Hongru Yang1, Xin Chen2, Sheng Lin3, Jinfeng Rong4, Mi Yang5, Qinglian Wen3, Changling Shang3, Lijia He3, Peirong Ren3, Shan Xu3, Jianwen Zhang3, Qiaoli Liu3, Haowen Pang3, Xiangxiang Shi3, Juan Fan3, Xiaoyang Sun3, Daiyuan Ma6, Bangxian Tan6, Tao Zhang7, Ling Zhang7, Defeng Hu7, Xiaobo Du8, Yu Zhang8, Shiming Wen9, Xinping Zhang9, Jingbo Wu10. 1. Chongqing Medical University, China; Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou, China. 2. Department of Oncology, the Second People's Hospital of Yibin, China. 3. Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou, China. 4. Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Oncology, the Second People's Hospital of Yibin, China. 5. Department of Oncology, Nanchong Central Hospital, China; Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou, China. 6. Department of Oncology, the Affiliated Hospital of North Sichuan Medical College, China. 7. Department of Oncology, Chendu Military General Hospital, China. 8. Department of Oncology, Mianyang Central Hospital, China. 9. Department of Oncology, Nanchong Central Hospital, China. 10. Chongqing Medical University, China; Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou, China. Electronic address: wjb6147@163.com.
Abstract
PURPOSE: To investigate whether reducing the target volume of intensity-modulated radiotherapy (IMRT) after induction chemotherapy (IC) improves the quality of life (QOL) in locoregionally advanced nasopharyngeal carcinoma (NPC) without decreasing the local control and survival rate. PATIENTS AND METHODS: A total number of 212 NPC patients staged as III-IVb were randomly assigned to group A (n=97) or group B (n=115) in this prospective clinical trial. All patients received IC followed by cisplatin concurrent with IMRT. IMRT was planned using the images of pre-IC in group A and post-IC in group B. RESULTS: The dose received by normal tissues in group B was lower than that of group A (P<0.05). The recovery of the dry mouth symptoms in group B was significantly improved than group B. The quality of life (QOL) scores in group B were higher than group A. With a median follow-up of 35months, the 1-year estimated overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS) in group A versus group B were 97.9% vs 97.3%, 90.7% vs 92,2%, 99.0% vs 98.2%, 91.8% vs 94.8%. The 2-year OS, PFS, LRFFS, DMFS in group A versus group B were 93.7% vs 92.9%, 83.4% vs 84.3%, 96.8% vs 95.5%, 86.5% vs 89.5%. The 3-year OS, PFS, LRFFS, DMFS in group A versus group B were 82.3% vs 87%, 74.7% vs 83.4%, 91.8 vs 93.9%, 81.3% vs 88.6%, respectively. CONCLUSION: Reducing the IMRT target volume after IC did not reduce the local control and survival rate in locoregionally advanced NPC but the doses received by normal tissues were decreased, and the QOL scores were improved.
RCT Entities:
PURPOSE: To investigate whether reducing the target volume of intensity-modulated radiotherapy (IMRT) after induction chemotherapy (IC) improves the quality of life (QOL) in locoregionally advanced nasopharyngeal carcinoma (NPC) without decreasing the local control and survival rate. PATIENTS AND METHODS: A total number of 212 NPC patients staged as III-IVb were randomly assigned to group A (n=97) or group B (n=115) in this prospective clinical trial. All patients received IC followed by cisplatin concurrent with IMRT. IMRT was planned using the images of pre-IC in group A and post-IC in group B. RESULTS: The dose received by normal tissues in group B was lower than that of group A (P<0.05). The recovery of the dry mouth symptoms in group B was significantly improved than group B. The quality of life (QOL) scores in group B were higher than group A. With a median follow-up of 35months, the 1-year estimated overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS) in group A versus group B were 97.9% vs 97.3%, 90.7% vs 92,2%, 99.0% vs 98.2%, 91.8% vs 94.8%. The 2-year OS, PFS, LRFFS, DMFS in group A versus group B were 93.7% vs 92.9%, 83.4% vs 84.3%, 96.8% vs 95.5%, 86.5% vs 89.5%. The 3-year OS, PFS, LRFFS, DMFS in group A versus group B were 82.3% vs 87%, 74.7% vs 83.4%, 91.8 vs 93.9%, 81.3% vs 88.6%, respectively. CONCLUSION: Reducing the IMRT target volume after IC did not reduce the local control and survival rate in locoregionally advanced NPC but the doses received by normal tissues were decreased, and the QOL scores were improved.
Authors: Joshua Giambattista; Nevin McVicar; Sarah Hamilton; Montgomery Martin; Benjamin Maas; Cheryl Ho; Jonn Wu; Eric Tran; John Hay; Eric Berthelet Journal: Cureus Date: 2018-09-13
Authors: Prashant Gabani; Justin Barnes; Alexander J Lin; Soumon Rudra; Peter Oppelt; Douglas Adkins; Jason T Rich; Jose P Zevallos; Mackenzie D Daly; Hiram A Gay; Wade L Thorstad Journal: Cancer Med Date: 2018-07-14 Impact factor: 4.452