scholarly journals Arterial interventional chemotherapy and IMRT with concurrent chemotherapy for nasopharyngeal carcinoma with intracranial involvement

2013 ◽  
Vol 6 (2) ◽  
pp. 427-431 ◽  
Author(s):  
XINGLAI FEN ◽  
WEIFENG QIN ◽  
WUAN BAO ◽  
FENG JIANG ◽  
BIN LI ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Concurrent Chemotherapy ◽  
Intracranial Involvement ◽  
Interventional Chemotherapy

scholarly journals Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy

Cancers ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 374 ◽  
Author(s):  
Yu-Jen Liu ◽  
Ngan-Ming Tsang ◽  
Chuen Hsueh ◽  
Chi-Ju Yeh ◽  
Shir-Hwa Ueng ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Nasopharyngeal Carcinoma ◽  
Local Recurrence ◽  
Epstein Barr Virus ◽  
Disease Free Survival ◽  
Concurrent Chemotherapy ◽  
Barr Virus ◽  
Programmed Death ◽  
Favorable Prognostic Factor ◽  
Epstein Barr

The prognostic value of programmed death-ligand 1 (PD-L1) expression in nasopharyngeal carcinoma (NPC) is controversial, with previous studies showing conflicting results. Most NPCs in endemic areas are Epstein-Barr virus (EBV)-positive. Our aim was to evaluate the clinical significance of PD-L1 expression in EBV-positive NPC. We retrospectively analyzed PD-L1 expression on tumor cells (TCs) and immune cells (ICs) by immunohistochemistry in 208 EBV-positive NPC patients who underwent radiotherapy (203 with concurrent chemotherapy). The percentages of TCs and ICs expressing PD-L1 were evaluated respectively. There was a strong correlation between local recurrence and low PD-L1 expression on ICs (p = 0.0012), TCs (p = 0.013) or both (p = 0.000044), whereas all clinical parameters had no influence on local recurrence. Using multivariate analysis, low PD-L1 expression on ICs was an independent adverse prognostic factor (p = 0.0080; HR = 1.88; 95% CI = 1.18–3.00) for disease-free survival. High PD-L1 expression on both ICs and TCs was an independent favorable prognostic factor (p = 0.022; HR = 0.46; 95% CI = 0.24–0.89) for overall survival. We show for the first time that low PD-L1 expression on ICs and TCs strongly correlates with local recurrence in EBV-positive NPC patients after radiation-based therapy. A simple immunohistochemical study for PD-L1 can identify patients prone to local recurrence, and such patients might benefit from more aggressive treatment in future clinical trials.

Comparison the clinical outcomes with altered versus conventional fractionated radiotherapy plus concurrent chemotherapy for advanced nasopharyngeal carcinoma

Head & Neck ◽  
2018 ◽  
Vol 40 (6) ◽  
pp. 1156-1163 ◽  
Author(s):  
Po-Ju Lin ◽  
Chih-Wen Twu ◽  
Yi-Chun Liu ◽  
Tian-Yun Lin ◽  
Wen-Yi Wang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Clinical Outcomes ◽  
Concurrent Chemotherapy ◽  
Fractionated Radiotherapy

Concurrent Chemotherapy-Radiotherapy Compared With Radiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: Progression-Free Survival Analysis of a Phase III Randomized Trial

2002 ◽  
Vol 20 (8) ◽  
pp. 2038-2044 ◽  
Author(s):  
A.T.C. Chan ◽  
P.M.L. Teo ◽  
R.K. Ngan ◽  
T.W. Leung ◽  
W.H. Lau ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Progression Free Survival ◽  
Patient Characteristics ◽  
Tumor Stage ◽  
Concurrent Chemotherapy ◽  
Phase Iii ◽  
Free Survival ◽  
Advanced Tumor ◽  
Nodal Size ◽  
Significant Difference

PURPOSE: Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy. This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC. PATIENTS AND METHODS: Patients with Ho’s N2 or N3 stage or N1 stage with nodal size ≥ 4 cm were randomized to receive cisplatin 40 mg/m2 weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone. The primary end point was progression-free survival (PFS). RESULTS: Three hundred fifty eligible patients were randomized. Baseline patient characteristics were comparable in both arms. There were significantly more toxicities, including mucositis, myelosuppression, and weight loss in the CRT arm. There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm. At a median follow-up of 2.71 years, the 2-year PFS was 76% in the CRT arm and 69% in the RT-alone arm (P = .10) with a hazards ratio of 1.367 (95% confidence interval [CI], 0.93 to 2.00). The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho’s stage T3 (P = .0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28). For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P = .016). CONCLUSION: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.

scholarly journals Cisplatin-based Concurrent Chemoradiotherapy Improved the Survival of Locoregionally Advanced Nasopharyngeal Carcinoma After Induction Chemotherapy by Reducing Early Treatment Failure

2021 ◽  
Author(s):  
Xing-Li Yang ◽  
Lu-Lu Zhang ◽  
Jia Kou ◽  
Guan-Qun Zhou ◽  
Chen-Fei Wu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Treatment Failure ◽  
Time Course ◽  
Concurrent Chemotherapy ◽  
P Value ◽  
Treatment Groups ◽  
Locoregional Failure ◽  
Distant Failure ◽  
Time Specific

Abstract PurposeLimited data are available on the time course of treatment failures and the nature and duration of concurrent cisplatin benefit in patients with locoregionally advanced nasopharyngeal carcinoma (LANPC).MethodsIn total, 3123 patients with stage III-IVa NPC receiving IC followed by concurrent cisplatin or not were analysed. The cut-off value of treatment failure was calculated using the minimum P-value approach. Random survival forest (RSF) model was to simulate the cumulative probabilities of treatment failure (locoregional recurrence and /or distant metastasis) over-time, as well as the monthly time-specific, event-occurring probabilities, for patients at different treatment groups. ResultsBased on subsequent prognosis, early locoregional failure (ELRF) should be defined as recurrence within 14 months (P = 1.47×10-3), and early distant failure (EDF) should be defined as recurrence within 20 months (P = 1.95×10-4). A cumulative cisplatin dose (CCD) > 200 mg/m2 independently reduced the risk of EDF (hazard ratio (HR), 0.351; 95% confidence interval (CI), 0.169-0.732; P = 0.005). Better failure-free survival (FFS) and overall survival (OS) were observed in concurrent chemotherapy settings ([0 mg/m2 vs. 1-200 mg/m2 vs. >200 mg/m2]: FFS: 70.4% vs. 74.4% vs. 82.6%, all P < 0.03; OS: 79.5% vs. 83.8% vs. 90.8%, all P < 0.01). In the monthly analysis, treatment failure mainly occurred during the first 4 years, and the risk of distant failure in patients treated with concurrent chemotherapy never exceeded that of patients without concurrent chemotherapy.ConclusionLocoregional failure that developed within 14 months and/or distant failure within 20 months had poorer subsequent survival. Concurrent chemotherapy provides a significant FFS benefit, primarily by reducing EDF, translating into a long-term OS benefit.

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