Comparison of Long-Term Outcomes and Sequelae Between Children and Adult Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy
Our purpose was to compare long-term survival outcomes and sequelae between child and adult nasopharyngeal carcinoma (NPC) in the era of intensity modulated radiation therapy. Data on 285 patients with NPC aged ≤18 years at diagnosis and treated with intensity modulated radiation therapy between Jan...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2020-03, Vol.106 (4), p.848-856 |
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| creator | Chen, Bin-bin Lu, Su-ying Peng, Hao Sun, Fei-fei Zhu, Jia Wang, Juan Huang, Jun-ting Zhen, Zi-jun Sun, Xiao-fei Han, Fei Zhang, Yi-zhuo |
| description | Our purpose was to compare long-term survival outcomes and sequelae between child and adult nasopharyngeal carcinoma (NPC) in the era of intensity modulated radiation therapy.
Data on 285 patients with NPC aged ≤18 years at diagnosis and treated with intensity modulated radiation therapy between January 2004 and November 2016 were retrospectively reviewed. A propensity score matching method was adopted to screen matched adult patients with NPC at a ratio of 1:3. Survival outcomes and treatment-related toxicities between child and adult groups were compared.
In total, 159 children and 477 adult patients with NPC were included in this study. The 5-year overall survival, distant metastasis–free survival, locoregional relapse–free survival, and disease-free survival between children and adults were 89.2% versus 83.6% (P = .144), 88.7% versus 83.5% (P = .124), 96.4% versus 89.1% (P = .013), and 86.5% versus 77.3% (P = .021), respectively. Subgroup analyses revealed that the young age was an independent prognostic factor of overall survival, distant metastasis–free survival, and locoregional relapse–free survival in the advanced N stage (N2-3) group and disease-free survival in the advanced T stage (T3-4) group and N2-3 and stage III-IVA groups. The most common sequela was ototoxicity (68.9%) in child patients and xerostomia (70.8%) in adult patients. Adult survivors had a significantly higher incidence of grade 3 to 4 late toxicities in xerostomia (17.6% vs 8.9%; P = .004), skin dystrophy (9.3% vs 3.7%; P = .022), neck fibrosis (8.3% vs 4.4%; P < .001), and radiation encephalopathy (0.8% vs 0; P = .006). Child survivors were more likely to develop grade 3 to 4 growth retardation and endocrine insufficiency (3.0% vs 0.3%; P = .014).
Child patients with NPC achieved significantly better survival outcomes but fewer late toxicities than adult patients. However, we should pay great attention to growth problems of child survivors. |
| doi_str_mv | 10.1016/j.ijrobp.2019.11.035 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2321676239</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301619340805</els_id><sourcerecordid>2321676239</sourcerecordid><originalsourceid>FETCH-LOGICAL-c362t-7fbdc8ecd747700d770999d7324190384507f325b8d7e640458cc4fb4eb730d3</originalsourceid><addsrcrecordid>eNp9kdGO1CAUhonRuLOrb2AMl960QqGlvTFZG3U3Gd1EJ9E7QuF0h0kLFahm3sMHlnFWL70BkvP9nPOfH6EXlJSU0Ob1obSH4IelrAjtSkpLwupHaENb0RWsrr89RhvCGlKwDF-gyxgPhBBKBX-KLhgVHW9Zt0G_ej8vKtjoHfYj3np3X-wgzPhuTdrPELFyBn-B7ytMCvBbSD8BHO73djIhP07Va7NOCX9S0S97FY7uHtSEexW0dX5WeBdAJTD4q017fOsSuGjTEX_0Wfan8FkZq5LNE-z2ENRyfIaejGqK8PzhvkK79-92_U2xvftw219vC82aKhViHIxuQRvBhSDE5KPrOiNYxWlHWMtrIkZW1UNrBDSc8LrVmo8Dh0EwYtgVenX-dgk--4tJzjZqmCblwK9RVqyijWgq1mWUn1EdfIwBRrkEO2ezkhJ5ikMe5DkOeYpDUipzHFn28qHDOsxg_on-7j8Db84AZJs_LAQZtQWnwdgAOknj7f87_AY6Mp-y</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2321676239</pqid></control><display><type>article</type><title>Comparison of Long-Term Outcomes and Sequelae Between Children and Adult Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Chen, Bin-bin ; Lu, Su-ying ; Peng, Hao ; Sun, Fei-fei ; Zhu, Jia ; Wang, Juan ; Huang, Jun-ting ; Zhen, Zi-jun ; Sun, Xiao-fei ; Han, Fei ; Zhang, Yi-zhuo</creator><creatorcontrib>Chen, Bin-bin ; Lu, Su-ying ; Peng, Hao ; Sun, Fei-fei ; Zhu, Jia ; Wang, Juan ; Huang, Jun-ting ; Zhen, Zi-jun ; Sun, Xiao-fei ; Han, Fei ; Zhang, Yi-zhuo</creatorcontrib><description>Our purpose was to compare long-term survival outcomes and sequelae between child and adult nasopharyngeal carcinoma (NPC) in the era of intensity modulated radiation therapy.
Data on 285 patients with NPC aged ≤18 years at diagnosis and treated with intensity modulated radiation therapy between January 2004 and November 2016 were retrospectively reviewed. A propensity score matching method was adopted to screen matched adult patients with NPC at a ratio of 1:3. Survival outcomes and treatment-related toxicities between child and adult groups were compared.
In total, 159 children and 477 adult patients with NPC were included in this study. The 5-year overall survival, distant metastasis–free survival, locoregional relapse–free survival, and disease-free survival between children and adults were 89.2% versus 83.6% (P = .144), 88.7% versus 83.5% (P = .124), 96.4% versus 89.1% (P = .013), and 86.5% versus 77.3% (P = .021), respectively. Subgroup analyses revealed that the young age was an independent prognostic factor of overall survival, distant metastasis–free survival, and locoregional relapse–free survival in the advanced N stage (N2-3) group and disease-free survival in the advanced T stage (T3-4) group and N2-3 and stage III-IVA groups. The most common sequela was ototoxicity (68.9%) in child patients and xerostomia (70.8%) in adult patients. Adult survivors had a significantly higher incidence of grade 3 to 4 late toxicities in xerostomia (17.6% vs 8.9%; P = .004), skin dystrophy (9.3% vs 3.7%; P = .022), neck fibrosis (8.3% vs 4.4%; P < .001), and radiation encephalopathy (0.8% vs 0; P = .006). Child survivors were more likely to develop grade 3 to 4 growth retardation and endocrine insufficiency (3.0% vs 0.3%; P = .014).
Child patients with NPC achieved significantly better survival outcomes but fewer late toxicities than adult patients. However, we should pay great attention to growth problems of child survivors.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2019.11.035</identifier><identifier>PMID: 31794839</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Child ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma - pathology ; Nasopharyngeal Carcinoma - radiotherapy ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>International journal of radiation oncology, biology, physics, 2020-03, Vol.106 (4), p.848-856</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-7fbdc8ecd747700d770999d7324190384507f325b8d7e640458cc4fb4eb730d3</citedby><cites>FETCH-LOGICAL-c362t-7fbdc8ecd747700d770999d7324190384507f325b8d7e640458cc4fb4eb730d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2019.11.035$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31794839$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Bin-bin</creatorcontrib><creatorcontrib>Lu, Su-ying</creatorcontrib><creatorcontrib>Peng, Hao</creatorcontrib><creatorcontrib>Sun, Fei-fei</creatorcontrib><creatorcontrib>Zhu, Jia</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Huang, Jun-ting</creatorcontrib><creatorcontrib>Zhen, Zi-jun</creatorcontrib><creatorcontrib>Sun, Xiao-fei</creatorcontrib><creatorcontrib>Han, Fei</creatorcontrib><creatorcontrib>Zhang, Yi-zhuo</creatorcontrib><title>Comparison of Long-Term Outcomes and Sequelae Between Children and Adult Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Our purpose was to compare long-term survival outcomes and sequelae between child and adult nasopharyngeal carcinoma (NPC) in the era of intensity modulated radiation therapy.
Data on 285 patients with NPC aged ≤18 years at diagnosis and treated with intensity modulated radiation therapy between January 2004 and November 2016 were retrospectively reviewed. A propensity score matching method was adopted to screen matched adult patients with NPC at a ratio of 1:3. Survival outcomes and treatment-related toxicities between child and adult groups were compared.
In total, 159 children and 477 adult patients with NPC were included in this study. The 5-year overall survival, distant metastasis–free survival, locoregional relapse–free survival, and disease-free survival between children and adults were 89.2% versus 83.6% (P = .144), 88.7% versus 83.5% (P = .124), 96.4% versus 89.1% (P = .013), and 86.5% versus 77.3% (P = .021), respectively. Subgroup analyses revealed that the young age was an independent prognostic factor of overall survival, distant metastasis–free survival, and locoregional relapse–free survival in the advanced N stage (N2-3) group and disease-free survival in the advanced T stage (T3-4) group and N2-3 and stage III-IVA groups. The most common sequela was ototoxicity (68.9%) in child patients and xerostomia (70.8%) in adult patients. Adult survivors had a significantly higher incidence of grade 3 to 4 late toxicities in xerostomia (17.6% vs 8.9%; P = .004), skin dystrophy (9.3% vs 3.7%; P = .022), neck fibrosis (8.3% vs 4.4%; P < .001), and radiation encephalopathy (0.8% vs 0; P = .006). Child survivors were more likely to develop grade 3 to 4 growth retardation and endocrine insufficiency (3.0% vs 0.3%; P = .014).
Child patients with NPC achieved significantly better survival outcomes but fewer late toxicities than adult patients. However, we should pay great attention to growth problems of child survivors.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nasopharyngeal Carcinoma - pathology</subject><subject>Nasopharyngeal Carcinoma - radiotherapy</subject><subject>Radiotherapy, Intensity-Modulated</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kdGO1CAUhonRuLOrb2AMl960QqGlvTFZG3U3Gd1EJ9E7QuF0h0kLFahm3sMHlnFWL70BkvP9nPOfH6EXlJSU0Ob1obSH4IelrAjtSkpLwupHaENb0RWsrr89RhvCGlKwDF-gyxgPhBBKBX-KLhgVHW9Zt0G_ej8vKtjoHfYj3np3X-wgzPhuTdrPELFyBn-B7ytMCvBbSD8BHO73djIhP07Va7NOCX9S0S97FY7uHtSEexW0dX5WeBdAJTD4q017fOsSuGjTEX_0Wfan8FkZq5LNE-z2ENRyfIaejGqK8PzhvkK79-92_U2xvftw219vC82aKhViHIxuQRvBhSDE5KPrOiNYxWlHWMtrIkZW1UNrBDSc8LrVmo8Dh0EwYtgVenX-dgk--4tJzjZqmCblwK9RVqyijWgq1mWUn1EdfIwBRrkEO2ezkhJ5ikMe5DkOeYpDUipzHFn28qHDOsxg_on-7j8Db84AZJs_LAQZtQWnwdgAOknj7f87_AY6Mp-y</recordid><startdate>20200315</startdate><enddate>20200315</enddate><creator>Chen, Bin-bin</creator><creator>Lu, Su-ying</creator><creator>Peng, Hao</creator><creator>Sun, Fei-fei</creator><creator>Zhu, Jia</creator><creator>Wang, Juan</creator><creator>Huang, Jun-ting</creator><creator>Zhen, Zi-jun</creator><creator>Sun, Xiao-fei</creator><creator>Han, Fei</creator><creator>Zhang, Yi-zhuo</creator><general>Elsevier Inc</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>20200315</creationdate><title>Comparison of Long-Term Outcomes and Sequelae Between Children and Adult Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy</title><author>Chen, Bin-bin ; Lu, Su-ying ; Peng, Hao ; Sun, Fei-fei ; Zhu, Jia ; Wang, Juan ; Huang, Jun-ting ; Zhen, Zi-jun ; Sun, Xiao-fei ; Han, Fei ; Zhang, Yi-zhuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-7fbdc8ecd747700d770999d7324190384507f325b8d7e640458cc4fb4eb730d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nasopharyngeal Carcinoma - pathology</topic><topic>Nasopharyngeal Carcinoma - radiotherapy</topic><topic>Radiotherapy, Intensity-Modulated</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Bin-bin</creatorcontrib><creatorcontrib>Lu, Su-ying</creatorcontrib><creatorcontrib>Peng, Hao</creatorcontrib><creatorcontrib>Sun, Fei-fei</creatorcontrib><creatorcontrib>Zhu, Jia</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Huang, Jun-ting</creatorcontrib><creatorcontrib>Zhen, Zi-jun</creatorcontrib><creatorcontrib>Sun, Xiao-fei</creatorcontrib><creatorcontrib>Han, Fei</creatorcontrib><creatorcontrib>Zhang, Yi-zhuo</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>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Bin-bin</au><au>Lu, Su-ying</au><au>Peng, Hao</au><au>Sun, Fei-fei</au><au>Zhu, Jia</au><au>Wang, Juan</au><au>Huang, Jun-ting</au><au>Zhen, Zi-jun</au><au>Sun, Xiao-fei</au><au>Han, Fei</au><au>Zhang, Yi-zhuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Long-Term Outcomes and Sequelae Between Children and Adult Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2020-03-15</date><risdate>2020</risdate><volume>106</volume><issue>4</issue><spage>848</spage><epage>856</epage><pages>848-856</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Our purpose was to compare long-term survival outcomes and sequelae between child and adult nasopharyngeal carcinoma (NPC) in the era of intensity modulated radiation therapy.
Data on 285 patients with NPC aged ≤18 years at diagnosis and treated with intensity modulated radiation therapy between January 2004 and November 2016 were retrospectively reviewed. A propensity score matching method was adopted to screen matched adult patients with NPC at a ratio of 1:3. Survival outcomes and treatment-related toxicities between child and adult groups were compared.
In total, 159 children and 477 adult patients with NPC were included in this study. The 5-year overall survival, distant metastasis–free survival, locoregional relapse–free survival, and disease-free survival between children and adults were 89.2% versus 83.6% (P = .144), 88.7% versus 83.5% (P = .124), 96.4% versus 89.1% (P = .013), and 86.5% versus 77.3% (P = .021), respectively. Subgroup analyses revealed that the young age was an independent prognostic factor of overall survival, distant metastasis–free survival, and locoregional relapse–free survival in the advanced N stage (N2-3) group and disease-free survival in the advanced T stage (T3-4) group and N2-3 and stage III-IVA groups. The most common sequela was ototoxicity (68.9%) in child patients and xerostomia (70.8%) in adult patients. Adult survivors had a significantly higher incidence of grade 3 to 4 late toxicities in xerostomia (17.6% vs 8.9%; P = .004), skin dystrophy (9.3% vs 3.7%; P = .022), neck fibrosis (8.3% vs 4.4%; P < .001), and radiation encephalopathy (0.8% vs 0; P = .006). Child survivors were more likely to develop grade 3 to 4 growth retardation and endocrine insufficiency (3.0% vs 0.3%; P = .014).
Child patients with NPC achieved significantly better survival outcomes but fewer late toxicities than adult patients. However, we should pay great attention to growth problems of child survivors.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31794839</pmid><doi>10.1016/j.ijrobp.2019.11.035</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Child Disease Progression Disease-Free Survival Female Humans Male Middle Aged Nasopharyngeal Carcinoma - pathology Nasopharyngeal Carcinoma - radiotherapy Radiotherapy, Intensity-Modulated Retrospective Studies Time Factors Treatment Outcome Young Adult |
| title | Comparison of Long-Term Outcomes and Sequelae Between Children and Adult Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy |
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