- Head and Neck cancer
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Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx
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Heerim Nam, Yong Chan Ahn, Kyungmi Yang, Dongryul Oh, Jae Myoung Noh
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Cancer Res Treat. 2022;54(1):96-108. Published online March 26, 2021
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DOI: https://doi.org/10.4143/crt.2020.1349
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Abstract
PDFPubReaderePub
- Purpose
This study aimed to analyze the treatment outcomes of locally recurrent nasopharyngeal cancer (NPC) patients following moderate hypo-fractionation re-irradiation (re-RT).
Materials and Methods Sixty locally recurrent NPC patients underwent hypo-fractionation re-RT. Forty-eight point three percentage had rT3-4, and 30.0% did keratinizing squamous cell carcinoma. Intensity-modulated radiation therapy (IMRT), with or without intensity-modulated proton therapy (IMPT), was used in 66.7% of patients.
Results With the median follow-up of 22 months (range, 2 to 254 months), 31 patients (51.7%) died, 38 (63.3%) developed further treatment failure, and 30 (50.0%) developed ≥ grade 3 toxicity (including seven grade 5) at time of analysis. The 2- and 5-year rates of overall survival, local failure-free survival, and ≥ grade 3 toxicity-free survival were 57.9% and 45.8%, 64.1% and 52.5%, and 54.8% and 44.9%, respectively. In multivariate analyses, worse factors for overall survival (OS) were iT3-4 (p=0.010) and age at re-RT ≥ 53 years (p=0.003), those for local failure-free survival (LFFS) were rT3-4 (p=0.022) and rN0-1 (p=0.035), and those for toxicity-free survival (TFS) were iT3-4 (p=0.020) and re-IMRT/IMPT (p=0.030), respectively. Cumulative dose or fraction size ≥ 3 Gy at re-RT, however, showed no significance for OS, LFFS and TFS.
Conclusion Current re-RT with modern RT techniques by moderate hypo-fractionation scheme seemed feasible in treating locally recurrent NPC patients.
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Citations
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- Radiation oncology for the rhinologist
Helena Levyn, Fan Yang, Nancy Y. Lee Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(1): 5. CrossRef - Identifying the prognostic value of MRI-based tumor response and predicting the risk of radio-resistance in re-radiotherapy for locally recurrent nasopharyngeal carcinoma
Zi-Jian Lu, Ting Liu, Jie-Yi Lin, Sheng-Ting Pei, Ling Guo, Sai-Lan Liu, Hai-Qiang Mai Radiotherapy and Oncology.2023; 183: 109635. CrossRef - Low-dose radiotherapy effects the progression of anti-tumor response
Lei Gao, Anqi Zhang Translational Oncology.2023; 35: 101710. CrossRef - The Role of Hypofractionation in Proton Therapy
Alexandre Santos, Scott Penfold, Peter Gorayski, Hien Le Cancers.2022; 14(9): 2271. CrossRef - Toxicity Profiles and Survival Outcomes Among Patients With Nonmetastatic Nasopharyngeal Carcinoma Treated With Intensity-Modulated Proton Therapy vs Intensity-Modulated Radiation Therapy
Xingzhe Li, Sarin Kitpanit, Anna Lee, Dennis Mah, Kevin Sine, Eric J. Sherman, Lara A. Dunn, Loren S. Michel, James Fetten, Kaveh Zakeri, Yao Yu, Linda Chen, Jung Julie Kang, Daphna Y. Gelblum, Sean M. McBride, Chiaojung J. Tsai, Nadeem Riaz, Nancy Y. Lee JAMA Network Open.2021; 4(6): e2113205. CrossRef
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- Hematologic malignancy
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Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma
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Jong Yun Baek, Do Hoon Lim, Dongryul Oh, Heerim Nam, Jae J Kim, Jun Haeng Lee, Byung-Hoon Min, Hyuk Lee
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Cancer Res Treat. 2022;54(1):294-300. Published online April 1, 2021
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DOI: https://doi.org/10.4143/crt.2021.073
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Abstract
PDFSupplementary MaterialPubReaderePub
- Purpose
This study aimed to evaluate the effect of radiotherapy (RT) on the risk of diabetes by assessing hemoglobin A1c (HbA1c) levels in patients with gastroduodenal indolent lymphoma.
Materials and Methods This retrospective study included patients with stage I extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue or follicular lymphoma of the gastroduodenal region who were treated with Helicobacter pylori eradication and/or RT between 2000 and 2019 in our institution. Of total 79 patients with HbA1c test, 17 patients received RT (RT group), while 62 patients did not receive RT (control group). A diabetes-associated event (DAE) was defined as a ≥ 0.5% increase in HbA1c levels from baseline, and diabetes event (DE) were defined as HbA1c level of ≥ 6.5%.
Results During the median follow-up of 49 months, no local failure occurred after RT and no patients died of lymphoma. The RT group had significantly higher risk for DAEs on univariable analysis (hazard ratio [HR], 4.18; 95% confidence interval [CI], 1.64 to 10.66; p < 0.01) and multivariable analysis (HR, 3.68; 95% CI, 1.42 to 9.56; p=0.01). Further, the DE risk was significantly higher in the RT group than in the control group (HR, 4.32; 95% CI, 1.08 to 17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR, 35.83; 95% CI, 2.80 to 459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR, 4.55; 95% CI, 1.08 to 19.19; p=0.04), even after adjusting baseline HbA1c level (HR, 40.97; 95% CI, 3.06 to 548.01; p=0.01).
Conclusion Patients who received RT for gastroduodenal indolent lymphoma had an increased risk of diabetes compared to those who did not.
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- CHARACTERISTICS OF ENDOCRINE COMPONENT OF PANCREAS AFTER ADMINISTRATION OF N-ACETYLCYSTEINE IN THE MODEL OF ACUTE RADIATION-INDUCED PANCREATITIS
Grigoriy Aleksandrovich Demyashkin, Dali Ibragimovna Ugurchieva, Vladislav Andreevich Yakimenko, Matvey Anatol'evich Vadyukhin Ulyanovsk Medico-biological Journal.2024; (2): 166. CrossRef - ASSESSMENT OF THE INFLAMMATORY RESPONSE IN THE PANCREAS AFTER ADMINISTRATION OF N-ACETYL CYSTEINE IN A MODEL OF POST-RADIATION PANCREATITIS
G.A. Demyashkin, D.A. Atyakshin, D.I. Ugurchieva, V.A. Yakimenko, M.A. Vadyukhin, S.N. Koryakin Molekulyarnaya Meditsina (Molecular medicine).2024; : 58. CrossRef - Lactobacillus gasseriCKCC1913 mediated modulation of the gut–liver axis alleviated insulin resistance and liver damage induced by type 2 diabetes
Shuaiming Jiang, Aijie Liu, Wenyao Ma, Xinlei Liu, Pengfei Luo, Meng Zhan, Xiaoli Zhou, Lihao Chen, Jiachao Zhang Food & Function.2023; 14(18): 8504. CrossRef - Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
Reynalda Cordova, Vivian Viallon, Emma Fontvieille, Laia Peruchet-Noray, Anna Jansana, Karl-Heinz Wagner, Cecilie Kyrø, Anne Tjønneland, Verena Katzke, Rashmita Bajracharya, Matthias B. Schulze, Giovanna Masala, Sabina Sieri, Salvatore Panico, Fulvio Ricc The Lancet Regional Health - Europe.2023; 35: 100771. CrossRef - Risk of Diabetes Mellitus after Radiotherapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
Joongyo Lee, Hong In Yoon, Jihun Kim, Jaeho Cho, Kyung Hwan Kim, Chang-Ok Suh Cancers.2022; 14(17): 4110. CrossRef
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Feasibility of Selective Neck Irradiation with Lower Elective Radiation Dose in Treating Nasopharynx Cancer Patients
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Won Kyung Cho, Dongryul Oh, Eonju Lee, Tae Gyu Kim, Hyebin Lee, Heerim Nam, Jae Myoung Noh, Yong Chan Ahn
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Cancer Res Treat. 2019;51(2):603-610. Published online July 18, 2018
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DOI: https://doi.org/10.4143/crt.2018.240
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Abstract
PDFPubReaderePub
- Purpose
This study aimed to report the clinical outcomes following selective neck irradiation (SNI) with lower elective radiation therapy (RT) dose in treating nasopharyngeal cancer (NPC) patients.
Materials and Methods
A total of 347 NPC patients received definitive RT according to our SNI policy and were retrospectively analyzed. The clinical target volumes (CTVs) were subdivided into CTV at high risk (CTV-HR) and CTV at low risk (CTV-LR). The typical doses to gross tumor volume (GTV), CTV-HR, and CTV-LR were 68.4-70.0 Gy, 54.0-60.0 Gy, and 36.0 Gy.
Results
With the median follow-up of 68.1 months (range, 2.3 to 197.1 months), the 5-year rates of loco-regional control and progression-free survival in all the patients were 85.0% and 70.8%, respectively. Thirty patients developed regional failure and the regional control rates at 3 and 5 years were 92.6% and 91.4%, respectively. The sites of regional failure in relation to the target volume were exclusively inside GTV/CTV-HR in 20, inside and outside GTV/CTVHR in three, and exclusively outside GTV/CTV-HR in seven, which were 5.7%, 0.9%, and 2.0% of total patients, respectively.
Conclusion
The clinical outcomes by the current SNI policy were feasible and comparable to those following classic elective nodal irradiation policy.
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Kangpyo Kim, Yong Chan Ahn International Journal of Radiation Oncology*Biology*Physics.2024; 118(1): 308. CrossRef - Optimizing Cervical Target Volume in Patients with Nasopharyngeal Cancer Based On Nodal Drainage Distance
Yang Liu, Wenbin Yan, Chaosu Hu, Xiaodong Huang, Kai Wang, Yuan Qu, Xuesong Chen, Runye Wu, Ye Zhang, Jianghu Zhang, Jingwei Luo, Yexiong Li, Jingbo Wang, Junlin Yi Clinical Cancer Research.2024; 30(9): 1801. CrossRef - Dosimetric Comparison and Selection Criteria of Intensity-Modulated Proton Therapy and Intensity-Modulated Radiation Therapy for Adaptive Re-Plan in T3-4 Nasopharynx Cancer Patients
Mincheol Ko, Kyungmi Yang, Yong Chan Ahn, Sang Gyu Ju, Dongryul Oh, Yeong-bi Kim, Dong Yeol Kwon, Seyjoon Park, Kisung Lee Cancers.2024; 16(19): 3402. CrossRef - Less is more: level IB-sparing radiation therapy in nasopharyngeal cancer
Dongryul Oh Radiation Oncology Journal.2023; 41(1): 1. CrossRef - Dose and volume de-escalation of radiotherapy in head and neck cancer
MJ García-Anaya, S. Segado-Guillot, J. Cabrera-Rodríguez, MD Toledo-Serrano, JA Medina-Carmona, J. Gómez-Millán Critical Reviews in Oncology/Hematology.2023; 186: 103994. CrossRef - Can Definitive Radiation Therapy Substitute Surgical Resection in Locally Advanced T3 or T4 Sinonasal Squamous Cell Carcinoma?
Kangpyo Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Han-Sin Jeong, Man Ki Chung, Sang Duk Hong, Chung-Hwan Baek International Journal of Radiation Oncology*Biology*Physics.2023; 117(4): 893. CrossRef - Progress in the comprehensive treatment of nasopharyngeal carcinoma: a review for risk-stratified management strategies
Yang Liu, Ziou Du, Shiyu Song, Junlin Yi Holistic Integrative Oncology.2023;[Epub] CrossRef - Involved site radiation therapy in stage I-III nasopharyngeal carcinoma with limited lymph node burden (ISRT-NPC) or elective region irradiation: a study protocol for a multicenter non-inferiority randomized controlled phase III clinical trial
Yang Liu, Yaqian Han, Feng Liu, Desheng Hu, Zhijian Chen, Peiguo Wang, Jingao Li, Jiyong Qin, Feng Jin, Yexiong Li, Jingbo Wang, Junlin Yi BMC Cancer.2023;[Epub] CrossRef - The Metabolic Footprint of Systemic Effects in the Blood Caused by Radiotherapy and Inflammatory Conditions: A Systematic Review
Karol Jelonek, Katarzyna Mrowiec, Dorota Gabryś, Piotr Widłak Metabolites.2023; 13(9): 1000. CrossRef - Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment
Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn Cancer Research and Treatment.2022; 54(1): 84. CrossRef - Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx
Heerim Nam, Yong Chan Ahn, Kyungmi Yang, Dongryul Oh, Jae Myoung Noh Cancer Research and Treatment.2022; 54(1): 96. CrossRef - Risk of Stroke in Nasopharyngeal Cancer Survivors
Teng Hwee Tan, Huili Zheng, Timothy Cheo, Jeremy Tey, Yu Yang Soon Neurology.2022;[Epub] CrossRef - High Superior-Middle Pharyngeal Constrictor Muscle Mean Dose Correlates with Severe Late Lung Infection and Survival in Nasopharyngeal Cancer Patients
Wen-Shan Liu, Ju-Chun Chien, Yu-Hsien Huang, Po-Chun Chen, Wei-Lun Huang, Shao-Wei Chiang, Ching-Chih Lee, Bor-Hwang Kang, Yu-Chang Hu Cancer Management and Research.2022; Volume 14: 1063. CrossRef - Simultaneous Reduction of Volume and Dose in Clinical Target Volume for Nasopharyngeal Cancer Patients
Wen-Shan Liu, Kuo-Wang Tsai, Bor-Hwang Kang, Ching-Chieh Yang, Wei-Lun Huang, Ching-Chih Lee, Yu-Chang Hu, Kuo-Ping Chang, Hsiu-Min Chen, Yaoh-Shiang Lin International Journal of Radiation Oncology*Biology*Physics.2021; 109(2): 495. CrossRef - Clinical features of post-radiation nasopharyngeal necrosis and their outcomes following surgical intervention in nasopharyngeal cancer patients
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Wai Tong Ng, Raymond K. Y. Tsang, Jonathan J. Beitler, Remco de Bree, Andrés Coca‐Pelaz, Avraham Eisbruch, Orlando Guntinas‐Lichius, Anne W. M. Lee, Antti A. Mäkitie, William M. Mendenhall, Sandra Nuyts, Alessandra Rinaldo, K. Thomas Robbins, Juan P. Rodr Head & Neck.2021; 43(6): 1949. CrossRef - Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area
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Johannes H.A.M. Kaanders, Sven van den Bosch, Tim Dijkema, Abrahim Al-Mamgani, Cornelis P.J. Raaijmakers, Wouter V. Vogel Radiotherapy and Oncology.2020; 148: 140. CrossRef - Early clinical outcomes of helical tomotherapy/intensity‐modulated proton therapy combination in nasopharynx cancer
Seung Gyu Park, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Sang Gyu Ju, Dongyeol Kwon, Kwanghyun Jo, Kwangzoo Chung, Eunah Chung, Woojin Lee, Seyjoon Park Cancer Science.2019; 110(9): 2867. CrossRef
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Salvage Concurrent Chemo-radiation Therapy for Loco-regional Recurrence Following Curative Surgery of Non-small Cell Lung Cancer
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Kyung Hwa Lee, Yong Chan Ahn, Hongryull Pyo, Jae Myoung Noh, Seung Gyu Park, Tae Gyu Kim, Eonju Lee, Heerim Nam, Hyebin Lee, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park
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Cancer Res Treat. 2019;51(2):769-776. Published online September 11, 2018
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DOI: https://doi.org/10.4143/crt.2018.366
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Abstract
PDFPubReaderePub
- Purpose
This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer.
Materials and Methods
Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course.
Results
The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade ≥ 3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) (≥ 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV (≤ 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs. ≤ 1 year; HR, 0.489) were significantly favorable factors for OS.
Conclusion
The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED10, smaller CTV, and longer disease-free interval were favorable factors for improved survival.
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Yoichi Ohtaki, Toshiteru Nagashima, Naoko Okano, Nobuteru Kubo, Takeru Ohtaka, Noriaki Sunaga, Reiko Sakurai, Yosuke Miura, Seshiru Nakazawa, Natsuko Kawatani, Tomohiro Yazawa, Ryohei Yoshikawa, Eiji Narusawa, Ken Shirabe Thoracic Cancer.2024; 15(11): 859. CrossRef - Durvalumab after chemoradiotherapy for locoregional recurrence of completely resected non–small‐cell lung cancer (NEJ056)
Megumi Furuta, Hidehito Horinouchi, Isao Yokota, Teppei Yamaguchi, Shoichi Itoh, Takafumi Fukui, Akira Iwashima, Jun Sugisaka, Yu Miura, Hisashi Tanaka, Taichi Miyawaki, Hiroshi Yokouchi, Keita Miura, Ryota Saito, Go Saito, Tatsuhiko Kamoshida, Yusuke Uch Cancer Science.2024; 115(11): 3705. CrossRef - Impact of lymphadenectomy extent on immunotherapy efficacy in post-resectional recurred non-small cell lung cancer: a multi-institutional retrospective cohort study
Hongsheng Deng, Juan Zhou, Hualin Chen, Xiuyu Cai, Ran Zhong, Feng Li, Bo Cheng, Caichen Li, Qingzhu Jia, Caicun Zhou, René Horsleben Petersen, Gaetano Rocco, Alex Brunelli, Calvin S.H. Ng, Thomas A. D’Amico, Chunxia Su, Jianxing He, Wenhua Liang, Bo Zhu International Journal of Surgery.2023;[Epub] CrossRef - Treatment patterns and survival of patients with locoregional recurrence in early-stage NSCLC: a literature review of real-world evidence
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NaiBin Chen, QiWen Li, SiYu Wang, Mai Xiong, YiFeng Luo, Bin Wang, Li Chen, MaoSheng Lin, XiaoBo Jiang, JianLan Fang, SuPing Guo, JinYu Guo, Nan Hu, XinLei Ai, DaQuan Wang, Chu Chu, FangJie Liu, Hao Long, JunYe Wang, Bo Qiu, Hui Liu Lung Cancer.2021; 156: 82. CrossRef - Salvage radiation therapy for postoperative locoregionally recurrent non-small cell lung cancer: a single-center experience
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Tumor Volume Reduction Rate during Adaptive Radiation Therapy as a Prognosticator for Nasopharyngeal Cancer
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Hyebin Lee, Yong Chan Ahn, Dongryul Oh, Heerim Nam, Jae Myoung Noh, Su Yeon Park
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Cancer Res Treat. 2016;48(2):537-545. Published online July 14, 2015
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DOI: https://doi.org/10.4143/crt.2015.081
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Abstract
PDFPubReaderePub
- Purpose
The purpose of this study is to evaluate the prognostic significance of the tumor volume reduction rate (TVRR) measured during adaptive definitive radiation therapy (RT) for nasopharyngeal cancer (NPC).
Materials and Methods
We reviewed the RT records of 159 NPC patients treated with definitive RT with or without concurrent chemotherapy between January 2006 and February 2013. Adaptive re-planning was performed in all patients at the third week of RT. The pre- and mid-RT gross tumor volumes (GTVs) of the primary tumor and the metastatic lymph nodes were measured and analyzed for prognostic implications.
Results
After a median follow-up period of 41.5 months (range, 11.2 to 91.8 months) for survivors, there were 43 treatment failures. The overall survival and progression-free survival (PFS) rates at 5 years were 89.6% and 69.7%, respectively. The mean pre-RT GTV, mid-RT GTV, and TVRR were 45.9 cm3 (range, 1.5 to 185.3 cm3), 26.7 cm3 (1.0 to 113.8 cm3), and –41.9% (range, –87% to 78%), respectively. Patients without recurrence had higher TVRR than those with recurrence (44.3% in the no recurrence group vs. 34.0% in the recurrence group, p=0.004), and those with TVRR > 35% achieved a significantly higher rate of PFS at 5 years (79.2% in TVRR > 35% vs. 53.2% in TVRR ≤ 35%; p < 0.001). In multivariate analysis, TVRR was a significant factor affecting PFS (hazard ratio, 2.877; 95% confidence interval, 1.555 to 5.326; p=0.001).
Conclusion
TVRR proved to be a significant prognostic factor in NPC patients treated with definitive RT, and could be used as a potential indicator for early therapeutic modification during the RT course.
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