Management of Locally Recurrent Nasopharyngeal Carcinoma

The previous review by the International Head and Neck Scientific Group (IHNSG) on recurrent nasopharyngeal carcinoma (NPC) summarized the available data that had emerged over the past decade prior to 2010 to identify the scope of the problem [1]. With the adoption of intensity-modulated radiotherapy (IMRT) +/- stereotactic radiotherapy (SRT) for the primary management of NPC in the contemporary era, a renewed review of strategies is needed for the management of recurrent NPC as most failures are now likely to be related to radioresistance.
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Tumour Review Source Type: research

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Conclusions: 3D-HDR-BT achieves favorable clinical outcomes with mild late toxicity in patients with locally rNPC. Introduction Nasopharyngeal carcinoma (NPC), a tumor of epithelial origin, is a malignant disease of the head and neck common in southern China, especially in Guangdong province (1). As a result of advances in modern imaging and irradiation techniques, the 5-year overall survival (OS) of patients with newly diagnosed NPC without metastasis has reached 75% after external beam radiotherapy (EBRT) in Asia (2, 3). However, local recurrence, which occurs in 18–40% of patients, remains a major reason for...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: The selection of lymph node target volumes for head and neck cancers treated with IMRT/VMAT or other highly conformal techniques (e.g. proton therapy) requires a rigorous approach. This updated proposal of selection should help clinicians for the selection of lymph nodes target volumes and contribute to increase consistency. PMID: 31005201 [PubMed - in process]
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
Conclusions In the span of a very short time—less than a decade—robotic head and neck surgery has transformed the management of the head and neck cancer, and it seems clear that the future of treatment for these cancers lies in a multimodal approach in which TORS is likely to play an important role. Nevertheless, it is important to keep in mind that the current indications for TORS are limited and long-term data on the safety and oncological outcomes are needed to better understand the true role of TORS in treatment of head and neck cancer. Nonetheless, the emergence of ever more advanced robotic instruments i...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractBackground.The purpose of this study was to verify 10‐year results of survival and late toxicities and assess the ultimate therapeutic ratio of intensity‐modulated radiotherapy (IMRT) versus two‐dimensional radiotherapy (2DRT) in patients with nasopharyngeal carcinoma (NPC).Materials and Methods.We retrospectively reviewed the data from 1,276 patients with nonmetastatic NPC who received IMRT or 2DRT from January 2003 to December 2006.Results.Of the 1,276 patients, 512 were treated with IMRT and 764 with 2DRT. Median follow‐up was 115 months. At 10 years, the IMRT group demonstrated significantly better resu...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Head and Neck Cancers Source Type: research
Nasopharyngeal carcinoma (NPC) is one of the head and neck cancers with high incidence in Southeast Asia, and is connected with Epstein –Barr virus (EBV) infection [1]. Intensity-modulated radiotherapy (IMRT) alone or in combination with chemotherapy, targeted therapy, and immunotherapy is the main treatment for non-metastatic NPC, achieving good disease-free survival and overall survival (OS) [2,3]. But NPC tends to relapse and/o r metastase after definitive treatment [4,5]. Therefore, NPC patients, who develop local recurrence or distant metastases after treatment, require more intensive follow-up and effective treatment strategies.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Publication date: Available online 12 December 2018Source: Radiation Physics and ChemistryAuthor(s): Shichao Wang, Lin Zhou, Jianxin Xue, Jie Lan, Lei Deng, Tingwu Yi, You LuAbstractPurposeTo compare the fixed-beam intensity-modulated radiotherapy (IMRT) with the volumetric-modulated arc therapy (VMAT) plans for different cancers using the biologically effective dose (BED).MethodsRecruited patients were divided into three groups in terms of tumor anatomic site, including head and neck, thoracic, and abdominal cancers. All of plans were generated using the fixed-beam IMRT and the VMAT techniques. The qualities of the plans ...
Source: Radiation Physics and Chemistry - Category: Physics Source Type: research
Neurocognitive dysfunction occurs among cancer survivors across a broad spectrum of solid non-CNS malignancies [1 –4], including head and neck cancers (HNC) [5–9]. Lee et al. presented the first series recognizing neurocognitive dysfunction following radiotherapy for nasopharyngeal carcinoma (NPC) in 1989, however, subsequently minimal progress has been made [10]. Most published series predate intensity-mod ulated radiotherapy (IMRT) and heavily focus on cohorts with and without temporal lobe necrosis (TLN) [7,10–18].
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original article Source Type: research
CONCLUSIONS: Despite the implementation of IMRT, survivors of NPC still experience many physical symptoms that affect long-term QoL many years after treatment. Depression, anxiety, and fatigue remain common in long-term survivors and are highly correlated with QoL. PMID: 30191868 [PubMed - in process]
Source: Health Physics - Category: Physics Authors: Tags: Int J Radiat Oncol Biol Phys Source Type: research
CONCLUSION: Substantial risk of SPT, especially for in-field sarcoma and tongue cancers, exists after definitive IMRT for NPC. SPT severely negates longevity of NPC survivors. High awareness and careful surveillance is warranted for this late lethal complication. PMID: 29932287 [PubMed - as supplied by publisher]
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Asia Pac J Clin Oncol Source Type: research
Conclusion: The attenuation and bolus effects of the head and neck immobilization device reduce dose coverage rate and average dose of the planning target volumes in nasopharyngeal carcinoma and lead to an increase in the skin dose. During treatment planning and dose calculation, the immobilization device should be included within body contour to account for the dose attenuation and skin dose increment.
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
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