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Induction Chemotherapy Followed by Chemo-intensity-modulated Radiotherapy for Locally Advanced Nasopharyngeal Cancer.

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Chemo-intensity-modulated radiotherapy (chemo-IMRT) for locally advanced nasopharyngeal cancer (LA-NPC) shows feasibility and good survival rates. However, 31% of patients experience significant xerostomia one year post-treatment.

Keywords:
ChemoradiotherapyIMRTnasopharyngeal cancerradiotherapysequential

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Head and Neck Cancer

Background:

  • Locally advanced nasopharyngeal cancer (LA-NPC) requires effective treatment strategies.
  • Intensity-modulated radiotherapy (IMRT) combined with chemotherapy (chemo-IMRT) is a standard approach.
  • Assessing toxicity and tumor control is crucial for treatment optimization.

Purpose of the Study:

  • To evaluate the toxicity profile of chemo-IMRT in LA-NPC patients.
  • To determine the tumor control rates achieved with this treatment modality.
  • To assess survival outcomes following chemo-IMRT for LA-NPC.

Main Methods:

  • A prospective trial involving patients with LA-NPC.
  • Induction chemotherapy followed by parotid-sparing chemo-IMRT.
  • Radiation doses: 65 Gy (primary/involved nodes), 54 Gy (at-risk nodes).
  • Primary endpoint: incidence of ≥grade 2 subjective xerostomia.

Main Results:

  • 42 patients completed treatment; median follow-up of 32 months.
  • High acute toxicities observed: dysphagia (83%), xerostomia (76%), mucositis (97%).
  • At 12 months, ≥grade 2 subjective xerostomia was 31%; locoregional control was 86.2% at 2 years.
  • Two-year progression-free survival was 78.4%; overall survival was 85.9%.

Conclusions:

  • Chemo-IMRT is a feasible treatment for LA-NPC.
  • The treatment demonstrates promising survival outcomes.
  • Significant xerostomia remains a notable toxicity at one year post-treatment.