Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb;13(4):e6578.
doi: 10.1002/cam4.6578.

Deletion of concurrent chemotherapy on the basis of sequential chemoradiotherapy for non-metastatic stage T4 nasopharyngeal carcinoma in IMRT era

Yuming Zheng  1   2   3   4 , Fen Xue  1   2   3   4 , Dan Ou  1   2   3   4 , Xiaoshuang Niu  1   2   3   4 , Chaosu Hu  1   2   3   4 , Xiayun He  1   2   3   4
Affiliations

Deletion of concurrent chemotherapy on the basis of sequential chemoradiotherapy for non-metastatic stage T4 nasopharyngeal carcinoma in IMRT era

Yuming Zheng et al. Cancer Med. 2024 Feb.

Abstract

Purpose: Intensity-modulated radiotherapy (IMRT) combined with concurrent chemotherapy is deemed as the mainstay treatment in locoregionally advanced nasopharyngeal carcinoma (NPC). Nevertheless, the tolerance of severe acute toxicity of concurrent chemotherapy was unsatisfied. In addition, T4 is the predicting factor of poor prognosis for NPC patients. In this retrospective analysis, the long-term outcomes IMRT combined by induction chemotherapy deleting concurrent chemotherapy with or without adjuvant chemotherapy for T4 non-metastatic NPC were analyzed.

Materials and methods: From January 2005 to November 2016, a total of 145 biopsy-proven non-metastatic T4 NPC was treated with IMRT combined by induction chemotherapy with or without adjuvant chemotherapy. The survival and side effects of the patients were analyzed.

Results: Median follow-up time was 74 months (ranges, 8-186 months). 10.0%, 61.3%, 27.3%, and 1.3% developed grade 1, 2, 3, and 4 mucositis during IMRT, respectively. 5.5% and 2.0% patients experienced grade 1 and 2 nausea and vomiting; no patients developed grade 3 or 4 nausea and vomiting. Of 145 patients enrolled, 5-year and 10-year overall survival(OS) rates were 73.7% and 53.9%, local progression-free survival(LPFS) rates were 86.1% and 71.6%, regional progression-free survival(RPFS) rates were 96.7% and 92.8%, distant metastasis-free survival (DMFS) rates were 86.7%, 78.2%, respectively. At the last follow-up, five patients developed cranial nerve injury, one patient developed mandibular bone necrosis, four patients developed temporal lobe injury, four patients developed nasopharyngeal massive hemorrhage (three cases after recurrence and one case without recurrence), and five patients developed second primary tumor.

Conclusion: The survival outcomes of treating T4 NPC IMRT combined by induction chemotherapy deleting concurrent chemotherapy with or without adjuvant chemotherapy are encouraging. Moreover, mucosal reaction, nausea, and vomiting reaction were reduced during IMRT.

Keywords: T4; deleting of concurrent chemotherapy; intensity-modulated radiotherapy; nasopharyngeal carcinoma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier curves showing overall survival (OS) rates, local progression‐free survival (LPFS) rates, regional progression‐free survival (RPFS) and distant metastasis‐free survival (DMFS) for 145 patients with T4 nasopharyngeal carcinoma.
See this image and copyright information in PMC

References

    1. GLOBAL . Cancer Observatory. 2020; Available from: https://gco.iarc.fr/
    1. Ou X, Zhou X, Shi Q, et al. Treatment outcomes and late toxicities of 869 patients with nasopharyngeal carcinoma treated with definitive intensity modulated radiation therapy: new insight into the value of total dose of cisplatin and radiation boost. Oncotarget. 2015;6(35):38381‐38397. doi:10.18632/oncotarget.5420 - DOI - PMC - PubMed
    1. Au KH, Ngan RKC, Ng AWY, et al. Treatment outcomes of nasopharyngeal carcinoma in modern era after intensity modulated radiotherapy (IMRT) in Hong Kong: a report of 3328 patients (HKNPCSG 1301 study). Oral Oncol. 2018;77:16‐21. doi:10.1016/j.oraloncology.2017.12.004 - DOI - PubMed
    1. Wu LR, Liu YT, Jiang N, et al. Ten‐year survival outcomes for patients with nasopharyngeal carcinoma receiving intensity‐modulated radiotherapy: an analysis of 614 patients from a single center. Oral Oncol. 2017;69:26‐32. doi:10.1016/j.oraloncology.2017.03.015 - DOI - PubMed
    1. Huang J, Yang ZY, Wu B, et al. Long‐term therapeutic outcome and prognostic factors of patients with nasopharyngeal carcinoma receiving intensity‐modulated radiotherapy: an analysis of 608 patients from low‐endemic regions of China. Curr Med Sci. 2021;41(4):737‐745. doi:10.1007/s11596-021-2405-3 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources