Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area
Purpose To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region. Methods We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities...
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| Veröffentlicht in: | Strahlentherapie und Onkologie 2021-03, Vol.197 (3), p.188-197 |
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| container_title | Strahlentherapie und Onkologie |
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| creator | Boustani, J. Ruffier, A. Moya-Plana, A. Tao, Y. Nguyen, F. Even, C. Berthold, C. Casiraghi, O. Temam, S. Blanchard, P. |
| description | Purpose
To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region.
Methods
We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities in patients treated with curative intent for locally rNPC. We applied the prognostic model for OS and grade 5 radiotherapy (RT)-related toxicities published by Li et al. and evaluated its prognostic accuracy by receiver operating characteristic (ROC) curve analysis.
Results
Between 2005 and 2018, 33 patients were treated for rNPC in our institution. Median follow-up was 60 months. The mean time to local recurrence was 75 months. Six (18%) patients had a persistent grade 3 toxicity from a previous RT course. The median re-RT dose was 66 Gy. After re-RT, 13 patients had local failure and 3 patients had metastatic recurrence. Median PFS was 18 months with a 5-year PFS rate of 29%. Median OS was 35 months with a 5-year OS rate of 37%. Grade 3 or higher toxicities rate was 74%. There were 21% grade 5 toxicities. The median time to a grade 5 toxicity was less than 6 months following re-RT. The prognostic nomogram was not predictive for OS or grade 5 toxicities.
Conclusion
Reirradiation of rNPC is an effective treatment but is associated with a high rate of life-threatening toxicity. Stratification of patients based on their risk of developing severe toxicity is needed to select patients who will most likely benefit from re-RT. |
| doi_str_mv | 10.1007/s00066-020-01647-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2411108096</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2411108096</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-a6ffb983418b393736153fdeb07366cb7fdc24c1b66e90b9c48279f868a1d88d3</originalsourceid><addsrcrecordid>eNp9kc-KFDEQxoMo7uzoC3iQgBcv0Uonkz9HWVZXGPCi4C1Up5O1l-5kTLqFeRufxScz46wKHjxV4PvVV1X5CHnG4RUH0K8rACjFoAMGXEnNxAOy4VJYBtZ-fkg2wLVlmu_MBbms9Q5OlJWPyYXodlwqLjbk2z6nW7aEMtO8Lj7PoVJMA60Yw3KkGJtESxhLwWHEZcyJjolO2eM0HZvg11JCWmjCmg9fsBzTbcCJeix-THnGE40_vqecWEhDmEdPsQR8Qh5FnGp4el-35NPb649XN2z_4d37qzd75oXeLQxVjL01QnLTCyu0UHwn4hB6aE_lex0H30nPe6WChd56aTpto1EG-WDMILbk5dn3UPLXNdTFzWP1YZowhbxW10nOORiwqqEv_kHv8lpS265RFozUtq2wJd2Z8iXXWkJ0hzLO7W7HwZ1ScedUXEvF_UrFidb0_N567ecw_Gn5HUMDxBmoTWo_WP7O_o_tT9x1mcE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2490847939</pqid></control><display><type>article</type><title>Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Boustani, J. ; Ruffier, A. ; Moya-Plana, A. ; Tao, Y. ; Nguyen, F. ; Even, C. ; Berthold, C. ; Casiraghi, O. ; Temam, S. ; Blanchard, P.</creator><creatorcontrib>Boustani, J. ; Ruffier, A. ; Moya-Plana, A. ; Tao, Y. ; Nguyen, F. ; Even, C. ; Berthold, C. ; Casiraghi, O. ; Temam, S. ; Blanchard, P.</creatorcontrib><description>Purpose
To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region.
Methods
We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities in patients treated with curative intent for locally rNPC. We applied the prognostic model for OS and grade 5 radiotherapy (RT)-related toxicities published by Li et al. and evaluated its prognostic accuracy by receiver operating characteristic (ROC) curve analysis.
Results
Between 2005 and 2018, 33 patients were treated for rNPC in our institution. Median follow-up was 60 months. The mean time to local recurrence was 75 months. Six (18%) patients had a persistent grade 3 toxicity from a previous RT course. The median re-RT dose was 66 Gy. After re-RT, 13 patients had local failure and 3 patients had metastatic recurrence. Median PFS was 18 months with a 5-year PFS rate of 29%. Median OS was 35 months with a 5-year OS rate of 37%. Grade 3 or higher toxicities rate was 74%. There were 21% grade 5 toxicities. The median time to a grade 5 toxicity was less than 6 months following re-RT. The prognostic nomogram was not predictive for OS or grade 5 toxicities.
Conclusion
Reirradiation of rNPC is an effective treatment but is associated with a high rate of life-threatening toxicity. Stratification of patients based on their risk of developing severe toxicity is needed to select patients who will most likely benefit from re-RT.</description><identifier>ISSN: 0179-7158</identifier><identifier>EISSN: 1439-099X</identifier><identifier>DOI: 10.1007/s00066-020-01647-3</identifier><identifier>PMID: 32514613</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cancer therapies ; Chemotherapy ; Female ; Follow-Up Studies ; Head & neck cancer ; Humans ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Mortality ; Nasopharyngeal Carcinoma - radiotherapy ; Nasopharyngeal Neoplasms - radiotherapy ; Neoplasm Recurrence, Local - radiotherapy ; Nomograms ; Oncology ; Original Article ; Patients ; Radiation therapy ; Radiotherapy ; Re-Irradiation - adverse effects ; Re-Irradiation - methods ; Retrospective Studies ; Statistical analysis ; Survival ; Throat cancer ; Toxicity ; Treatment Outcome ; Tumors ; Young Adult</subject><ispartof>Strahlentherapie und Onkologie, 2021-03, Vol.197 (3), p.188-197</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-a6ffb983418b393736153fdeb07366cb7fdc24c1b66e90b9c48279f868a1d88d3</citedby><cites>FETCH-LOGICAL-c375t-a6ffb983418b393736153fdeb07366cb7fdc24c1b66e90b9c48279f868a1d88d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00066-020-01647-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00066-020-01647-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32514613$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boustani, J.</creatorcontrib><creatorcontrib>Ruffier, A.</creatorcontrib><creatorcontrib>Moya-Plana, A.</creatorcontrib><creatorcontrib>Tao, Y.</creatorcontrib><creatorcontrib>Nguyen, F.</creatorcontrib><creatorcontrib>Even, C.</creatorcontrib><creatorcontrib>Berthold, C.</creatorcontrib><creatorcontrib>Casiraghi, O.</creatorcontrib><creatorcontrib>Temam, S.</creatorcontrib><creatorcontrib>Blanchard, P.</creatorcontrib><title>Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area</title><title>Strahlentherapie und Onkologie</title><addtitle>Strahlenther Onkol</addtitle><addtitle>Strahlenther Onkol</addtitle><description>Purpose
To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region.
Methods
We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities in patients treated with curative intent for locally rNPC. We applied the prognostic model for OS and grade 5 radiotherapy (RT)-related toxicities published by Li et al. and evaluated its prognostic accuracy by receiver operating characteristic (ROC) curve analysis.
Results
Between 2005 and 2018, 33 patients were treated for rNPC in our institution. Median follow-up was 60 months. The mean time to local recurrence was 75 months. Six (18%) patients had a persistent grade 3 toxicity from a previous RT course. The median re-RT dose was 66 Gy. After re-RT, 13 patients had local failure and 3 patients had metastatic recurrence. Median PFS was 18 months with a 5-year PFS rate of 29%. Median OS was 35 months with a 5-year OS rate of 37%. Grade 3 or higher toxicities rate was 74%. There were 21% grade 5 toxicities. The median time to a grade 5 toxicity was less than 6 months following re-RT. The prognostic nomogram was not predictive for OS or grade 5 toxicities.
Conclusion
Reirradiation of rNPC is an effective treatment but is associated with a high rate of life-threatening toxicity. Stratification of patients based on their risk of developing severe toxicity is needed to select patients who will most likely benefit from re-RT.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Head & neck cancer</subject><subject>Humans</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nasopharyngeal Carcinoma - radiotherapy</subject><subject>Nasopharyngeal Neoplasms - radiotherapy</subject><subject>Neoplasm Recurrence, Local - radiotherapy</subject><subject>Nomograms</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Re-Irradiation - adverse effects</subject><subject>Re-Irradiation - methods</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Survival</subject><subject>Throat cancer</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0179-7158</issn><issn>1439-099X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kc-KFDEQxoMo7uzoC3iQgBcv0Uonkz9HWVZXGPCi4C1Up5O1l-5kTLqFeRufxScz46wKHjxV4PvVV1X5CHnG4RUH0K8rACjFoAMGXEnNxAOy4VJYBtZ-fkg2wLVlmu_MBbms9Q5OlJWPyYXodlwqLjbk2z6nW7aEMtO8Lj7PoVJMA60Yw3KkGJtESxhLwWHEZcyJjolO2eM0HZvg11JCWmjCmg9fsBzTbcCJeix-THnGE40_vqecWEhDmEdPsQR8Qh5FnGp4el-35NPb649XN2z_4d37qzd75oXeLQxVjL01QnLTCyu0UHwn4hB6aE_lex0H30nPe6WChd56aTpto1EG-WDMILbk5dn3UPLXNdTFzWP1YZowhbxW10nOORiwqqEv_kHv8lpS265RFozUtq2wJd2Z8iXXWkJ0hzLO7W7HwZ1ScedUXEvF_UrFidb0_N567ecw_Gn5HUMDxBmoTWo_WP7O_o_tT9x1mcE</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Boustani, J.</creator><creator>Ruffier, A.</creator><creator>Moya-Plana, A.</creator><creator>Tao, Y.</creator><creator>Nguyen, F.</creator><creator>Even, C.</creator><creator>Berthold, C.</creator><creator>Casiraghi, O.</creator><creator>Temam, S.</creator><creator>Blanchard, P.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature 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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20210301</creationdate><title>Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area</title><author>Boustani, J. ; Ruffier, A. ; Moya-Plana, A. ; Tao, Y. ; Nguyen, F. ; Even, C. ; Berthold, C. ; Casiraghi, O. ; Temam, S. ; Blanchard, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-a6ffb983418b393736153fdeb07366cb7fdc24c1b66e90b9c48279f868a1d88d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Head & neck cancer</topic><topic>Humans</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nasopharyngeal Carcinoma - radiotherapy</topic><topic>Nasopharyngeal Neoplasms - radiotherapy</topic><topic>Neoplasm Recurrence, Local - radiotherapy</topic><topic>Nomograms</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Re-Irradiation - adverse effects</topic><topic>Re-Irradiation - methods</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Survival</topic><topic>Throat cancer</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boustani, J.</creatorcontrib><creatorcontrib>Ruffier, A.</creatorcontrib><creatorcontrib>Moya-Plana, A.</creatorcontrib><creatorcontrib>Tao, Y.</creatorcontrib><creatorcontrib>Nguyen, F.</creatorcontrib><creatorcontrib>Even, C.</creatorcontrib><creatorcontrib>Berthold, C.</creatorcontrib><creatorcontrib>Casiraghi, O.</creatorcontrib><creatorcontrib>Temam, S.</creatorcontrib><creatorcontrib>Blanchard, P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Strahlentherapie und Onkologie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boustani, J.</au><au>Ruffier, A.</au><au>Moya-Plana, A.</au><au>Tao, Y.</au><au>Nguyen, F.</au><au>Even, C.</au><au>Berthold, C.</au><au>Casiraghi, O.</au><au>Temam, S.</au><au>Blanchard, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area</atitle><jtitle>Strahlentherapie und Onkologie</jtitle><stitle>Strahlenther Onkol</stitle><addtitle>Strahlenther Onkol</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>197</volume><issue>3</issue><spage>188</spage><epage>197</epage><pages>188-197</pages><issn>0179-7158</issn><eissn>1439-099X</eissn><abstract>Purpose
To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region.
Methods
We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities in patients treated with curative intent for locally rNPC. We applied the prognostic model for OS and grade 5 radiotherapy (RT)-related toxicities published by Li et al. and evaluated its prognostic accuracy by receiver operating characteristic (ROC) curve analysis.
Results
Between 2005 and 2018, 33 patients were treated for rNPC in our institution. Median follow-up was 60 months. The mean time to local recurrence was 75 months. Six (18%) patients had a persistent grade 3 toxicity from a previous RT course. The median re-RT dose was 66 Gy. After re-RT, 13 patients had local failure and 3 patients had metastatic recurrence. Median PFS was 18 months with a 5-year PFS rate of 29%. Median OS was 35 months with a 5-year OS rate of 37%. Grade 3 or higher toxicities rate was 74%. There were 21% grade 5 toxicities. The median time to a grade 5 toxicity was less than 6 months following re-RT. The prognostic nomogram was not predictive for OS or grade 5 toxicities.
Conclusion
Reirradiation of rNPC is an effective treatment but is associated with a high rate of life-threatening toxicity. Stratification of patients based on their risk of developing severe toxicity is needed to select patients who will most likely benefit from re-RT.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32514613</pmid><doi>10.1007/s00066-020-01647-3</doi><tpages>10</tpages></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Aged Aged, 80 and over Cancer therapies Chemotherapy Female Follow-Up Studies Head & neck cancer Humans Male Medical prognosis Medicine Medicine & Public Health Metastasis Middle Aged Mortality Nasopharyngeal Carcinoma - radiotherapy Nasopharyngeal Neoplasms - radiotherapy Neoplasm Recurrence, Local - radiotherapy Nomograms Oncology Original Article Patients Radiation therapy Radiotherapy Re-Irradiation - adverse effects Re-Irradiation - methods Retrospective Studies Statistical analysis Survival Throat cancer Toxicity Treatment Outcome Tumors Young Adult |
| title | Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area |
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