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Simultaneous Reduction of Volume and Dose in Clinical Target Volume for Nasopharyngeal Cancer Patients
- Source :
- International Journal of Radiation Oncology*Biology*Physics. 109:495-504
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- To compare the treatment outcome and severe late adverse effects (AEs) between conventional volume and dose (CVD) and simultaneously reduced volume and dose (SRVD) of clinical target volume treatments in patients with nasopharyngeal carcinoma.This retrospective cohort study enrolled patients with nonmetastatic stage II to IV nasopharyngeal cancer from a single institute. Survival endpoints and severe (≥grade 3) late AEs and comorbidity were compared between groups. The correlation of severe late AEs, comorbidity, and overall survival (OS) were evaluated using Kaplan-Meier and Cox regression methods.From January 2012 to June 2017, this study enrolled 178 patients, 64 in the CVD group and 114 in the SRVD group. The 2 groups did not differ significantly in patient characteristics except for mean follow-up time (37.6 vs 48.8 months; P = .01). The SRVD group did not significantly differ from the CVD group in local control survival (82.0% vs 78.4%; P = .85), regional control survival (89.9% vs 86.0%; P = .62), or disease-free survival (76.4% vs 66.9%; P = .67). The SRVD group had significantly better OS (93.9% vs 67.0%; P.001) and salvage survival (79.3% vs 20.7%; P.01) and a significantly lower ratio of severe lung infection (1 of 113 vs 5 of 59; P = .02). The SRVD group had a significantly lower risk of mortality (hazard ratio [HR], 0.3; P = .03). The factors associated with a significantly higher risk of mortality were N3 (regional lymph node stage status of N3) (HR, 3.0; P = .02); comorbidities of diabetes, coronary artery disease, or chronic kidney disease (grades 2-3) (HR, 3.8; P = .009), and severe lung infection (HR, 6.3; P = .007).Simultaneously reduced volume and dose of clinical target volumes did not impair locoregional control or disease-free survival. The benefits of SRVD treatment may include significant reduction in severe late AEs, particularly lung infection, dysphagia, and xerostomia. However, additional studies with longer patient follow-up are required to confirm these benefits.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Endpoint Determination
Planning target volume
Gastroenterology
Disease-Free Survival
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Internal medicine
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Adverse effect
Aged
Retrospective Studies
Nasopharyngeal cancer
Radiation
business.industry
Proportional hazards model
Dose-Response Relationship, Radiation
Nasopharyngeal Neoplasms
Retrospective cohort study
Middle Aged
medicine.disease
Dysphagia
Comorbidity
Oncology
Nasopharyngeal carcinoma
030220 oncology & carcinogenesis
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 03603016
- Volume :
- 109
- Database :
- OpenAIRE
- Journal :
- International Journal of Radiation Oncology*Biology*Physics
- Accession number :
- edsair.doi.dedup.....ceec13d2708917c7cfd7faa093c0d5e0