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Radiotherapy alone and with concurrent chemotherapy for nasopharyngeal carcinoma: A retrospective study.

Abstract We sought to evaluate clinical outcomes and toxicities of radiation therapy (RT) alone compared to RT with concurrent chemotherapy (CCT) for nasopharyngeal carcinoma (NPC) treatment.We conducted a retrospective review of consecutive patients with biopsy-proven nonmetastatic NPC who underwent RT at our institution. From May 2001 to April 2015; 62 newly diagnosed NPC patients were treated with three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) with or without CCT. The patients were classified as follows: 8% stage I, 15% stage II, 32% stage III, and 45% stage IVA/IVB. A total of 76% of tumors were World Health Organization types II or III. Acute and late toxicities were graded according to the Common Terminology Criteria for Adverse Events version 3.0. Overall survival (OS), progression-free survival (PFS), locoregional progression-free survival (LRPFS), and distant metastasis-free survival (DMFS) were analyzed.The median follow-up period for living patients was 53 months. The median actual delivered dose was 70 Gy with a range of 28 to 70 Gy in fraction sizes of 2 Gy. The estimated 5-year OS, PFS, LRPFS, and DMFS rates were 72.7%, 59.8%, 77.9%, and 84.2%, respectively. The use of CCT was a predictive factor of significantly better OS and PFS, whereas stage IV was a significant predictor of poor OS and PFS. The most severe acute toxicities included Grade 3 mucositis in 56% and Grade 3 dermatitis in 8%. Subset analysis revealed that Grade 2 xerostomia was significantly lower in the IMRT (23%) group than in the 3D-CRT (52%) group (P = .02).RT yielded favorable outcomes. CCT was associated with longer PFS and OS than RT alone.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29718841
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20180514
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 18
DP  - 2018 May
TI  - Radiotherapy alone and with concurrent chemotherapy for nasopharyngeal carcinoma:
      A retrospective study.
PG  - e0502
LID - 10.1097/MD.0000000000010502 [doi]
AB  - We sought to evaluate clinical outcomes and toxicities of radiation therapy (RT) 
      alone compared to RT with concurrent chemotherapy (CCT) for nasopharyngeal
      carcinoma (NPC) treatment.We conducted a retrospective review of consecutive
      patients with biopsy-proven nonmetastatic NPC who underwent RT at our
      institution. From May 2001 to April 2015; 62 newly diagnosed NPC patients were
      treated with three-dimensional conformal radiotherapy (3D-CRT) or
      intensity-modulated radiotherapy (IMRT) with or without CCT. The patients were
      classified as follows: 8% stage I, 15% stage II, 32% stage III, and 45% stage
      IVA/IVB. A total of 76% of tumors were World Health Organization types II or III.
      Acute and late toxicities were graded according to the Common Terminology
      Criteria for Adverse Events version 3.0. Overall survival (OS), progression-free 
      survival (PFS), locoregional progression-free survival (LRPFS), and distant
      metastasis-free survival (DMFS) were analyzed.The median follow-up period for
      living patients was 53 months. The median actual delivered dose was 70 Gy with a 
      range of 28 to 70 Gy in fraction sizes of 2 Gy. The estimated 5-year OS, PFS,
      LRPFS, and DMFS rates were 72.7%, 59.8%, 77.9%, and 84.2%, respectively. The use 
      of CCT was a predictive factor of significantly better OS and PFS, whereas stage 
      IV was a significant predictor of poor OS and PFS. The most severe acute
      toxicities included Grade 3 mucositis in 56% and Grade 3 dermatitis in 8%. Subset
      analysis revealed that Grade 2 xerostomia was significantly lower in the IMRT
      (23%) group than in the 3D-CRT (52%) group (P = .02).RT yielded favorable
      outcomes. CCT was associated with longer PFS and OS than RT alone.
FAU - Katano, Atsuto
AU  - Katano A
AD  - Department of Radiology, University of Tokyo Hospital.
FAU - Takahashi, Wataru
AU  - Takahashi W
AD  - Department of Radiology, University of Tokyo Hospital.
FAU - Yamashita, Hideomi
AU  - Yamashita H
AD  - Department of Radiology, University of Tokyo Hospital.
FAU - Yamamoto, Kentaro
AU  - Yamamoto K
AD  - Department of Radiology, Japan Self Defense Force Central Hospital.
FAU - Ando, Mizuo
AU  - Ando M
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Tokyo Hospital,
      Tokyo, Japan.
FAU - Yoshida, Masafumi
AU  - Yoshida M
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Tokyo Hospital,
      Tokyo, Japan.
FAU - Saito, Yuki
AU  - Saito Y
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Tokyo Hospital,
      Tokyo, Japan.
FAU - Abe, Osamu
AU  - Abe O
AD  - Department of Radiology, University of Tokyo Hospital.
FAU - Nakagawa, Keiichi
AU  - Nakagawa K
AD  - Department of Radiology, University of Tokyo Hospital.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - Nasopharyngeal carcinoma
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Carcinoma/mortality/*therapy
MH  - Chemoradiotherapy/adverse effects/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasopharyngeal Neoplasms/mortality/*therapy
MH  - Radiotherapy, Conformal/adverse effects/*methods
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2018/05/03 06:00
MHDA- 2018/05/15 06:00
CRDT- 2018/05/03 06:00
PHST- 2018/05/03 06:00 [entrez]
PHST- 2018/05/03 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
AID - 10.1097/MD.0000000000010502 [doi]
AID - 00005792-201805040-00009 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(18):e0502. doi: 10.1097/MD.0000000000010502.