Treatment outcomes after reduction of the target volume of intensity-modulated radiotherapy following induction chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A prospective, multi-center, randomized clinical trial
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. A total number of 212 NP...
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| Veröffentlicht in: | Radiotherapy and oncology 2018-01, Vol.126 (1), p.37-42 |
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| creator | Yang, Hongru Chen, Xin Lin, Sheng Rong, Jinfeng Yang, Mi Wen, Qinglian Shang, Changling He, Lijia Ren, Peirong Xu, Shan Zhang, Jianwen Liu, Qiaoli Pang, Haowen Shi, Xiangxiang Fan, Juan Sun, Xiaoyang Ma, Daiyuan Tan, Bangxian Zhang, Tao Zhang, Ling Hu, Defeng Du, Xiaobo Zhang, Yu Wen, Shiming Zhang, Xinping Wu, Jingbo |
| description | 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.
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.
The dose received by normal tissues in group B was lower than that of group A (P |
| doi_str_mv | 10.1016/j.radonc.2017.07.020 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2017.07.020</identifier><identifier>PMID: 28864073</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adult ; Aged ; Antineoplastic Agents - administration & dosage ; Carcinoma - drug therapy ; Carcinoma - pathology ; Carcinoma - radiotherapy ; Chemoradiotherapy ; Cisplatin - administration & dosage ; Concurrent chemoradiotherapy (CRT) ; Disease-Free Survival ; Dose-Response Relationship, Radiation ; Female ; Humans ; Induction Chemotherapy ; Induction chemotherapy (IC) ; Intensity-modulated radiation therapy (IMRT) ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal carcinoma (NPC) ; Nasopharyngeal Neoplasms - drug therapy ; Nasopharyngeal Neoplasms - pathology ; Nasopharyngeal Neoplasms - radiotherapy ; Neoplasm Staging ; Prospective Studies ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Intensity-Modulated - methods ; Survival Rate ; Target delineation ; Treatment Outcome</subject><ispartof>Radiotherapy and oncology, 2018-01, Vol.126 (1), p.37-42</ispartof><rights>2017 Elsevier B.V.</rights><rights>Copyright © 2017 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-dbc913c06e83bc71e8ce44ed3f4c36e32e6c1ebcf3b01ecf7ffddc118481dd293</citedby><cites>FETCH-LOGICAL-c362t-dbc913c06e83bc71e8ce44ed3f4c36e32e6c1ebcf3b01ecf7ffddc118481dd293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.radonc.2017.07.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28864073$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Hongru</creatorcontrib><creatorcontrib>Chen, Xin</creatorcontrib><creatorcontrib>Lin, Sheng</creatorcontrib><creatorcontrib>Rong, Jinfeng</creatorcontrib><creatorcontrib>Yang, Mi</creatorcontrib><creatorcontrib>Wen, Qinglian</creatorcontrib><creatorcontrib>Shang, Changling</creatorcontrib><creatorcontrib>He, Lijia</creatorcontrib><creatorcontrib>Ren, Peirong</creatorcontrib><creatorcontrib>Xu, Shan</creatorcontrib><creatorcontrib>Zhang, Jianwen</creatorcontrib><creatorcontrib>Liu, Qiaoli</creatorcontrib><creatorcontrib>Pang, Haowen</creatorcontrib><creatorcontrib>Shi, Xiangxiang</creatorcontrib><creatorcontrib>Fan, Juan</creatorcontrib><creatorcontrib>Sun, Xiaoyang</creatorcontrib><creatorcontrib>Ma, Daiyuan</creatorcontrib><creatorcontrib>Tan, Bangxian</creatorcontrib><creatorcontrib>Zhang, Tao</creatorcontrib><creatorcontrib>Zhang, Ling</creatorcontrib><creatorcontrib>Hu, Defeng</creatorcontrib><creatorcontrib>Du, Xiaobo</creatorcontrib><creatorcontrib>Zhang, Yu</creatorcontrib><creatorcontrib>Wen, Shiming</creatorcontrib><creatorcontrib>Zhang, Xinping</creatorcontrib><creatorcontrib>Wu, Jingbo</creatorcontrib><title>Treatment outcomes after reduction of the target volume of intensity-modulated radiotherapy following induction chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A prospective, multi-center, randomized clinical trial</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>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.
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.
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.
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Carcinoma - drug therapy</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma - radiotherapy</subject><subject>Chemoradiotherapy</subject><subject>Cisplatin - administration & dosage</subject><subject>Concurrent chemoradiotherapy (CRT)</subject><subject>Disease-Free Survival</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Female</subject><subject>Humans</subject><subject>Induction Chemotherapy</subject><subject>Induction chemotherapy (IC)</subject><subject>Intensity-modulated radiation therapy (IMRT)</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nasopharyngeal Carcinoma</subject><subject>Nasopharyngeal carcinoma (NPC)</subject><subject>Nasopharyngeal Neoplasms - drug therapy</subject><subject>Nasopharyngeal Neoplasms - pathology</subject><subject>Nasopharyngeal Neoplasms - radiotherapy</subject><subject>Neoplasm Staging</subject><subject>Prospective Studies</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>Survival Rate</subject><subject>Target delineation</subject><subject>Treatment Outcome</subject><issn>0167-8140</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1r3DAQhk1pabZp_0EpOvYQbyXbteUeCiH0CwK9pGehHY13tejDleQN2x_ec2fZJMfCgEA8884781bVW8HXgov-w36dtIkB1g0Xw5pTNfxZtRJyGGsu5fC8WhE21FJ0_KJ6lfOec0La4WV10UjZd3xoV9Xfu4S6eAyFxaVA9JiZngomltAsUGwMLE6s7JAVnbZY2CG6xePp04aCIdtyrH00i9MFDSNPNhKd9HxkU3Qu3tuwJfRRDHbonwAb2KyLpemZ3duyYy5CTLglUDt3ZNocdACSDTrHeafTMWxROwY6gQ3R60_sms0p5hlJ_YBXzC-u2BpIEdMVuQkmevuHFMDZYIF6S7Lava5eTNplfPPwXla_vn65u_le3_789uPm-raGtm9KbTYwihZ4j7LdwCBQAnYdmnbqCMC2wR4EbmBqN1wgTMM0GQNCyE4KY5qxvazen3XJ5O8Fc1HeZkDndMC4ZCXGthf9x3GUhHZnFGifnHBSc7KeVlaCq1Piaq_OiatT4opTUZyX1buHCcvGo3lqeoyYgM9nAGnPg8WkMtDF6ao20dWUifb_E_4BdpbJsg</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Yang, Hongru</creator><creator>Chen, Xin</creator><creator>Lin, Sheng</creator><creator>Rong, Jinfeng</creator><creator>Yang, Mi</creator><creator>Wen, Qinglian</creator><creator>Shang, Changling</creator><creator>He, Lijia</creator><creator>Ren, Peirong</creator><creator>Xu, Shan</creator><creator>Zhang, Jianwen</creator><creator>Liu, Qiaoli</creator><creator>Pang, Haowen</creator><creator>Shi, Xiangxiang</creator><creator>Fan, Juan</creator><creator>Sun, Xiaoyang</creator><creator>Ma, Daiyuan</creator><creator>Tan, Bangxian</creator><creator>Zhang, Tao</creator><creator>Zhang, Ling</creator><creator>Hu, Defeng</creator><creator>Du, Xiaobo</creator><creator>Zhang, Yu</creator><creator>Wen, Shiming</creator><creator>Zhang, Xinping</creator><creator>Wu, Jingbo</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201801</creationdate><title>Treatment outcomes after reduction of the target volume of intensity-modulated radiotherapy following induction chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A prospective, multi-center, randomized clinical trial</title><author>Yang, Hongru ; Chen, Xin ; Lin, Sheng ; Rong, Jinfeng ; Yang, Mi ; Wen, Qinglian ; Shang, Changling ; He, Lijia ; Ren, Peirong ; Xu, Shan ; Zhang, Jianwen ; Liu, Qiaoli ; Pang, Haowen ; Shi, Xiangxiang ; Fan, Juan ; Sun, Xiaoyang ; Ma, Daiyuan ; Tan, Bangxian ; Zhang, Tao ; Zhang, Ling ; Hu, Defeng ; Du, Xiaobo ; Zhang, Yu ; Wen, Shiming ; Zhang, Xinping ; Wu, Jingbo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-dbc913c06e83bc71e8ce44ed3f4c36e32e6c1ebcf3b01ecf7ffddc118481dd293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Carcinoma - drug therapy</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma - radiotherapy</topic><topic>Chemoradiotherapy</topic><topic>Cisplatin - administration & dosage</topic><topic>Concurrent chemoradiotherapy (CRT)</topic><topic>Disease-Free Survival</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Female</topic><topic>Humans</topic><topic>Induction Chemotherapy</topic><topic>Induction chemotherapy (IC)</topic><topic>Intensity-modulated radiation therapy (IMRT)</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nasopharyngeal Carcinoma</topic><topic>Nasopharyngeal carcinoma (NPC)</topic><topic>Nasopharyngeal Neoplasms - drug therapy</topic><topic>Nasopharyngeal Neoplasms - pathology</topic><topic>Nasopharyngeal Neoplasms - radiotherapy</topic><topic>Neoplasm Staging</topic><topic>Prospective Studies</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>Survival Rate</topic><topic>Target delineation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Hongru</creatorcontrib><creatorcontrib>Chen, Xin</creatorcontrib><creatorcontrib>Lin, Sheng</creatorcontrib><creatorcontrib>Rong, Jinfeng</creatorcontrib><creatorcontrib>Yang, Mi</creatorcontrib><creatorcontrib>Wen, Qinglian</creatorcontrib><creatorcontrib>Shang, Changling</creatorcontrib><creatorcontrib>He, Lijia</creatorcontrib><creatorcontrib>Ren, Peirong</creatorcontrib><creatorcontrib>Xu, Shan</creatorcontrib><creatorcontrib>Zhang, Jianwen</creatorcontrib><creatorcontrib>Liu, Qiaoli</creatorcontrib><creatorcontrib>Pang, Haowen</creatorcontrib><creatorcontrib>Shi, Xiangxiang</creatorcontrib><creatorcontrib>Fan, Juan</creatorcontrib><creatorcontrib>Sun, Xiaoyang</creatorcontrib><creatorcontrib>Ma, Daiyuan</creatorcontrib><creatorcontrib>Tan, Bangxian</creatorcontrib><creatorcontrib>Zhang, Tao</creatorcontrib><creatorcontrib>Zhang, Ling</creatorcontrib><creatorcontrib>Hu, Defeng</creatorcontrib><creatorcontrib>Du, Xiaobo</creatorcontrib><creatorcontrib>Zhang, Yu</creatorcontrib><creatorcontrib>Wen, Shiming</creatorcontrib><creatorcontrib>Zhang, Xinping</creatorcontrib><creatorcontrib>Wu, Jingbo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Hongru</au><au>Chen, Xin</au><au>Lin, Sheng</au><au>Rong, Jinfeng</au><au>Yang, Mi</au><au>Wen, Qinglian</au><au>Shang, Changling</au><au>He, Lijia</au><au>Ren, Peirong</au><au>Xu, Shan</au><au>Zhang, Jianwen</au><au>Liu, Qiaoli</au><au>Pang, Haowen</au><au>Shi, Xiangxiang</au><au>Fan, Juan</au><au>Sun, Xiaoyang</au><au>Ma, Daiyuan</au><au>Tan, Bangxian</au><au>Zhang, Tao</au><au>Zhang, Ling</au><au>Hu, Defeng</au><au>Du, Xiaobo</au><au>Zhang, Yu</au><au>Wen, Shiming</au><au>Zhang, Xinping</au><au>Wu, Jingbo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment outcomes after reduction of the target volume of intensity-modulated radiotherapy following induction chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A prospective, multi-center, randomized clinical trial</atitle><jtitle>Radiotherapy and oncology</jtitle><addtitle>Radiother Oncol</addtitle><date>2018-01</date><risdate>2018</risdate><volume>126</volume><issue>1</issue><spage>37</spage><epage>42</epage><pages>37-42</pages><issn>0167-8140</issn><eissn>1879-0887</eissn><abstract>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.
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.
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.
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.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>28864073</pmid><doi>10.1016/j.radonc.2017.07.020</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-8140 |
| ispartof | Radiotherapy and oncology, 2018-01, Vol.126 (1), p.37-42 |
| issn | 0167-8140 1879-0887 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1936165998 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Aged Antineoplastic Agents - administration & dosage Carcinoma - drug therapy Carcinoma - pathology Carcinoma - radiotherapy Chemoradiotherapy Cisplatin - administration & dosage Concurrent chemoradiotherapy (CRT) Disease-Free Survival Dose-Response Relationship, Radiation Female Humans Induction Chemotherapy Induction chemotherapy (IC) Intensity-modulated radiation therapy (IMRT) Male Middle Aged Nasopharyngeal Carcinoma Nasopharyngeal carcinoma (NPC) Nasopharyngeal Neoplasms - drug therapy Nasopharyngeal Neoplasms - pathology Nasopharyngeal Neoplasms - radiotherapy Neoplasm Staging Prospective Studies Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Intensity-Modulated - methods Survival Rate Target delineation Treatment Outcome |
| title | Treatment outcomes after reduction of the target volume of intensity-modulated radiotherapy following induction chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A prospective, multi-center, randomized clinical trial |
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