Cancer Research and Treatment

Original Articles

Head and Neck cancer

Long-term Survivals, Toxicities and the Role of Chemotherapy in Early-Stage Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy: A Retrospective Study with 15-Year Follow-up: Lin Wang, Jingjing Miao, Huageng Huang, Boyu Chen, Xiao Xiao, Manyi Zhu, Yingshan Liang, Weiwei Xiao, Shaomin Huang, Yinglin Peng, Xiaowu Deng, Xing Lv, Weixiong Xia, Yanqun Xiang, Xiang Guo, Fei Han, Chong Zhao; Cancer Res Treat. 2022;54(1):118-129. Published online June 7, 2021; DOI: https://doi.org/10.4143/crt.2021.101

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Purpose
This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients.
Materials and Methods
Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010.
Results
With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group.
Conclusion
Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.

Citations

Citations to this article as recorded by

Molecular Functions and Drug Prediction of MMP1 and TGFBR2 in Nasopharyngeal Carcinoma
Feng Wang, Binbin Ge, Ming Li, Xiaochun Xia, Fuming Zhang, Pengqin Xu
Journal of Clinical Laboratory Analysis.2026;[Epub] CrossRef
Primary endoscopic nasopharyngectomy for nasopharyngeal carcinoma: systematic review & meta-analysis
Siyuan Ding, Leo Li, Jenny Lee, Brian Mak, Christopher Liao, Andy Chan, Levina Li, Calvin Lai, Samuel Chow, Jason Chan, David Yeung
Frontiers in Surgery.2026;[Epub] CrossRef
TRAF4 promotes nasopharyngeal carcinoma progression by stabilizing SETDB1 to suppress mitochondrial apoptosis
Jing-Yuan Wang, Kai-Xue Wen, Shu-Xin Wen, Yu-Hao Zhang, Li-Xia Zhang, Tian Wang, Qiang-Wei Zhang
Molecular and Cellular Biochemistry.2026;[Epub] CrossRef
Prognostic Value of Cranial Nerve Invasion in T4‐Stage Nasopharyngeal Carcinoma: A Retrospective Cohort Study With a Median Follow‐Up of 136 Months
Cuidai Zhang, Hui Liu, Xuejia Liu, Yihao Ye, Zeman Cai, Zewei Chen, Qizhi Zheng
Health Science Reports.2026;[Epub] CrossRef
Biomimetic Cancer Cell Membrane-Coated Polymeric Nanogels as a Therapeutic Vaccine for Synergistic Photothermo-Chemo-Immunotherapy of Nasopharyngeal Carcinoma
Shanbin Wen, Yifan Huang, Xianghao Xiao, Cheng Ni, Ruiqi Ji, Jiahui Liu, Mingwu Shen, Xiangyang Shi
ACS Applied Materials & Interfaces.2026;[Epub] CrossRef
Retrospective analysis of 1539 nasopharyngeal carcinoma cases: chemotherapy should not be excluded for non-Asian patients with T1-2N1M0 stage
Xin-Yu Li, Chang-Ying Zhong, Hui-Xian Xu
Frontiers in Oncology.2025;[Epub] CrossRef
Genistein and chlorin E6-loaded versatile nanoformulation for remodeling the hypoxia-related tumor microenvironment and boosting photodynamic therapy in nasopharyngeal carcinoma treatment
Qiang Zhou, Quazi T. H. Shubhra, Peng Lai, Jiayi Shi, Chenhao Fang, Qian Guo, Wanqing Li, Rui Chen, Xinkun Shen, Lina Huang, Xiaojun Cai, Sen Lin
Advanced Composites and Hybrid Materials.2025;[Epub] CrossRef
Vaccine-Based Immunotherapy for Oropharyngeal and Nasopharyngeal Cancers
Daria Maria Filippini, Elisabetta Broseghini, Carlotta Liberale, Giulia Gallerani, Giambattista Siepe, Elisabetta Nobili, Manuela Ferracin, Gabriele Molteni
Journal of Clinical Medicine.2025; 14(4): 1170. CrossRef
Integrative analysis of taurine metabolism-related genes prognostic signature with immunotherapy and identification of ABCB1 and GORASP1 as key genes in nasopharyngeal carcinoma
Zhang Feng, Yuhang Yang, Wenqi Luo, Jinqing Li, Zhenlian Xie, Long Zuo, Meijiao Duan, Dongzhi Zuo, Ruwei MO, Xuejing Tang, Shijiang Yi, Xiaosong He, Fangxian Liu, Ning Ma, Feng He
Amino Acids.2025;[Epub] CrossRef
Sintilimab‑induced acute erosive hemorrhagic gastritis as an adverse reaction of third‑line therapy in a nasopharyngeal carcinoma patient: A case report
Wenqiang Tang, Yun Lv, Xiyue Yang, Kunyuan Gan, Gang Feng, Jie Li, Lu Ni, Yuxi Bai, Xiaobo Du, Feng Gao
Oncology Letters.2025; 30(1): 1. CrossRef
The Impact of Whole-Course Immunonutrition Management on Patients With Stage III and IV Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy: A Randomized Controlled Trial
Yuchen Hua, Shu Zhou, Weilin Xu, Yuandong Cao, Xinchen Sun, Menglin Chao, Minqiong Cheng, Yuanyuan Tang
Nutrition and Cancer.2025; 77(9): 1035. CrossRef
Efficacy of primary lesion re-irradiation in nasopharyngeal carcinoma with synchronous recurrence and distant metastasis
Qin Wang, Qi Yang, Zimeng Wang, Xiaotong Duan, Lan Peng, Rui You, Youping Liu, Shangbiao Li, Tianliang Xia, Mingyuan Chen, Peiyu Huang
Oral Oncology.2025; 170: 107743. CrossRef
Analysis of the application of 3D‐printed personalized positioning fixation in nasopharyngeal carcinoma radiotherapy
Zeyu Ding, Guo‐quan Li, Qi Liu, Xiaohui Zhu, Lin Tan, Jun Kang, Ye Wang, Zhiyong Yang, Jinghua Ren, Jun Han, Pinjing Cheng
Journal of Applied Clinical Medical Physics.2025;[Epub] CrossRef
Radiation oncology for the rhinologist
Helena Levyn, Fan Yang, Nancy Y. Lee
Current Opinion in Otolaryngology & Head & Neck Surgery.2024; 32(1): 5. CrossRef
Examining patient-reported late toxicity and its association with quality of life and unmet need for symptom management among nasopharyngeal cancer survivors: a cross-sectional survey
Victor C. W. Tam, Jerry C. F. Ching, Sindy S. T. Yip, Virginia H. Y. Kwong, Catherine P. L. Chan, Kenneth C. W. Wong, Shara W. Y. Lee
Frontiers in Oncology.2024;[Epub] CrossRef
Multifactorial clinical analysis of factors affecting necrosis of nasal septal mucosal flap after salvage surgery for recurrent nasopharyngeal carcinoma
Qilin Gong, Huaying Li, Hui Liu, Youyuan Shi
Scientific Reports.2024;[Epub] CrossRef
Long noncoding RNA LINC00173 induces radioresistance in nasopharyngeal carcinoma via inhibiting CHK2/P53 pathway
Jingjing Miao, Boyu Chen, Yunyun Xiao, Runda Huang, Xiao Xiao, Shunzhen Lu, Lu Zhang, Xuguang Wang, Ying Ouyang, Xiangfu Chen, Qiuyan Chen, Yanqun Xiang, Xiang Guo, Xiaowu Deng, Lin Wang, Haiqiang Mai, Chong Zhao
Cancer Gene Therapy.2023; 30(9): 1249. CrossRef
Therapeutic hyperthermia regulates complement C3 activation and suppresses tumor development through HSPA5/NFκB/CD55 pathway in nasopharyngeal carcinoma
Chengcong Chen, Anbang Ren, Qi Yi, Jiazuo Cai, Muhammad Khan, Yunen Lin, Zhong Huang, Jie Lin, Jian Zhang, Wei Liu, Anan Xu, Yunhong Tian, YaWei Yuan, Ronghui Zheng
Clinical and Experimental Immunology.2023; 213(2): 221. CrossRef
Immunotherapy for nasopharyngeal carcinoma: Current status and prospects (Review)
Huageng Huang, Yuyi Yao, Xinyi Deng, Zongyao Huang, Yungchang Chen, Zhao Wang, Huangming Hong, He Huang, Tongyu Lin
International Journal of Oncology.2023;[Epub] CrossRef
Quality of life and swallowing outcomes after early proactive swallowing rehabilitation by either transcutaneous neuromuscular electrical stimulation or exercise‐based swallowing training in patients with nasopharyngeal carcinoma after radiotherapy
Peter K. M. Ku, Alexander C. Vlantis, Rita W. M. Wong, Thomas S. C. Hui, Thomas Law, Louisa K. Y. Ng, Eddy W. Y. Wong, W. T. Chang, David R. Johnson, Florence S. T. Mok, K. H. Wong, Victor Abdullah, Andrew van Hasselt, Kathy Y. S. Lee, Michael C. F. Tong
Laryngoscope Investigative Otolaryngology.2023; 8(6): 1532. CrossRef
Prognostic nutritional index and serum lactate dehydrogenase predict the prognosis of nasopharyngeal carcinoma patients who received intensity-modulated radiation therapy
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A Systematic Review and Meta-Analysis of Studies Comparing Concurrent Chemoradiotherapy With Radiotherapy Alone in the Treatment of Stage II Nasopharyngeal Carcinoma
Yao-Can Xu, Kai-Hua Chen, Zhong-Guo Liang, Xiao-Dong Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
Minimally Invasive Surgery for Early-Stage Nasopharyngeal Carcinoma
Jinping Liu, Zesheng Zeng, Dingting Wang, Gang Qin
Journal of Craniofacial Surgery.2022; 33(8): e834. CrossRef
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Pui-Lam Yip, Shing-Fung Lee, Cheuk-Wai Horace Choi, Po-Chung Sunny Chan, Ka-Wai Alice Cheung, Chung-Hang James Chow, Ka-Man Cheung, Wing-Yu Jessica Lai, Ho-Fun Victor Lee, Ka-On Lam, Chi-Leung Chiang, Chun-Yin Edwin Wong, Ming-Chun Darren Poon, Macy Tong,
Cancers.2021; 13(17): 4286. CrossRef

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Reduction of Target Volume and the Corresponding Dose for the Tumor Regression Field after Induction Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma: Lei Wang, Zheng Wu, Dehuan Xie, Ruifang Zeng, Wanqin Cheng, Jiang Hu, Shaomin Huang, Shu Zhou, Rui Zhong, Yong Su; Cancer Res Treat. 2019;51(2):685-695. Published online August 13, 2018; DOI: https://doi.org/10.4143/crt.2018.250

Abstract PDF PubReader ePub

Purpose
This study aims to investigate the feasibility of contouring target volume according to residual tumor and decreasing the dose to the tumor regression field after induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (NPC).
Materials and Methods
From August 2009 to August 2013, patients with stage III–IVB NPC were treated with IC and concurrent chemoradiotherapy. Gross tumor volume of nasopharynx (GTVnx)–residual and gross tumor volume of cervical lymph node (GTVnd)–residual were contoured according to post-IC residual primary tumor and any N+ disease, respectively. The tumor regression field was included in CTVnx1/CTVnd1 and prescribed a dose of 60 Gy. Outcomes and toxicities of all patients were evaluated.
Results
A total of 57 patients were enrolled. At a median follow-up of 68 months, three cases displayed locoregional recurrence and one case showed both distant metastasis and locoregional recurrence. All locoregional recurrences were in the GTVnx-residual/GTVnd-residual and in-field. The 5-year overall, locoregional relapse-free, distant metastasis-free, and progression-free survival rates were 82.2%, 87.7%, 85.8% and 80.3%, respectively.
Conclusion
After IC, contouring of GTVnx-residual/GTVnd-residual as residual tumor volume and distribution 60 Gy ofradiation dose to the tumorregression field may be feasible and need further investigation.

Citations

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