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Comparative Study between Patients Treated with Conventional Radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report
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作者 Mamady Keita Juan Li +6 位作者 Malick Bah Mamadou Aliou Diallo Alhassane Ismaël Touré Abou Camara Bangaly Traoré Abdoulaye Keita Wenbing Shen 《Journal of Cancer Therapy》 2023年第12期451-464,共14页
Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of tw... Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively;in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ<sup>2</sup> = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy offers better locoregional relapse-free survival and overall survival in patients with stage III and IVA nasopharyngeal carcinoma, and may significantly reduce the occurrence of radiation-induced xerostomia. 展开更多
关键词 nasopharyngeal carcinoma Conventional radiotherapy Intensity Modulated radiotherapy CHEMOTHERAPY PROGNOSIS
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Clinical Effect of Biafine in Preventing and Treating Radioactive Skin Destruction of Nasopharyngeal Carcinoma Patients Caused by Concurrent Intensity- Modulated Radiotherapy and Chemotherapy
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作者 王若峥 吾甫尔 +1 位作者 王多明 刘凯 《Chinese Journal of Clinical Oncology》 CSCD 2008年第1期58-63,共6页
OBJECTIVE To observe the clinical effect of Biafine cream in preventing and treating radioactive skin destruction of nasopharyngeal carcinoma (NPC) patients induced by synchronized intensity-modulated radiotherapy a... OBJECTIVE To observe the clinical effect of Biafine cream in preventing and treating radioactive skin destruction of nasopharyngeal carcinoma (NPC) patients induced by synchronized intensity-modulated radiotherapy and chemotherapy. METHODS The patients were treated with Varian-600CD 6 MV X-ray three-dimensional (3D) conformal intensity-modulation radiotherapy (IMRT), with a 120-blade multiple leaf-blade grating and in combination with synchronal Capecitabine chemotherapy. Fifty-one patients undergoing radiotherapy and chemotherapy were randomized into 2 groups: 25 in the treatment group received a Biafine cream application following the first radiotherapy and / or chemotherapy, while the other 26, served as controls. They received no application of the cream, but only followed normal procedures for conventional radiotherapy and health education. RESULTS The rate of the skin-reaction was 100% in the patients of both groups. A mild radiation reaction (grade-Ⅰ and Ⅱ) occurred as follows: 88.0% (22/25 cases) in the treatment group and 57.7% (15/26 cases) in the control group. A grade-Ⅲ radiation reaction developed in 12.0% (3/25 cases) in the treatment group, and 42.3% (11/26 cases) in the controls. There was a significant difference, P〈0.01 between the two groups. Concerning the degree of the skin response before the patients received a dose of 40 Gy, the radiation reaction emerged in 32.0% (8/25) of the cases in the treatment group, and in 96.2% (25/26) of the cases of the control group. CONCLUSION Biafine cream can effectively reduce the acute irradiation or chemotherapy-induced dermal injury. It can alleviate the patients' suffering, improve their quality of life, and can ensure less injurious radiotherapy. 展开更多
关键词 nasopharyngeal carcinoma synchronized radiotherapy and chemotherapy radiation injury radiation protection agent.
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Clinical role of ^(18)F-FDG PET/CT-based simultaneous modulated accelerated radiotherapy treatment planning for locally advanced nasopharyngeal carcinoma 被引量:1
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作者 Jianshe Wang Tianyou Tang +4 位作者 Jing Xu Andrew Z.Wang Liang Li Junnian Zheng Longzhen Zhang 《Oncology and Translational Medicine》 2015年第6期264-270,共7页
Objective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography (PET/CT)-guided dose escalation radio- therapy ve... Objective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography (PET/CT)-guided dose escalation radio- therapy versus conventional radiotherapy in the concurrent chemoradiotherapy treatment of locally ad- vanced nasopharyngeal carcinoma (NPC). Methods Atotal of 48 patients with stage IIl-IVa NPC were recruited and randomly administered PET/CT- guided dose escalation chemoradiotherapy (group A) or conventional chemoradiotherapy (group B). The dose-escalation radiotherapy was performed using the simultaneous modulated accelerated radiotherapy technique at prescribed doses of 77 gray (Gy) in 32 fractions (f) to the gross target volume (GTV): planning target volume (PTV) 1 received 64 Gy/32 f, while PTV2 received 54.4 Gy/32 f. Patients in group B received uniform-dose intensity-modulated radiotherapy, PTV1 received 70 Gy/35 f and PTV2 received 58 Gy/29 f. Concurrent chemotherapy consisted of cisplatin [20 mg/m2 intravenous (IV) on days 1-4] and docetaxel (75 mg/m2 IV on days 1 and 8) administered during treatment weeks 1 and 4. All patients received 2-4 cycles of adjuvant chemotherapy of the same dose and drug regimen. Results The use of fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT significantly reduced the treat- ment volume delineation of the GTV in 83.3% (20/24) of patients. The 5-year local recurrence-free survival rates of the two groups were 100% and 79.2%, respectively (P = 0.019). The 5-year disease free survival (DFS) rates were 95.8% and 75.0%, respectively (P = 0.018). The 5-year local progression-free survival and DFS rates were significantly different. The 5-year overall survival (OS) rates were 95.8% and 79.2%, re- spectively. Differences in OS improvement were insignificant (P = 0.079). Late toxicities were similar in the two groups. The most common late toxicities of the two arms were grade 1-2 skin dystrophy, xerostomia, subcutaneous fibrosis, and hearing loss. There were no cases of grade 4 late toxicity. Conclusion The use of 18F-FDG PET/CT-guided dose escalation radiotherapy is well tolerated and can reduce local recurrence rates for patients with locally advanced NPC compared to conventional chemora- diotherapy. 展开更多
关键词 nasopharyngeal carcinoma (NPC) simultaneous modulated accelerated radiotherapy in-tensity-modulated radiotherapy positron emission tomography/computed tomography (PET/CT) fluorine-18-fluorodeoxyglucose (18F-FDG)
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Stereotactic radiotherapy for the treatment of nasopharyngeal carcinoma: a Meta-analysis of 1371 cases in China
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作者 Hanyou Xu 《Oncology and Translational Medicine》 2019年第6期293-300,共8页
Objective The aim of this study was to clarify the outcomes of stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal carcinoma and to promote scientific clinical treatmen... Objective The aim of this study was to clarify the outcomes of stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal carcinoma and to promote scientific clinical treatment and research on it in China and other countries by creating a large data resource.Methods This Meta-analysis conducted a literature search using the China National Knowledge Infrastructure database for all clinical research articles on stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal carcinoma in China.Data on patient cohort numbers and other research factors were recorded for every relevant clinical research article.Calculated and analyzed these fact sheets to pave the way for the objective of this project.Results A total of 40 clinical research articles including 1,371 patients in China from 1998 to 2012 were identified.The average cohort size was 34 patients(range 9-98 patients).The average total radiation dose range was 16-33.6 Gy.The average study or treatment duration was 3.51 years.The calculated average follow-up time was 31.59 months.Conclusion The study provided the largest resource for further research and Meta-analyses to determine the clinical pathway of stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal carcinoma.The results indicated that variability in the total radiation dose,treatment or research time,and follow-up duration may have contributed to the complications and side effects of stereotactic radiotherapy for local residual and(or) local recurrent nasopharyngeal carcinoma in China.The calculated average total radiation dose,follow-up time,and treatment and research durations may be referenced for future treatment and research.This study also proposed worldwide cooperation for the metaanalysis of research articles on stereotactic radiotherapy for treating local residual and(or) local recurrent nasopharyngeal carcinoma. 展开更多
关键词 stereotactic radiotherapy residual nasopharyngeal carcinoma recurrent nasopharyngeal carcinoma META-ANALYSIS total radiation dose radiotherapy
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Analysis of 80 Cases of Nasopharyngeal Carcinoma Treated by Intracavitary Brachytherapy Using A New-Type Applicator
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作者 Zhongjie Chen Ruiying Li Ping Wang 《Chinese Journal of Clinical Oncology》 CSCD 2007年第1期52-55,共4页
OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma (NPC) treated with combined external-beam radiotherapy (EBR) and intracavitary brachytherapy (IB) using a new-type app... OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma (NPC) treated with combined external-beam radiotherapy (EBR) and intracavitary brachytherapy (IB) using a new-type applicator. METHODS Eighty patients with untreated NPC were divided into two groups based on therapy methods. An experimental group was treated with EBR plus IB and a control group was treated only with EBR. IB was given to the patients of the experimental group when the external radiotherapy dose amounted to more than 60~65 Gy. The total dose of IB was 6~20 Gy and the total dose of EBR of the control group was 70~75 Gy. RESULTS Follow-up was conducted for 97.5% of the patients with re- suits as follows: the overall response rates (ORR) for the experimental and the control groups were 92.5% and 75.3% respectively (P〈0.05); the 3 and 5-year survival rates for the experimental group were 87.5% and 74.2% and for the control group, 65.0% and 55.6% (P〈0.05); for the experimental group, the 3 and 5-year disease-free survival rates were 72.5% and 64.5% and for the control group, 60.0% and 52.8% (P〉0.05).Some complications following radiotherapy showed a significant difference. CONCLUSION External irradiation plus intracavitary brachytherapy using a new-type applicator may improve the ORR and survival rates, reduce radiation complications and increase the quality of life.   展开更多
关键词 nasopharyngeal carcinoma external-beam radiotherapy intracavitary brachytherapy applicator.
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Clinical Study on Simultaneous Modulated Accelerated Radiotherapy and Concurrent Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma
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作者 Haiqun Lin Baosheng Li Zicheng Zhang Yumei Wei Limin Zhai 《Clinical oncology and cancer researeh》 CAS CSCD 2009年第5期354-358,共5页
OBJECTIVE To evaluate the clinical efficacy and toxicities of simultaneous modulated accelerated radiotherapy (SMART) and concurrent chemotherapy for locally advanced nasopharyngeal carcinoma. METHODS Eightyseven pa... OBJECTIVE To evaluate the clinical efficacy and toxicities of simultaneous modulated accelerated radiotherapy (SMART) and concurrent chemotherapy for locally advanced nasopharyngeal carcinoma. METHODS Eightyseven patients with nasopharyngeal carcinoma received SMART from April 2002 to September 2006. According to the UICC staging system, 30 patients were diagnosed as stage IIb, 42 patients stage III, 13 patients stage IVa and 2 patients stage IVb. The intensitymodulated radiotherapy was delivered with the "step and shoot" SMART technique with the prescribed dose of 66-76 Gy (2.2-2.4 Gy/day) to the gross tumor volume (GTV) and positive neck lymph nodes (GTVLN), with 60 Gy (2.0 Gy/day) to the highrisk clinical target volume (CTV1), encompassing the area around the nasopharynx and the upper neck, and with 54 Gy (1.8 Gy/day) to the lowrisk clinical target volume (CTV2), including the lower neck and supraclavicular area. Among all the patients, 31 received 2 cycles of SMART concurrently with 5 fluorouracil (5-Fu) and cisplatin (the FP group) and 56 received 2 cycles of concurrent cisplatin. All the patients received 3 to 4 cycles of adjuvant combination chemotherapy of cisplatin and 5fluorouracil starting from the 1st month after completion of SMART. RESULTS With a median follow up of 59 months (ranging from 19 to 85 months), the 1, 2 and 3year overall survival rates were 100%, 94.6% and 91.3% respectively. Acute mucositis and pharyngitis were more frequently observed in the FP group than in the cisplatin group. CONCLUSION SMART technique provides an excellent opportunity to spare normal tissue and is probably more biologically effective. Combination of single cisplatin was more tolerable. 展开更多
关键词 simultaneous modulated accelerated radiotherapy (SMART) intensitymodulated radiotherapy nasopharyngeal carcinoma concurrent chemoradiotherapy.
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Prognostic factors and failure patterns in non-metastatic nasopharyngeal carcinoma after intensity-modulated radiotherapy 被引量:43
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作者 Yan-Ping Mao Ling-Long Tang +7 位作者 Lei Chen Ying Sun Zhen-Yu Qi Guan-Qun Zhou Li-Zhi Liu Li Li Ai-Hua Lin Jun Ma 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第12期673-682,共10页
Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of ... Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of non?meta?static nasopharyngeal carcinoma(NPC) in the intensity?modulated radiotherapy(IMRT) era.Methods: We reviewed the data from 749 patients with newly diagnosed, biopsy?proven, non?metastatic NPC in our cancer center(South China, an NPC endemic area) between January 2003 and December 2007. All patients under?went magnetic resonance imaging(MRI) before receiving IMRT. The actuarial survival rates were estimated using the Kaplan–Meier method, and survival curves were compared using the log?rank test. Multivariate analyses with the Cox proportional hazards model were used to test for the independent prognostic factors by backward eliminating insigniicant explanatory variables.Results: The 5?year occurrence rates of local failure, regional failure, locoregional failure, and distant failure were 5.4, 3.0, 7.4, and 17.4%, respectively. The 5?year survival rates were as follows: local relapse?free survival, 94.6%; nodal relapse?free survival, 97.0%; distant metastasis?free survival, 82.6%; disease?free survival, 75.1%; and overall survival, 82.0%. Multivariate Cox regression analysis revealed that orbit involvement was the only signiicant prognostic fac?tor for local failure(P = 0.011). Parapharyngeal tumor extension, retropharyngeal lymph node involvement, and the laterality, longest diameter, and Ho's location of the cervical lymph nodes were signiicant prognostic factors for both distant failure and disease failure(all P < 0.05). Intracranial extension had signiicant prognostic value for distant failure(P = 0.040).Conclusions: The key failure pattern for NPC was distant metastasis in the IMRT era. With changes in diagnostic and therapeutic technologies as well as treatment modalities, the signiicant prognostic parameters for local control have also been altered substantially. 展开更多
关键词 nasopharyngeal carcinoma Intensity-modulated radiotherapy PROGNOSIS Failure pattern Tumor staging
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Prognostic value and predictive threshold of tumor volume for patients with locally advanced nasopharyngeal carcinoma receiving intensity-modulated radiotherapy 被引量:12
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作者 Yu-Xiang He Ying Wang +9 位作者 Peng-Fei Cao Lin Shen Ya-Jie Zhao Zi-Jian Zhang Deng-Ming Chen Tu-Bao Yang Xin-Qiong Huang Zhou Qin You-Yi Dai Liang-Fang Shen 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第12期725-734,共10页
Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NP... Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy(IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ind a suitable cut?of value of GTV?P for prognosis prediction.Methods: Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic(ROC) curves were used to identify the cut?of values of GTV?P for the prediction of diferent end?points [overall survival(OS), local relapse?free survival(LRFS), distant metastasis?free survival(DMFS), and disease?free survival(DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system.Results: The 358 patients with locally advanced NPC were divided into two groups by the cut?of value of GTV?P as determined using ROC curves: 219(61.2%) patients with GTV?P ≤46.4 mL and 139(38.8%) with GTV?P >46.4 mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P ≤46.4 mL than in those with GTV?P > 46.4 mL(all P < 0.05). Multivariate analysis indicated that GTV?P >46.4 mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriied that the predictive ability of GTV?P was superior to that of T category(P < 0.001). The cut?of values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4 mL, respectively.Conclusion: In patients with locally advanced NPC, GTV?P >46.4 mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category. 展开更多
关键词 nasopharyngeal carcinoma Intensity-modulated radiotherapy Gross target volume of primary tumor PROGNOSIS
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A model to predict the risk of lethal nasopharyngeal necrosis after re-irradiation with intensity-modulated radiotherapy in nasopharyngeal carcinoma patients 被引量:5
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作者 Ya-Hui Yu Wei-Xiong Xia +9 位作者 Jun-Li Shi Wen-Juan Ma Yong Li Yan-Fang Ye Hu Liang Liang-Ru Ke Xing Lv Jing Yang Yan-Qun Xiang Xiang Guo 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第11期617-624,共8页
Background:For patients with nasopharyngeal carcinoma(NPC) who undergo re-irradiation with intensity-modulated radiotherapy(IMRT),lethal nasopharyngeal necrosis(LNN) is a severe late adverse event.The purpose of this ... Background:For patients with nasopharyngeal carcinoma(NPC) who undergo re-irradiation with intensity-modulated radiotherapy(IMRT),lethal nasopharyngeal necrosis(LNN) is a severe late adverse event.The purpose of this study was to identify risk factors for LNN and develop a model to predict LNN after radical re-irradiation with IMRT in patients with recurrent NPC.Methods:Patients who underwent radical re-irradiation with IMRT for locally recurrent NPC between March 2001 and December 2011 and who had no evidence of distant metastasis were included in this study.Clinical characteristics,including recurrent carcinoma conditions and dosimetric features,were evaluated as candidate risk factors for LNN.Logistic regression analysis was used to identify independent risk factors and construct the predictive scoring model.Results:Among 228 patients enrolled in this study,204 were at risk of developing LNN based on risk analysis.Of the 204 patients treated,31(15.2%) developed LNN.Logistic regression analysis showed that female sex(P = 0.008),necrosis before re-irradiation(P = 0.008),accumulated total prescription dose to the gross tumor volume(GTV) ≥ 145.5 Gy(P = 0.043),and recurrent tumor volume >25.38 cm3(P = 0.009) were independent risk factors for LNN.A model to predict LNN was then constructed that included these four independent risk factors.Conclusions:A model that includes sex,necrosis before re-irradiation,accumulated total prescription dose to GTV,and recurrent tumor volume can effectively predict the risk of developing LNN in NPC patients who undergo radical re-irradiation with IMRT. 展开更多
关键词 nasopharyngeal carcinoma RE-IRRADIATION Intensity-modulated radiotherapy NECROSIS
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Forty-six cases of nasopharyngeal carcinoma treated with 50 Gy radiotherapy plus hematoporphyrin derivative:20 years of follow-up and outcomes from the Sun Yat-sen University Cancer Center 被引量:3
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作者 Bing-Qing Xu Zi-Wei Tu +5 位作者 Ya-Lan Tao Zhi-Gang Liu Xiao-Hui Li Wei Yi Chang-Bing Jiang Yun-Fei Xia 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第6期53-62,共10页
Background:With the improved overall survival(OS) of nasopharyngeal carcinoma(NPC) patients,the importance of quality of life(Qo L) is increasingly being recognized.For some radiosensitive NPC patients,whether low?dos... Background:With the improved overall survival(OS) of nasopharyngeal carcinoma(NPC) patients,the importance of quality of life(Qo L) is increasingly being recognized.For some radiosensitive NPC patients,whether low?dose radio?therapy can improve the Qo L without affecting clinical efficacy is unknown.This study aimed to assess the survival rates and Qo L of NPC patients treated with 50 Gy radiotherapy plus hematoporphyrin derivative(HPD).Methods:Forty?six newly diagnosed NPC patients treated with 50 Gy radiotherapy plus HPD between June 1988 and July 1992 were analyzed.All patients were restaged according to the 7th edition of the American Joint Commit?tee on Cancer staging system.The radiotherapy plan was designed on the basis of pretreatment computed tomog?raphy.The OS,local recurrence?free survival(LRFS),distant metastasis?free survival(DMFS),and disease?free survival(DFS) rates were estimated using the Kaplan–Meier method.Qo L was assessed using the Late Radiation Morbidity Scoring Criteria of the Radiation Therapy Oncology Group.Results:The 5?year OS,LRFS,DMFS,and DFS rates were 74.3%,72.6%,82.1%,and 61.2%,respectively.The corre?sponding 10?year rates were 38.4%,62.9%,78.5%,and 49.8%,respectively,and the 20?year rates were 27.7%,51.4%,78.5%,and 40.7%,respectively.None of the patients developed severe radiation?related complications,such as radiation?induced temporal lobe necrosis,hearing loss,trismus,and dysphagia.Conclusion:Some NPC patients were sensitive to 50 Gy radiotherapy plus HPD,and this sensitivity was characterized by long?term survival without significant late treatment morbidities. 展开更多
关键词 Low-dose radiotherapy nasopharyngeal carcinoma RADIOSENSITIVITY Quality of life
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Clinical study of docetaxel combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma 被引量:2
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作者 Wei Luo Wei Ge +4 位作者 Yongfa Zheng Xianfeng Pan Jing Song Huilin Xu Pingpo Ming 《The Chinese-German Journal of Clinical Oncology》 CAS 2013年第12期592-595,共4页
Objective: The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel (DOC) in concurrent chemoradiotherapy compared to DDP plus 5-Fu (DF) combined with concurrent radio... Objective: The aim of this study was to study the short-term curative effects and adverse reactions of docetaxel (DOC) in concurrent chemoradiotherapy compared to DDP plus 5-Fu (DF) combined with concurrent radiotherapy in patients with advanced nasopharyngeal carcinoma. Methods: Thirty-three patients in the experimental group (DOC group) were given DOC 25 mg/m2 ivgtt, dl, 7 times, concurrent radiotherapy was performed from dl. Thirty-three patients in the control group (DF group) were given cisplatin 25 mg/@ivgtt dl-3 and 5-Fu 550 mg/m2iv, dl-5, 3 weeks a cycle, 2 cycles, and concurrent radiotherapy was performed from dl. Six MV X-ray and 9 MeV electronic line for external irradiation were adopted in concur- rent radiotherapy. Results: The response rates of DOC group and DF group were 90.9% and 93.9%, the rates of neutropenia were 45.45% and 67.74%, and the rates of oral mucositis were 60.61% and 90.32%. Conclusion: The difference of short- term curative effects between DOC group and DF group was not statistically significant in patients with advanced nasopha- ryngeal carcinoma. The rates of adverse reactions were lower in DOC group. DOC combined with concurrent radiotherapy could be a new choice for patients with advanced nasopharyngeal carcinoma. 展开更多
关键词 nasopharyngeal carcinoma docetaxel (DOC) concurrent radiotherapy
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THE IMPACT OF RADIOTHERAPY COURSE LENGTH ON THE TREATMENT RESULTS OF NASOPHARYNGEAL CARCINOMA(NPC)
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作者 陈显钊 唐启信 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 1995年第2期130-133,共4页
Analyses made among four radiotherapy schedules for NPC in order to determine whether there is an impact of radiotherapy course length on treatment results.A series of 320 NPC patients were divided into four radiati... Analyses made among four radiotherapy schedules for NPC in order to determine whether there is an impact of radiotherapy course length on treatment results.A series of 320 NPC patients were divided into four radiation treatment branches each with a schedule, this clinical trial was non-randomized.Radiotherapy course length factor was considered with a derivative LQ model formula that biological effective dose(BED)=nd[1 +d/(α/β)]-(T-28).The four branches were:1.split-course 103 cases, with an intermediary rest of 3-4 weeks,mean total dose 70Gy/35fx,73d, BED 51.6 Gy; 2.continuous 115 cases, 72Gy/36fx, 61d, BED 62.6 Gy;3.hyperfractionation I 52 cases, 1.5 Gy b.i.d.,time interval(Ti)≥6 hr, 75Gy/49fx,57d,BED 65.5Gy;4. hyperfractionation Ⅱ 50 cases, 1.2 Gy b.i.d., Ti≥6hr,76Gy/60fx,59d,BED 63.0 Gy.Treatment results were compared with 1-, and 3-year loco-regional recurrent rates,and 1-,and 3-year survival rates, and these rates were of a negative interrelation with prolonged course duration, but of a positive one with BED valas.Continuous branch was of a course mean 12 days shorter than the spilt-course one, its treatment results were nearly 10% higher in some subgroups;and hyperfractionation branches were slightly better than continuous one. 展开更多
关键词 radiotherapy couse Biological effective dose(BED) nasopharyngeal carcinoma(NPC) .
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Significant value of 18F-FDG-PET/CT in diagnosing small cervical lymph node metastases in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy 被引量:19
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作者 Hao Peng Lei Chen +11 位作者 Ling-Long Tang Wen-Fei Li Yan-Ping Mao Rui Guo Yuan Zhang Li-Zhi Liu Li Tian Xu Zhang Xiao-Ping Lin Ying Guo Ying Sun Jun Ma 《Chinese Journal of Cancer》 SCIE CAS CSCD 2017年第12期757-766,共10页
Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(^(18)F-FDG) positron emiss... Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(^(18)F-FDG) positron emission tomography/computed tomography(PET/CT).The present study aimed to evaluate the diagnostic values of PET/CT in identifying metastasis in SCLNs in NPC patients.Methods: Magnetic resonance images(MRI) and PET/CT scans for 470 patients with newly diagnosed, non-distant metastatic NPC were analyzed. Metastatic rates of SCLNs were defined by the positive number of SCLNs on PET/CT scans and total number of SCLNs on MRI scans. Receiver operating characteristic curve was applied to compare PET/CT-determined stage with MRI-determined stage.Results: In total, 2082 SCLNs were identified, with 808(38.8%) ≥ 5 and < 6 mm in diameter(group A), 526(25.3%)≥ 6 and < 7 mm in diameter(group B),374(18.0%)≥ 7 and < 8 mm in diameter(group C), 237(11.4%) ≥8 and<9 mm in diameter(group D),and 137(6.5%) ≥ 9 and <10 mm in diameter(group E).The overall metastatic rates examined by using PET/CT for groups A, B,C,D, and E were 3.5%, 8.0%, 31.3%, 60.0%, and 83.9%, respectively(P< 0.001). In level IV/Vb, the metastatic rate for nodes ≥ 8 mm was 84.6%. PET/CT examination resulted in modification of N category and overall stage for 135(28.7%) and 46(9.8%) patients, respectively. The areas under curve of MRIdetermined and PET/CT-determined overall stage were 0.659 and 0.704 for predicting overall survival, 0.661 and 0.711 for predicting distant metastasis-free survival, and 0.636 and 0.663 for predicting disease-free survival.Conclusions: PET/CT was more effective than MRI in identifying metastatic SCLNs, and the radiologic diagnostic criteria for metastatic lymph nodes in level IV/Vb should be re-defined. 展开更多
关键词 nasopharyngeal carcinoma 18-fluoro-2-deoxy-glucose positron emission TOMOGRAPHY with computed TOMOGRAPHY (18F-PET/CT) Magnetic resonance image INTENSITY-MODULATED radiotherapy SMALL cervical LYMPH nodes
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Effects of dosimetric inadequacy on local control and toxicities in the patients with T4 nasopharyngeal carcinoma extending into the intracranial space and treated with intensity.modulated radiotherapy plus chemotherapy 被引量:4
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作者 Fen Xue Chao.Su Hu Xia.Yun He 《Chinese Journal of Cancer》 SCIE CAS CSCD 2017年第9期398-406,共9页
Background:To protect neurological tissues,underdosing occurs in most cases of T4 nasopharyngeal carcinoma(NPC) with intracranial extension.In this study,we aimed to evaluate the effect of dosimetric inadequacy on loc... Background:To protect neurological tissues,underdosing occurs in most cases of T4 nasopharyngeal carcinoma(NPC) with intracranial extension.In this study,we aimed to evaluate the effect of dosimetric inadequacy on local control and late neurological toxicities for patients treated with intensity-modulated radiotherapy(IMRT) plus chemotherapy.Methods:We prospectively enrolled patients who had non-metastaticT4 NPC with intracranial extension treated between January 2009 and November 2013.The prescribed dose was 66.0-70.4 Gy to the primary planning target volume(primary gross tumor volume [GTVp;i.e.,the nasopharyngeal tumor] +5.0 mm).Dose-volume histogram parameters were calculated,including minimum point dose(D_(min)) and dose to 95% of the target volume(D95).All patients received chemotherapy with the cisplatin,5-fluorouracil,and docetaxel regimen.Survivals were estimated using the Kaplan-Meier method and compared using the log-rank test.Results:In total,41 patients were enrolled.The local partial response rate was 87.8% after induction chemotherapy.With a median follow-up of 51 months,7 patients experienced failure in the nasopharynx;the 3-year local failure-free survival and overall survival rates of the 41 patients were 87.4% and 90.2%,respectively.The actual mean D_(min) to the GTVp was 55.2 Gy(range 48.3-67.3 Gy),and D95 was 61.6 Gy(range 52.6-69.0 Gy).All doses received by neurological organs remained well within their dose constraints.No patients developed temporal lobe necrosis or other neurological dysfunctions.Conclusions:With relative underdosed IMRT plus effective chemotherapy,the patients achieved satisfactory local control with few late toxicities of the central nervous system.Determining the acceptable extent of dosimetric inadequacy requires further exploration. 展开更多
关键词 nasopharyngeal carcinoma CHEMOTHERAPY INTENSITY-MODULATED radiotherapy Local control Dosimetric inadequacy
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Clinical treatment considerationsin the intensity-modulated radiotherapy era for patients with NO-category nasopharyngeal carcinoma and enlarged neck lymph nodes 被引量:4
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作者 Hao Peng Lei Chen +8 位作者 Rui Guo Yuan Zhang Wen.Fei Li Yan.Ping Mao Ying Sun Fan Zhang Li.Zhi Liu Li Tian Jun Ma 《Chinese Journal of Cancer》 SCIE CAS CSCD 2017年第7期306-314,共9页
Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patien... Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs <5.5 mm(100%vs.98.8%,P=0.049),whereas disease-free,overall,and distant metastasis-free survival rates were similar between the two groups.After adjusting for various factors,ENLN diameter was not identified as an independent prognostic factor(P > 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study. 展开更多
关键词 nasopharyngeal carcinoma N0-category ENLARGED NECK lymph node Biological equivalent dose INTENSITY-MODULATED radiotherapy Prognosis
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Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis 被引量:13
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作者 Ming-Yuan Chen Rou Jiang +10 位作者 Ling Guo Xiong Zou Qing Liu Rui Sun Fang Qiu Zhong-Jun Xia Hui-Qiang Huang Li Zhang Ming-Huang Hong Hai-Qiang Mai Chao-Nan Qian 《Chinese Journal of Cancer》 SCIE CAS CSCD 2013年第11期604-613,共10页
Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma(NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes aff... Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma(NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P<0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival(OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio(HR)=0.9, P=0.529]; this risk was 60% lower than that of the group undergoing supportive treatment(HR=0.4, P=0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy(HR=2.3, P<0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC. 展开更多
关键词 鼻咽癌 放疗 患者 放射治疗 诊断 多因素分析 转移性 化疗
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Randomized study of sinusoidal chronomodulated versus flat intermittent induction chemotherapy with cisplatin and 5-fluorouracil followed by traditional radiotherapy for locoregionally advanced nasopharyngeal carcinoma 被引量:8
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作者 Huan-Xin Lin Yi-Jun Hua +9 位作者 Qiu-Yan Chen Dong-Hua Luo Rui Sun Fang Qiu Hao-Yuan Mo Hai-Qiang Mai Xiang Guo Li-Jian Xian Ming-Huang Hong Ling Guo 《Chinese Journal of Cancer》 SCIE CAS CSCD 2013年第9期502-511,共10页
Neoadjuvant chemotherapy plus radiotherapy is the most common treatment regimen for advanced nasopharyngeal carcinoma(NPC).Whether chronomodulated infusion of chemotherapy can reduce its toxicity is unclear.This study... Neoadjuvant chemotherapy plus radiotherapy is the most common treatment regimen for advanced nasopharyngeal carcinoma(NPC).Whether chronomodulated infusion of chemotherapy can reduce its toxicity is unclear.This study aimed to evaluate the toxic and therapeutic effects of sinusoidal chronomodulated infusion versus flat intermittent infusion of cisplatin(DDP)and 5-fluorouracil(5-FU)followed by radiotherapy in patients with locoregionally advanced NPC.Patients with biopsy-diagnosed untreated stages III and IV NPC(according to the 2002 UICC staging system)were randomized to undergo2 cycles of sinusoidal chronomodulated infusion(Arm A)or flat intermittent constant rate infusion(Arm B)of DDP and 5-FU followed by radical radiotherapy.Using a"MELODIE"multi-channel programmed pump,the patients were given 12-hour continuous infusions of DDP(20 mg/m2)and 5-FU(750 mg/m2)for 5days,repeated every 3 weeks for 2 cycles.DDP was administered from 10:00 am to 10:00 pm,and 5-FU was administered from 10:00 pm to 10:00 am each day.Chronomodulated infusion was performed in Arm A,with the peak deliveries of 5-FU at 4:00 am and DDP at 4:00 pm.The patients in Arm B underwent a constant rate of infusion.Radiotherapy was initiated in the fifth week,and both arms were treated with the same radiotherapy techniques and dose fractions.Between June 2004 and June 2006,125 patients were registered,and 124 were eligible for analysis of response and toxicity.The major toxicity observed during neoadjuvant chemotherapy was neutropenia.The incidence of acute toxicity was similar in both arms.During radiotherapy,the incidence of stomatitis was significantly lower in Arm A than in Arm B(38.1%vs.59.0%,P=0.020).No significant differences were observed for other toxicities.The 1-,3-,and 5-year overall survival rates were 88.9%,82.4%,and 74.8%for Arm A and 91.8%,90.2%,and 82.1%for Arm B.The 1-,3-,and 5-year progression-free survival rates were 91.7%,88.1%,and 85.2%for Arm A and 100%,94.5%,and 86.9%for Arm B.The 1-,3-,and 5-year distant metastasis-free survival rates were 82.5%,79.1%,and 79.1%for Arm A and 90.2%,85.2%,and 81.7%for Arm B.Chronochemotherapy significantly reduced stomatitis but was not superior to standard chemotherapy in terms of hematologic toxicities and therapeutic response. 展开更多
关键词 氟尿嘧啶 鼻咽癌 放疗 化疗 顺铂 间歇 正弦 晚期
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Neoadjuvant chemotherapy plus intensity-modulated radiotherapy versus concurrent chemoradiotherapy plus adjuvant chemotherapy for the treatment of locoregionally advanced nasopharyngeal carcinoma:a retrospective controlled study 被引量:23
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作者 Wen-Ze Qiu Pei-Yu Huang +3 位作者 Jun-Li Shi Hai-Qun Xia Chong Zhao Ka-Jia Cao 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第1期46-54,共9页
Background:In the era of intensity-modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NAC)for locoregionally advanced nasopharyngeal carcinoma(NPC)is under-evaluated.The aim of this study was to compare... Background:In the era of intensity-modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NAC)for locoregionally advanced nasopharyngeal carcinoma(NPC)is under-evaluated.The aim of this study was to compare the efficacy of NAC plus IMRT and concurrent chemoradiotherapy(CCRT)plus adjuvant chemotherapy(AC)on locoregionally advanced NPC.Methods:Between January 2004 and December 2008,240 cases of locoregionally advanced NPC confirmed by pathologic assessment in Sun Yat-sen University Cancer Center were reviewed.Of the 240 patients,117 received NAC followed by IMRT,and 123 were treated with CCRT plus AC.The NAC+IMRT group received a regimen that included cisplatin and 5-fluorouracil(5-FU).The CCRT+AC group received cisplatin concurrently with radiotherapy,and subsequently received adjuvant cisplatin and 5-FU.The survival rates were assessed by Kaplan-Meier analysis,and the survival curves were compared using a log-rank test.Multivariate analysis was conducted using the Cox proportional hazard regression model.Results:The 5-year overall survival(OS),locoregional relapse-free survival(LRRFS),distant metastasis-free survival(DMFS),and disease-free survival(DFS)were 78.0,87.9,79.0,and 69.8%,respectively,for the NAC+IMRT group and78.7,84.8,76.2,and 65.6%,respectively,for the CCRT+AC group.There were no significant differences in survival between the two groups.In multivariate analysis,age(<50 years vs.>50 years)and overall stage(Ⅲvs.Ⅳ)were found to be independent predictors for OS and DFS;furthermore,the overall stage was a significant prognostic factor for DMFS.Compared with the CCRT+AC protocol,the NAC+IMRT protocol significantly reduced the occurrence rates of grade 3-4 nausea-vomiting(6.5 vs.1.5%,P=0.023)and leukopenia(9.7 vs.0.8%,P=0.006).Conclusions:The treatment outcomes of the NAC+IMRT and CCRT+AC groups were similar.Distant metastasis remained the predominant mode of treatment failure. 展开更多
关键词 《癌症》 期刊 英文
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Prognostic scoring system for locoregional control among the patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy 被引量:7
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作者 Chang-Juan Tao Xu Liu +9 位作者 Ling-Long Tang Yan-Ping Mao Lei Chen Wen-Fei Li Xiao-Li Yu Li-Zhi Liu Rong Zhang Ai-Hua Lin Jun Ma Ying Sun 《Chinese Journal of Cancer》 SCIE CAS CSCD 2013年第9期494-501,共8页
The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic... The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma(NPC)has decreased with the extensive use of intensity-modulated radiotherapy(IMRT).We aimed to develop a prognostic scoring system(PSS)that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT.The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed.Age,pathologic classification,primary tumor extension,primary gross tumor volume(GTV-p),T and N categories,and baseline lactate dehydrogenase(LDH)level were analyzed.Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS.Independent prognostic factors for locoregional relapse included N2–3 stage,GTV-p≥26.8 mL,and involvement of one or more structures within cluster3.We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups:low risk(score 0),intermediate risk(score>0 and≤1),high risk(score>1 and≤2),and extremely high risk(score>2).The 5-year locoregional control rates for these groups were 97.4%,93.6%,85.2%,and 78.6%,respectively(P<0.001).We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients. 展开更多
关键词 评分系统 鼻咽癌 控制率 患者 预后 治疗 放疗 中山大学
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Effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy
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作者 Dan Wang Qian-Cheng Hu 《Journal of Hainan Medical University》 2018年第9期62-66,共5页
Objective:To study the effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy.Methods:Patients with nasopharyngeal carcinom... Objective:To study the effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy.Methods:Patients with nasopharyngeal carcinoma who received radiotherapy in West China Hospital between and November January 2017 were selected and randomly divided into the nutrition support group who received oral nutrition support and the normal control group who received routine intervention. The levels of nutrition indicators and radiation damage indicators in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and 1 week after end of radiotherapy.Results: Compared with those before radiotherapy, serum ALB, PA, TWEAK, Leptin and Ghrelin levels as well as peripheral blood CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD56+ immune cell contents of nutrition support group didn't change significantly whereas serum TGF-β1, IL-6, IL-17 and MMP9 levels increased significantly 1 week after end of radiotherapy;serum ALB and PA levels as well as peripheral blood CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD56+ immune cell contents of normal control group decreased significantly whereas TWEAK, Leptin, Ghrelin, TGF-β1, IL-6, IL-17 and MMP9 levels increased significantly 1 week after end of radiotherapy.Conclusion:Oral nutrition support can avoid the damage of nutritional status and immune function and reduce the radiation damage in patients with nasopharyngeal carcinoma radiotherapy. 展开更多
关键词 nasopharyngeal carcinoma radiotherapy NUTRITION support Immune function Radiation damage
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