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Objectives/Hypothesis:Tumor burden has been confirmed as one of the important indicators in disease control after treatment for various types of malignancies. This report aims to document the value of the primary tumor volume of nasopharyngeal carcinoma [gross tumor volume of the primary site (GTV‐P)] in predicting the treatment outcome after high‐dose definitive radiation therapy.

Purpose:The purpose of this study was to investigate the role of posttreatment computed tomography (CT) scans in assessing response of nasopharyngeal carcinoma (NPC) to definitive radiotherapy.

Second primary tumors (SPTs) have a substantial impact on survival in cancer patients. However, risk factors for SPTs have not been documented well, especially in nasopharyngeal carcinoma (NPC). The objective of this retrospective analysis was to evaluate such risks in patients with NPC after they received definitive radiation treatment.Three hundred twenty‐six consecutive patients with pathologically confirmed, nonmetastatic, undifferentiated NPC who received treatment between January 1, 1994 and December 30, 1995 were analyzed. All patients were restaged in accordance with the 2002 American Joint Committee on Cancer staging classification. There were 18 patients (5.5%) with Stage I NPC, 152 patients (46.6%) with Stage II NPC, 101 patients (31.0%) with Stage III NPC, and 55 patients (16.9%) with Stage IVA or IVB NPC at initial diagnosis. All patients received definitive radiotherapy with either Cobalt‐60 or megavoltage therapy. High‐dose‐rate brachytherapy was given to 23 patients either as part of their primary treatment or as adjuvant treatment for residual lesions.The median follow‐up for all patients was 5.6 years (range, 1.0–8.0 years). Seventeen patients (5.2%) developed SPTs, for an average annual rate of 1.0%, and the 5‐year cumulative incidence was 5.8%. Six SPTs were located within the radiation field. The cumulative incidence of in‐field SPTs was 0.35% at 3 years and 1.2% at 5 years, and the average annual rate was 0.35%. Eleven patients (64.7%) had tumors of the upper aerodigestive tract (UADT). Among the 14 SPTs that occurred within 5 years after radiotherapy, only 3 tumors (21.4%) occurred within the radiation field. In contrast, all 3 SPTs that occurred >5 years after radiotherapy occurred within the radiation field (P = .029). Multivariate analysis showed that age was the only independent risk factor for developing SPTs after RT for NPC. Advanced age (age ≥50 years) was associated with a 37% increased risk of developing SPTs (relative risk, 1.367; 95% confidence interval, 1.067–1.1753; P = .014). Other factors, including gender, tumor or lymph node classification, chemotherapy, total radiation dose to the nasopharynx, reirradiation, and adjuvant brachytherapy did not influence the risk of SPTs.SPTs in patients with NPC occurred preferentially in the UADT and tended to develop within the irradiated field >5 years after patients received radiation. Older patients with NPC (age ≥50 years) may be at increased risk. Further studies with larger samples and longer follow‐up will be needed to confirm these findings. Cancer 2006. © 2006 American Cancer Society.

Primary objective. Confidence levels, clinical significance curves and risk - benefit contours have recently been developed with the aim of improving the interpretation of clinical studies. It has been suggested that their use may complement traditional methods of result reporting (i.e. p values and 95% confidence intervals), and subsequently improve medical decision-making. These new methods have been used to report study results; however, widespread use may be hampered by the lack of available computer software. Our objective was to design user-friendly software to enable researchers to use these statistical methods.Research design. A spreadsheet was designed to calculate these statistics for the assessment of two arm medical studies. The spreadsheet was tested using a wide range of input data and operating systems. User-friendliness was tested by researchers who had no background in statistics.Main outcomes and results. The confidence calculator was successfully designed, and found to be user-friendly. The spreadsheet is MS Excel-based to allow wide usage. The spreadsheet is freely available from the author and from the web site http://www.primercollaboration.com/Tools/tools.html.Conclusions. We have successfully designed a spreadsheet that is simple to use and freely accessible for researchers. This is the first such software that calculates confidence levels, clinical significance curves, and risk - benefit contours.

Introduction:Stage II nasopharyngeal carcinoma (NPC) treated with conventionally fractionated radiotherapy results in loco‐regional control of around 80%. This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost (C‐Boost) schedule.