Failure patterns and prognostic factors for cervical node‐negative nasopharyngeal carcinoma in the intensity‐modulated radiotherapy era

2020 ◽  
Author(s):  
Zheng Wu ◽  
Lei Wang ◽  
De‐Huan Xie ◽  
Shao‐Wen Lv ◽  
Yong Su ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Intensity Modulated Radiotherapy ◽  
Node Negative ◽  
Failure Patterns ◽  
Intensity Modulated ◽  
Cervical Node

scholarly journals Induction Chemotherapy Combined With Intensity-Modulated Radiotherapy for 129 Nasopharyngeal Carcinoma Patients With Synchronous Metastases: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengshan Ni ◽  
Lijun Geng ◽  
Fangfang Kong ◽  
Chengrun Du ◽  
Ruiping Zhai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Induction Chemotherapy ◽  
Survival Rates ◽  
Intensity Modulated Radiotherapy ◽  
Initial Diagnosis ◽  
Intensity Modulated ◽  
Synchronous Metastases ◽  
Pre Treatment

ObjectiveTo analyze the therapeutic effect and prognostic factors of nasopharyngeal carcinoma (NPC) patients with distant metastases at initial diagnosis receiving induction chemotherapy with intensity-modulated radiotherapy (IMRT).MethodsA total of 129 patients who underwent platinum-based induction chemotherapy followed by definitive IMRT with or without concurrent or adjuvant chemotherapy for newly diagnosed distant metastatic NPC in our center between March 2008 and November 2018 were retrospectively analyzed. 41 patients underwent local therapy for metastatic sites. Kaplan-Meier method was used to estimate survival rates, Log-rank test and Cox proportional hazards model were used to figure out independent prognostic factors of overall survival (OS).ResultsA total of 66 patients had been dead (median follow-up time, 51.5 months). The median overall survival (OS) time was 54.2 months (range, 7-136 months), and the 1-year, 2-year, 3-year, 5-year overall survival rates were 88.0%,71.0%,58.0%, and 47.0%. Multivariate analysis found that the factors correlated with poor overall survival were pre-treatment serum lactate dehydrogenase (SLDH) >180U/L, chemotherapy cycles<4, and M1 stage subdivision (M1b, single hepatic metastasis and/or multiple metastases excluding the liver; and M1c, multiple hepatic metastases). The 5-year OS rates for M1a, M1b and M1c were 62.6%,40.4% and 0%, respectively.ConclusionPlatinum-containing induction chemotherapy combined with IMRT seemed to be advantageous to prolong survival for some NPC patients with synchronous metastases at initial diagnosis. The independent factors to prognosticate OS were pre-treatment SLDH, number of chemotherapy cycles, and M1 subcategories. Prospective clinical trials are needed to confirm the result.

scholarly journals Local failure patterns for patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy

2014 ◽  
Vol 9 (1) ◽  
pp. 87 ◽  
Author(s):  
Jia-xin Li ◽  
Shao-min Huang ◽  
Xin-hua Jiang ◽  
Bin Ouyang ◽  
Fei Han ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Intensity Modulated Radiotherapy ◽  
Local Failure ◽  
Failure Patterns ◽  
Intensity Modulated

Prognostic factors of 305 nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy

2010 ◽  
Vol 29 (2) ◽  
pp. 145-150 ◽  
Author(s):  
Lu Han ◽  
Shao-Jun Lin ◽  
Jian-Ji Pan ◽  
Chuan-Ben Chen ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Intensity Modulated Radiotherapy ◽  
Intensity Modulated

scholarly journals Clinical Outcome and Prognostic Factors of Intensity-Modulated Radiotherapy for T4 Stage Nasopharyngeal Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yangkun Luo ◽  
Yang Gao ◽  
Guangquan Yang ◽  
Jinyi Lang
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Nasopharyngeal Carcinoma ◽  
Lymph Nodes ◽  
Distant Metastasis ◽  
Intensity Modulated Radiotherapy ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Intensity Modulated ◽  
T4 Stage

Objective. To analyze the clinical outcomes and prognostic factors of intensity-modulated radiotherapy (IMRT) for T4 stage nasopharyngeal carcinoma (NPC).Methods. Between March 2005 and March 2010, 110 patients with T4 stage NPC without distant metastases were treated. All patients received IMRT. Induction and/or concurrent chemotherapy were given. 47 (42.7%) patients received IMRT replanning.Results. The 5-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 90.1%, 97.0%, 67.5%, 63.9%, and 64.5%, respectively. Eleven patients experienced local-regional failure and total distant metastasis occurred in 34 patients. 45 patients died and 26 patients died of distant metastasis alone. The 5-year LRFS rates were 97.7% and 83.8% for the patients that received and did not receive IMRT replanning, respectively (P=0.023). Metastasis to the retropharyngeal lymph nodes (RLN) was associated with inferior 5-year OS rate (61.0% versus 91.7%,P=0.034). The gross tumor volume of the right/left lymph nodes (GTVln) was an independent prognostic factor for DMFS (P=0.006) and PFS (P=0.018). GTVln was with marginal significance as the prognostic factor for OS (P=0.050).Conclusion. IMRT provides excellent local-regional control for T4 stage NPC. Benefit of IMRT replanning may be associated with improvement in local control. Incorporating GTVln into the N staging system may provide better prognostic information.

scholarly journals The Value of Cervical Node Features in Predicting Long-Term Survival of Nasopharyngeal Carcinoma in Intensity-Modulated Radiotherapy Era

2020 ◽  
Author(s):  
Yunming Tian ◽  
Lei Zeng ◽  
Runda Huang ◽  
Yuhong Lan ◽  
Xia Yuan ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Intensity Modulated Radiotherapy ◽  
Distant Metastases ◽  
Term Survival ◽  
Intensity Modulated ◽  
Cervical Node ◽  
Extranodal Extension ◽  
N Stage ◽  
Multivariate Proportional Hazard

Abstract The prognostic value of cervical node features in nasopharyngeal carcinoma(NPC) patients treated with intensity-modulated radiotherapy (IMRT) was controversial. In this study, about 1752 patients after IMRT from 2008 to 2011 were recruited. The nodal features including the nodal number, maximize dimension diameter, extranodal extension(ENE)and cervical node necrosis(CNN) were retrospective analyzed. Univariate Cox and multivariate proportional hazard regression models were used to test the prognostic value of nodal features. Prognostic nomograms were built to predict the survival. The 10-year distant metastases free survival (DMFS) and disease-specific survival(DSS) rates were 86.5% and 80.8%. By multivariate analysis, the independent factors for the DSS were gender, age, lactate dehydrogenase (LDH), CNN, ENE, T stage and N stage. Nomogram A (without nodal features ) and nomogram B (with nodal features) were built. The calibration curve for the probability of DSS showed good agreement between prediction by nomogram and actual observation.The C-index of nomogram B was higher than for nomogram A in predicting DSS ( 0.708 vs 0.676,P <.01). These results demonstrated the nodal features including the ENE and CNN were negative prognostic factors in patients with NPC, and the prognostic nomogram incorporating the nodal features was more accurate.

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