant Difference ◽  
Choice Of Treatment

18204 Background: In addition to established second-line treatments for NSCLC in Europe, docetaxel and pemetrexed; erlotinib, has recently been approved. The only study directly comparing alternative options in second-line NSCLC showed no significant difference in efficacy between docetaxel and pemetrexed (median survival 7.9 vs 8.3 months, p = 0.226) but significant differences in toxicity profile (Hanna et al, 2004). It is of interest to observe how different second-line treatment options are used in real life settings, particularly length of therapy, reasons for discontinuation and its impact on patient’s outcomes. Methods: In observational studies patients are not assigned to different treatments at random and physicians and patients decide on treatment. A careful design is paramount to ensure the correct interpretation of data obtained. SELECTTION is the first observational, non-interventional, prospective study to be carried out in Europe in second-line NSCLC treatment. The primary objective of SELECTTION is to assess the time from treatment initiation to treatment discontinuation. Secondary objectives are to observe the reasons for treatment discontinuation and assess its impact on patient’s outcomes. A total of 13 countries will participate including: France, Portugal, Germany, Denmark, and UK with approximately 200 sites enrolling 950 patients. Information regarding patients and disease characteristics and treatment history are collected. Patients may be enrolled if they have received first-line chemotherapy for locally advanced or metastatic NSCLC, and have subsequently progressed, are at least 18 years old and are about to initiate second line treatment. Treatment cohorts will be constructed based on the distribution of patients across second-line treatments by physician decision. Results: At this stage details about design and analyses planned as well as evolution of the study, will be presented. Conclusions: SELECTTION will provide a unique set of data on how patients with stage IIIb\/IV NSCLC previously treated with chemotherapy, are treated in routine clinical practice. No significant financial relationships to disclose.

Higher dose per fraction and shorter overall treatment time using intensity-modulated radiation therapy versus conventional radiation therapy with concurrent carboplatin and 5-fluorouracil for locally advanced oropharyngeal carcinoma: A comparison of toxicity and efficacy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6038-6038 ◽  
Author(s):  
S. Clavel ◽  
D. Nguyen ◽  
P. Després ◽  
B. Fortin ◽  
G. Coulombe ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Retrospective Study ◽  
Treatment Time ◽  
Locally Advanced ◽  
Intensity Modulated Radiation Therapy ◽  
Disease Free Survival ◽  
Oropharyngeal Carcinoma ◽  
Overall Treatment Time ◽  
Intensity Modulated ◽  
Dose Per Fraction

6038 Background: The aim of this retrospective study was to compare toxicity and efficacy of two different radiotherapy regimens, the first one using intensity-modulated radiation therapy (IMRT) to that of conventional radiotherapy (CRT) in patients treated with concomitant chemotherapy for locally advanced oropharyngeal cancer. Methods: Between January 2000 and December 2007, 249 patients with stage III-IV squamous cell oropharyngeal carcinoma were treated at our institution with definitive concurrent chemoradiation using carboplatin 70 mg/m2/day for four days and 5-fluorouracil 600 mg/m2/day as a continuous infusion every 3 weeks. One hundred patients had 70 Gy in 33 fractions using IMRT (2.12 Gy per day) and 149 received CRT at 70 gy in 35 fractions (2 Gy per day), both administered five times a week. Toxicities were compared using Fisher's exact test. Overall survival (OS), disease-free survival (DFS), and locoregional control (LRC) were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: Median follow-up was 33 months. Three year actuarial rates for OS, DFS, and LRC were 95.4 vs. 75.8% (p < 0.001), 89.3 vs. 71.6% (p < 0.001), and 92.4 vs. 85.3% (p = 0.050) for IMRT and CRT respectively. To minimize the effect of changes in treatment paradigm over time, analyses were performed for patients treated after January 2004 and still showed OS, DFS, and LRC differences. Comparison of toxicities demonstrated that IMRT was associated with fewer dermatitis than CRT (p < 0.01), but caused the same rates of mucositis, weight loss, enteral feeding, hospitalization and death during treatment. There was significantly less xerostomia at 24 and 36 months (p < 0.001) following the end of treatment with IMRT. Conclusions: In this retrospective study, higher dose per fraction and shorter overall treatment time using IMRT given concurrently with chemotherapy when compared to CRT is a safe regimen with better OS, DFS, LRC, and less long term xerostomia. Altered fractionation RT with chemotherapy seems to result in better outcome and future prospective trials are needed to confirm this hypothesis. No significant financial relationships to disclose.

Induction chemotherapy with cisplatin and epirubicin followed by radiotherapy and concurrent cisplatin in locally advanced nasopharyngeal carcinoma observed in a nonendemic population

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17040-e17040
Author(s):  
M. Airoldi ◽  
M. Garzaro ◽  
A. Gabriele ◽  
L. Raimondo
Keyword(s):  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Induction Chemotherapy ◽  
Objective Response ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Efficient Treatment ◽  
Free Survival ◽  
Therapy Choice

e17040 Background: Chemoradiotherapy (CRT) represents the main therapy choice in the treatment of locoregionally advanced nasopharyngeal carcinoma (NPC). Aim of this study was the clinical evaluation of neoadjuvant chemotherapy (NACT) followed by CRT in a non endemic population affected by advanced NPC. Methods: Patients with locoregionally advanced NPC were treated with three cycles of induction chemotherapy (CHT) with cisplatin (100 mg/m2) plus epirubicin (90 mg/m2), followed by cisplatin (100 mg/m2) and concomitant radiotherapy (70 Gy). Results: In 40 patients treated with such protocol, after the completion of induction CHT and CRT we observed the objective response rates of 90% and 100% respectively. Treatment tolerability and toxicity were easily controllable. With a median follow-up time of 54.5 months 3- and 5-years disease-free survival was 75% and 65.4% and 3- and 5-years overall survival was 84% and 77.5%. 3- and 5-years loco-regional control was 82.4% and 70.3%, and 5-years distant metastases-free survival was 75%. Conclusions: NACT with cisplatin and epirubicin followed by concomitant CRT represents a feasible, efficient treatment for patients with advanced NPC. This regimen ensures an excellent locoregional disease control and overall survival with a low incidence of distant metastases. No significant financial relationships to disclose.

Preoperative imatinib for locally advanced gastrointestinal stromal tumors (GIST): CONVERT trial.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 130-130
Author(s):  
Bruno Dos Santos Vilhena Pereira
Keyword(s):  
Progressive Disease ◽  
Response Rate ◽  
Residual Disease ◽  
Objective Response ◽  
Locally Advanced ◽  
Local Treatment ◽  
Primary Objective ◽  
Medical Decision ◽  
Serious Adverse Events ◽  
Choi Criteria

130 Background: Primary GISTs are frequently diagnosed as large masses requiring wide resections. Our primary objective is to evaluate response rate of imatinib through RECIST and Choi criteria in these patients. Secondary endpoints were downstaging, resectability, safety and tolerability. Methods: This phase II Brazilian study was conducted in 7 centers between 2008 and 2012. To standardize elegibility, inclusion criteria took into account the primary site, size and multi-visceral resection need per surgeon evaluation. Thirty-nine non-metastatic GIST patients with measurable disease and no previous systemic or local treatment were assigned to daily imatinib 400mg for 16 weeks followed by surgery or until medical decision, progressive disease or toxicity. Imatinib could be continued whether adjuvant or palliative according to risk stratification and residual disease. Clinicaltrials.gov NCT01483014. Results: The objective response rate was 32,1% (IC95% 17,9% - 50,7%) on RECIST and 78,6% (IC95% 60,5% - 89.8%) on Choi. One patient (3,8%) had progressive disease, six patients (20%) had serious adverse events with two (6,7%) deaths, not related to the study drug. Treatment discontinuation due to intolerance was observed in 10% of patients caused by extremities pain, nausea, neutropenia, constipation and thrombocytopenia. Surgery was performed on 23 patients (82.1%), with 83,3% being R0. Median tumor size was 9,4cm (1,2 to 22,0cm) and 72,7% had <5 mitosis/50HPF. Conclusions: Imatinib is active and safe in the preoperative setting. Although Choi criteria evaluates responses earlier, a longer course of imatinib, from 6 to 12 months, should be studied to evaluate if longer courses can increase tumor shrinkage and improve this strategy’s usefulness. Clinical trial information: NCT01483014.

Phase II study of durvalumab plus total neoadjuvant therapy (TNT) in locally advanced rectal cancer: The GEMCAD-1703 DUREC trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS4122-TPS4122
Author(s):  
Jaume Capdevila ◽  
Ismael Macias Declara ◽  
Maria Carmen Riesco Martinez ◽  
Joan Maurel ◽  
Jorge Hernando ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cell Death ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Rectal Adenocarcinoma ◽  
Disease Free Survival ◽  
Primary Objective ◽  
Tumor Regression Grade ◽  
Open Label ◽  
Post Surgery

TPS4122 Background: In clinical stages II and III (cT3-4 and/or N+), preoperative chemoradiotherapy (CRT) or short-course radiation followed by total mesorectal escision (TME) have been the standard of care for the last 15 years. Induction chemotherapy (CT) before CRT (strategy known as TNT) results in fewer toxic effects and improved compliance. TNT may release tumor-neoantigens with platinum-based induction CT, and radiotherapy has the potential ability to induce an immunogenic cell death and counteract an immune-suppressive tumor microenvironment that provides the rationale for combining with immunotherapies. In addition, the presence of tumor infiltrating lymphocytes has been demonstrated in patients with rectal cancer treated with neoadjuvant CRT, reinforcing the rational for immune check-point inhibitors in this setting. We hypothesize that combining TNT with durvalumab (an optimized monoclonal antibody directed against programmed cell death-1 ligand 1) would improve outcome. Methods: DUREC is a multicenter, single-arm, open-label, phase Ib/II study for patients with magnetic resonance (mr) image middle or distal third, mrT3c-d/T4/N2 rectal adenocarcinoma. Treatment: Patients will receive 6 cycles of modified FOLFOX6 prior to CRT (capecitabine with 50.4 Gy in 28 fractions) and TME, combined with durvalumab 1500 mg every 4 weeks during induction CT, CRT and waiting period until surgery. To assess the tolerability and toxicity profile we plan to perform a run-in treatment phase including the first 6 patients in the study, holding recruitment until all of them will be operated and 30-days post-surgery period completed. If ≤ 2 durvalumab-related dose-limiting toxicities (DLTs) are observed, recruitment will continue. The primary objective is pathological complete response (pCR) rate. Secondary endpoints include toxicity, tumor regression grade, R0 resections, clear circumferential margins, surgical complications, NAR score, disease-free survival and a biomarker program on tumor tissue, blood samples and stool microbiota. Statistical design: 58 evaluable patients (assuming a P0 of 16% and a P1 of 30%, with 0.1 alpha and 0.1 beta); Study started recruitment on December 2019. Clinical trial information: 2018-004835-56 .

scholarly journals T4-Locally Advanced Nasopharyngeal Carcinoma: Prognostic Influence of Cranial Nerve Involvement in Different Radiotherapy Techniques

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Hsin-I Huang ◽  
Kee-Tak Chan ◽  
Chih-Hung Shu ◽  
Ching-Yin Ho
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cranial Nerve ◽  
Locally Advanced ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Cranial Nerve Involvement ◽  
Free Survival ◽  
Nerve Involvement ◽  
Disease Free ◽  
3D Crt

Background. Cranial nerve involvement at disease presentation of nasopharyngeal carcinoma was not uncommon. We investigated the prognosis of patients with T4-locally advanced NPC, with or without cranial nerve involvement, and compared the outcome of patients treated using different radiotherapy techniques.Methods. In this retrospective study, 83 T4-locally advanced NPC patients were diagnosed according to the seventh edition of the American Joint Committee on Cancer staging system. All patients were treated using three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiation therapy (IMRT). The survival rate was analyzed using the Kaplan-Meier method.Results. The 5-year overall, locoregional-free, and disease-free survival rates of patients treated using IMRT were 88.9%, 75.2%, and 69.2%, respectively. The outcome in these patients was significantly better than that in patients treated using 3D-CRT, with survival rates of 58.2%, 54.4%, and 47.2%, respectively. There was no significant difference in the 5-year overall, locoregional-free, and disease-free survival rates of the patients with (64.2%, 60.5%, and 53.5%, resp.) and without (76.9%, 63.6%, and 57.6%, resp.) cranial nerve involvement.Conclusion. Locally advanced NPC patients treated using IMRT had significantly better outcomes than patients treated using 3D-CRT. Our results showed that the outcome of T4 NPC patients with or without cranial nerve involvement was not different.

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