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El-Hennawy G, ElMenawi S, Nasr Said E, Zekri W, Zaghloul M, Elsalam AMA, El-Fendy H, Elantably I. Predictive significance of pretreatment 18F-FDG PET volumetric parameters on survival outcomes in pediatric patients with locally advanced undifferentiated nasopharyngeal carcinoma. Pediatr Blood Cancer 2024; 71:e30998. [PMID: 38650170 DOI: 10.1002/pbc.30998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/20/2024] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is a rare pediatric cancer. Most children are first diagnosed with advanced locoregional disease. Identification of patients at higher risk of treatment failure is crucial as they may benefit from more aggressive initial treatment approaches. 18Fluorine-labeled fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) has shown promise as a prognostic tool for predicting outcomes. METHODS Retrospective study of pediatric patients with locally advanced undifferentiated NPC who underwent 18F-FDG PET/CT prior to intial treatment. Predictive significance of metabolic PET parameters on survival outcomes were estimated. RESULTS Thirty-two children were included, age range was 7.1-18 years at the time of diagnosis. The median follow-up duration was 46.1 months. Three patients (9.4%) were classified as AJCC stage IIb, 13 patients (40.6%) as stage IIIa, eight patients (25%) as stage IIIb, and eight patients (25%) as stage IVa. Our findings revealed that high whole-body metabolic tumor volume at the threshold of hepatic reference SUVmean (WB-MTV-HR) (>135 mL) was associated with significantly lower event-free survival (EFS) compared to the low WB-MTV-HR group (≤135 mL) (3-year EFS: 50% ± 18% vs. 82% ± 8%; p = .015). Additionally, the 3-year overall survival (OS) rates differed significantly between the high whole-body metabolic tumor volume at the threshold of an SUV of 2.5 isocontour (WB-MTV-2.5) group (MTV >74 mL) and the low WB-MTV-2.5 group (MTV ≤74 mL) (63% ± 18% vs. 100%; p = .021). CONCLUSION Our study suggests that WB-MTV parameters could serve as significant prognostic factors for disease progression in pediatric patients with locally advanced undifferentiated NPC. However, further prospective studies with larger sample sizes are needed to validate these findings.
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Affiliation(s)
- Gihan El-Hennawy
- Department of Nuclear Medicine and Radiation Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
- Department of Nuclear Medicine, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Salma ElMenawi
- Department of Clinical Research, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Eman Nasr Said
- Department of Diagnostic & Interventional Radiology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
- Department of Radiodiagnosis, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Wael Zekri
- Department of Pediatric Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
- Department of Pediatric Oncology, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Mohamed Zaghloul
- Department of Nuclear Medicine and Radiation Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
- Department of Radiotherapy, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Ahmed Mustafa Abd Elsalam
- Department of Pediatric Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
- Department of Pediatric Oncology, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Habiba El-Fendy
- Department of Pathology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Ismail Elantably
- Department of Nuclear Medicine and Radiation Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
- Department of Nuclear Medicine, Children Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
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Liu Y, Li Y, Hou Y, Zhao Z, Wang G, Gao C, Sun Y, Li N, Jiang Y. The use of adjuvant chemotherapy combined with concurrent chemoradiotherapy enhances survival rates in cases of locally advanced nasopharyngeal carcinoma. Am J Cancer Res 2024; 14:3142-3152. [PMID: 39005679 PMCID: PMC11236796 DOI: 10.62347/wmla4979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/03/2024] [Indexed: 07/16/2024] Open
Abstract
This study aimed to evaluate the impact of adjuvant chemotherapy on survival rates, adverse events, and quality of life (QOL) in patients with locally advanced nasopharyngeal carcinoma (NPC). A retrospective cohort study was conducted, including patients with firstly histologically confirmed non-metastatic stage III-IVB NPC between February 2018 and February 2020, and with continuous follow-up data available, were chosen from the medical records of the affiliated hospital of Qingdao University and Zibo Central Hospital. There were 395 patients receiving concurrent chemoradiotherapy (CCRT) with adjuvant chemotherapy (adjuvant chemotherapy group) and 428 patients receiving CCRT alone (control group). The two groups were compared for treatment response, adverse events, and QOL scores. Besides, Kaplan-Meier plots, and multivariate COX analysis were conducted. The adjuvant chemotherapy group demonstrated a significantly higher overall survival and disease-free survival compared to the control group. The use of adjuvant chemotherapy was significantly correlated with improved overall survival and disease-free survival. Adjuvant chemotherapy was associated with reduced local recurrence and distant metastasis rates. However, higher rates of adverse events were observed in the adjuvant chemotherapy group. QOL scores for physical functioning, emotional functioning, and overall quality of life were higher in the adjuvant chemotherapy group. The findings of this study indicate that adjuvant chemotherapy in locally advanced NPC is associated with improved treatment response, extended overall and disease-free survivals, and better QOL, despite higher rates of adverse events.
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Affiliation(s)
- Yongliang Liu
- Department of Otolaryngolgogy, The Affiliated Hospital of Qingdao University Qingdao, Shandong, China
- Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China
| | - Yan Li
- Center of Translational Medicine, Zibo Central Hospital Zibo, Shandong, China
| | - Ying Hou
- Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China
| | - Zhenan Zhao
- Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China
| | - Guoquan Wang
- Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China
| | - Chunmiao Gao
- Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China
| | - Yuqing Sun
- Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China
| | - Na Li
- Department of Blood Transfusion Medicine, Zibo Central Hospital Zibo, Shandong, China
| | - Yan Jiang
- Department of Otolaryngolgogy, The Affiliated Hospital of Qingdao University Qingdao, Shandong, China
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Ben-Ami T. Nasopharyngeal Carcinoma in Children, Current Treatment Approach. J Pediatr Hematol Oncol 2024; 46:117-124. [PMID: 38447121 PMCID: PMC10956687 DOI: 10.1097/mph.0000000000002848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/04/2024] [Indexed: 03/08/2024]
Abstract
Nasopharyngeal carcinoma (NPC) is a rare and locally aggressive form of childhood cancer. Treatment of pediatric NPC includes chemotherapy and radiotherapy. Most studies on the treatment of pediatric NPC are single-arm studies. With current treatment protocols survival rates for patients with nonmetastatic disease exceed 80%, although most children will have long-term treatment-related late effects. Efforts to reduce early and late toxicities include reduced radiotherapy doses in children with good responses to induction chemotherapy. Further studies are needed to evaluate the role of immunotherapy in both the primary setting and in children with progressive or relapsed disease. This review summarizes current clinical approaches to the treatment of pediatric NPC.
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Ollivier L, Laprie A, Jouglar E, Claude L, Martin V, Muracciole X, Padovani L, Supiot S, Escande A. [Characteristics of radiotherapy for adolescents and young adults]. Cancer Radiother 2023; 27:736-745. [PMID: 38652674 DOI: 10.1016/j.canrad.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 04/25/2024]
Abstract
Radiotherapy for adolescents and young adults is complex in several aspects. The population is very heterogeneous and has characteristics derived from both paediatric and adult populations both in terms of pathology (anatomical pathology, response to treatment) and the patient's physical, biological and psychological characteristics. This article reviews the characteristics to be taken into account in adolescent and young adult patients radiotherapy and more particularly in some of the most common diseases.
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Affiliation(s)
- L Ollivier
- Département de radiothérapie, institut de cancérologie de l'Ouest (ICO), Saint-Herblain, France
| | - A Laprie
- Département d'oncologie-radiothérapie, oncopole institut Claudius-Regaud, institut universitaire du cancer de Toulouse, université Toulouse III, Toulouse, France
| | - E Jouglar
- Département de radiothérapie, institut Curie, université Paris Science et Lettres, Paris, France
| | - L Claude
- Département de radiothérapie, centre Léon-Bérard, Lyon, France
| | - V Martin
- Département d'oncologie-radiothérapie, Gustave-Roussy, Villejuif, France
| | - X Muracciole
- Département d'oncologie-radiothérapie, Assistance publique-hôpitaux de Marseille, CHU La Timone, CHU Nord, Marseille, France
| | - L Padovani
- Département d'oncologie-radiothérapie, Assistance publique-hôpitaux de Marseille, CHU La Timone, CHU Nord, Marseille, France
| | - S Supiot
- Département de radiothérapie, institut de cancérologie de l'Ouest (ICO), Saint-Herblain, France
| | - A Escande
- Département de radiothérapie, centre Léonard-de-Vinci, Dechy, France; Laboratoire CRIStAL, UMR 9186, université de Lille, Villeneuve-d'Ascq, France.
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Vaughn JA. Imaging of Pediatric Cervical Lymphadenopathy. Neuroimaging Clin N Am 2023; 33:581-590. [PMID: 37741659 DOI: 10.1016/j.nic.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
There is a wide variety of disease entities in children, which can present with cervical adenopathy. The spectrum of pathology and imaging appearance differs in many cases from that seen in adults. This review aims to compare the strengths and limitations of the various imaging modalities available to image pediatric patients presenting with cervical adenopathy, provide guidance on when to image, and highlight the imaging appearance of both common and uncommon disorders affecting the cervical nodes in children to aid the radiologist in their clinical practice.
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Affiliation(s)
- Jennifer A Vaughn
- Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA; Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA; Radiology, Creighton University School of Medicine, Phoenix, AZ, USA; Barrows Neurological Institute, Phoenix, AZ, USA.
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Wu B, Shen L, Peng G, Li Y, Zhou Z, Li J, Huang X, Zhou Q, Jiang H, Huang J, Ding Q, Zhang Z, Qin Y, Hong X, Shi L, Zou Z, Yao J, Zhang J, Liu D, Wan C, Wu G, Song L, Chen S, Yi J, Yang K. Molecular characteristics of pediatric nasopharyngeal carcinoma using whole-exome sequencing. Oral Oncol 2022; 135:106218. [DOI: 10.1016/j.oraloncology.2022.106218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022]
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Steffen C, Piwonski I, Heiland M, Stromberger C, Kofla G, Doll C, Coordes A, Beck-Broichsitter B. Influence of Tumor Site on Survival in Young Patients with Head and Neck Squamous Cell Carcinoma. Curr Oncol 2022; 29:969-980. [PMID: 35200581 PMCID: PMC8870694 DOI: 10.3390/curroncol29020082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 11/16/2022] Open
Abstract
The number of patients under the age of 45 diagnosed with head and neck squamous cell carcinomas (HNSCC) is increasing, probably due to the incidence of oropharyngeal cancers. Comparisons of HNSCC in young and old patients regarding tumor site and survival in sample sizes of relevance are rarely published. The aim of the study was to analyze the differences in survival between age groups dependent on tumor site and the influence of oropharyngeal cancers on the rising rates of HNSCC in the young. The records of 4466 patients diagnosed with HNSCC were reviewed retrospectively. Patients younger than 45 years were divided further into four subgroups for specific age differences in the young. The influences of patient and clinicopathological characteristics on survival were assessed using Kaplan–Meier analyses. Among the patient cohort, 4.8% were younger than 45 years. Overall survival (OS) in these patients was better, with a 5-year OS of 66.1% (vs. 46.4%), while relapse-free survival (RFS) was better in the older patient population, with a 5-year RFS of 74.9% (vs. 68.1%). Decreased RFS in the young was found for advanced tumor stages and tumor sited at the larynx. Hypopharynx and advanced stages were independent risk factors for OS under 45 years. Overall, 44.4% of all HNSCC in patients under 30 years were nasopharyngeal cancers, and incidence decreased with age. The incidence of oropharyngeal cancers increased significantly with age. Better OS in the young may be explained by lower tumor and disease stages, whereas oropharyngeal tumors and HPV were not found to cause rising rates of HNSCC. Laryngeal malignancies in young patients might be related to an increased malignant potential and should, consequently, be treated as such.
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Affiliation(s)
- Claudius Steffen
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany; (M.H.); (C.D.); (B.B.-B.)
- Correspondence: ; Tel.: +49-30-450-655083; Fax: +49-30-450-555901
| | - Iris Piwonski
- Department of Pathology, Campus Mitte, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany;
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany; (M.H.); (C.D.); (B.B.-B.)
| | - Carmen Stromberger
- Department of Radiooncology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany;
| | - Grzegorz Kofla
- Department of Oncology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany;
| | - Christian Doll
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany; (M.H.); (C.D.); (B.B.-B.)
| | - Annekatrin Coordes
- Department of Otorhinolaryngology, Head and Neck Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany;
| | - Benedicta Beck-Broichsitter
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany; (M.H.); (C.D.); (B.B.-B.)
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8
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Asakage T. Epidemiology and treatment of head and neck malignancies in the AYA generation. Int J Clin Oncol 2022; 27:465-472. [PMID: 35028770 DOI: 10.1007/s10147-021-02093-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/19/2021] [Indexed: 11/05/2022]
Abstract
The Adolescent and Young Adult (AYA) population refers to the population of young adults and adolescents in the 15-39 years age group. This population subgroup experiences various important life events. Head and neck malignancies are rare tumors, in general, but they are extremely rare in the AYA population. When analyzed by the primary site of the tumors, thyroid gland, soft tissue, and nasopharyngeal malignancies are the most commonly encountered head and neck malignancies in the AYA generation. The most common histopathologic subtypes are carcinomas (thyroid carcinoma, nasopharyngeal carcinoma) and rhabdomyosarcoma. Therefore, in this review, the author discusses these three diseases in the AYA population in detail. Especially, patients with parameningeal rhabdomyosarcoma are at a high risk of dysfunction and facial deformity. Infertility problems may also occur as long-term sequelae of chemotherapy in this population. Radiation therapy might be associated with considerable morbidity. Complications such as cataract, xerostomia, hearing loss, neck fibrosis, and trismus are also common. Head and neck surgeons and medical oncologists should choose the optimal treatment taking into account the curability of the tumors relative to the long-term adverse events of treatment use. Finally, little evidence has been accumulated on head and neck malignancies in the AYA population, and it is urgently necessary to build a high level of evidence for the future.
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Affiliation(s)
- Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Lee SW, Yang CC, Lai HY, Tsai HH, Yeh CF, Kuo YH, Kang NW, Chen TJ, Chang SL. Roundabout Guidance Receptor 1 Is an Emerging Prognostic Biomarker for Nasopharyngeal Carcinoma. CLINICAL MEDICINE INSIGHTS: ONCOLOGY 2022; 16:11795549221113244. [PMID: 35898392 PMCID: PMC9310334 DOI: 10.1177/11795549221113244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Nasopharyngeal carcinoma (NPC) is a malignant tumor originating from the nasopharynx with high morbidity and mortality in Southeast Asia and south of China. Roundabout guidance receptor 1 (ROBO1) can regulate axonogenesis (axon-like protrusion), which may play an important role in migration. However, the roles of ROBO1 in NPC have not been clarified. Methods: A comparative analysis employing the NPC transcriptome (GSE12452) and the axonogenesis-related genes (GO: 0050772) was performed. In total, 124 tissue blocks from patients primarily diagnosed as NPC (1993-2002) were examined using immunohistochemical staining. The connections between clinicopathological variables and protein immunoexpression were analyzed by Pearson’s chi-square test. The Kaplan–Meier method with a log-rank test was employed to plot survival curves. Multivariate analysis was performed using the Cox proportional hazards model to identify independent prognostic biomarker. Results: According to transcriptome analysis, we found that ROBO1 is significantly highly expressed in NPC tissues compared with normal tissues. The immunohistochemistry (IHC) staining showed that high expression of ROBO1 was significantly related to primary tumor (T1T2 and T3T4) ( P = .024), nodal metastasis status (N0N1 and N2N3) ( P = .030), stage (I-II and III-IV) ( P = .019), and histological grade (keratinizing, non-keratinizing, and undifferentiated) ( P = .065). Importantly, NPC patients with high ROBO1 expression had poorer disease-specific survival (DSS) ( P = .0001), distal metastasis-free survival (DMeFS) ( P < .0001), and local recurrence-free survival (LRFS) ( P = .0001) compared with NPC patients with low ROBO1 expression through the uni-/multivariate and the Kaplan–Meier survival analyses. Conclusion: Our report indicates that ROBO1 might be a potential prognostic biomarker for NPC.
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Affiliation(s)
- Sung-Wei Lee
- Department of Radiation Oncology, Chi Mei Medical Center, Liouying
| | - Ching-Chieh Yang
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan
- Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan
| | - Hong-Yue Lai
- Department of Medical Research, Chi Mei Medical Center, Tainan
- Trans-Omic Laboratory for Precision Medicine, Chi Mei Medical Center, Tainan
| | - Hsin-Hwa Tsai
- Department of Medical Research, Chi Mei Medical Center, Tainan
- Trans-Omic Laboratory for Precision Medicine, Chi Mei Medical Center, Tainan
| | - Cheng-Fa Yeh
- Department of Internal Medicine, Chi Mei Medical Center, Tainan
| | - Yu-Hsuan Kuo
- Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan
- College of Pharmacy and Science, Chia Nan University, Tainan
| | - Nai-Wen Kang
- Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan
| | - Tzu-Ju Chen
- Department of Pet care and grooming, Chung Hwa University of Medical Technology, Tainan
- Department of Clinical Pathology, Chi-Mei Medical Center, Tainan
- Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung
| | - Shih-Lun Chang
- Department of Pet care and grooming, Chung Hwa University of Medical Technology, Tainan
- Department of Otolaryngology, Chi Mei Medical Center, Tainan
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Laprie A, Bernier V, Padovani L, Martin V, Chargari C, Supiot S, Claude L. Guide for paediatric radiotherapy procedures. Cancer Radiother 2021; 26:356-367. [PMID: 34969622 DOI: 10.1016/j.canrad.2021.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
A third of children with cancer receive radiotherapy as part of their initial treatment, which represents 800 paediatric irradiations per year in France carried out in 15 specialized centres approved on the recommendations of the French national cancer institute in decreasing order of frequency, the types of cancer that require irradiation are: brain tumours, neuroblastomas, Ewing's sarcomas, Hodgkin's lymphomas, soft tissue sarcomas including rhabdomyosarcomas, and nephroblastomas. The treatment guidelines follow the recommendations of the French society for childhood cancers (SFCE) or the French and European prospective protocols. The therapeutic indications, the technical and/and ballistic choices of complex cases are frequently discussed during bimonthly paediatric radiotherapy technical web-conferences. All cancers combined, overall survival being 80%, long-term toxicity logically becomes an important concern, making the preparation of treatments complex. The irradiation methods include all the techniques currently available: 3D conformational irradiation, intensity modulation radiation therapy, irradiation under normal or hypofractionated stereotaxic conditions, brachytherapy and proton therapy. We present the update of the recommendations of the French society for radiation oncology on the indications, the technical methods of realization and the organisation and the specificities of paediatric radiation oncology.
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Affiliation(s)
- A Laprie
- Département d'oncologie radiothérapie, Institut universitaire du cancer de Toulouse-Oncopole (IUCT-oncopole), université Paul-Sabatier Toulouse III, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| | - V Bernier
- Département d'oncologie radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France
| | - L Padovani
- Département de cancérologie radiothérapie, CHU, 13000 Marseille, France; Université Aix-Marseille, 13000 Marseille, France
| | - V Martin
- Département de cancérologie radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - C Chargari
- Département d'oncologie radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; Service de santé des armées, 75000 Paris, France
| | - S Supiot
- Département de radiothérapie, Institut de cancérologie de l'Ouest (ICO) centre René-Gauducheau, 44800 Saint-Herblain, France; Université de Nantes, 44000 Nantes, France
| | - L Claude
- Département d'oncologie radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France
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Kebudi R, Buyukkapu SB, Gorgun O, Ozkaya K, Meral R, Ayan I, Altun M. Nasopharyngeal carcinoma in children: Multimodal treatment and long-term outcome of 92 patients in a single center over a 28-year period. Pediatr Blood Cancer 2021; 68:e29372. [PMID: 34582092 DOI: 10.1002/pbc.29372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate the long-term outcome and late effects in pediatric patients with nasopharyngeal carcinoma (NPC) treated with neoadjuvant chemotherapy (NACT), followed by radiotherapy (RT). METHODS Ninety-two children (65 male, 27 female) diagnosed with NPC between 1989 and 2017 in the Istanbul University, Institute of Oncology were evaluated retrospectively. NACT consisted of three cycles of cisplatin-containing regimen every 3 weeks, followed by RT. RESULTS The median age was 13 years (5-18 years). Most had locoregionally advanced disease (stage III/IVA/IVB) and five had distant metastases at presentation. At a median follow-up of 108 months (3-332 months), 5- and 10-year overall survival rates and event-free survival rates were 87.5%, 79.7% and 82.1%, 78.9%, respectively. Three patients with distant metastasis are long-term survivors. Thirteen patients relapsed at a median of 8 months (2-23 months). Hypothyroidism (36%) and xerostomia (25%) were the most frequent long-term treatment-related toxicities. Nine second malignancies developed in eight patients, eight in the irradiated field at a median of 14 years (range 5-26 years), five of whom are long-term survivors after curative surgery. CONCLUSIONS Three courses of cisplatin-containing NACT, followed by RT lead to high survival and locoregional control rate in advanced stage NPC in children. Patients with distant metastasis should also be treated with curative intent by systemic chemotherapy and locoregional radiotherapy. Patients should be followed closely for recurrences and long-term morbidities including second malignancies, which may be treated with curative surgeries if diagnosed early.
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Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Sema Bay Buyukkapu
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Omer Gorgun
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Kübra Ozkaya
- Division of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Rasim Meral
- Division of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Inci Ayan
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Musa Altun
- Division of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.,Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Convolutional Neural Network Intelligent Segmentation Algorithm-Based Magnetic Resonance Imaging in Diagnosis of Nasopharyngeal Carcinoma Foci. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:2033806. [PMID: 34456649 PMCID: PMC8380181 DOI: 10.1155/2021/2033806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/25/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022]
Abstract
The aim of this study was to explore the adoption value of convolutional neural network- (CNN-) based magnetic resonance imaging (MRI) image intelligent segmentation model in the identification of nasopharyngeal carcinoma (NPC) lesions. The multisequence cross convolutional (MSCC) method was used in the complex convolutional network algorithm to establish the intelligent segmentation model two-dimensional (2D) ResUNet for the MRI image of the NPC lesion. Moreover, a multisequence multidimensional fusion segmentation model (MSCC-MDF) was further established. With 45 patients with NPC as the research objects, the Dice coefficient, Hausdorff distance (HD), and percentage of area difference (PAD) were calculated to evaluate the segmentation effect of MRI lesions. The results showed that the 2D-ResUNet model processed by MSCC had the largest Dice coefficient of 0.792 ± 0.045 for segmenting the tumor lesions of NPC, and it also had the smallest HD and PAD, which were 5.94 ± 0.41 mm and 15.96 ± 1.232%, respectively. When batch size = 5, the convergence curve was relatively gentle, and the convergence speed was the best. The largest Dice coefficient of MSCC-MDF model segmenting NPC tumor lesions was 0.896 ± 0.09, and its HD and PAD were the smallest, which were 5.07 ± 0.54 mm and 14.41 ± 1.33%, respectively. Its Dice coefficient was lower than other algorithms (P < 0.05), but HD and PAD were significantly higher than other algorithms (P < 0.05). To sum up, the MSCC-MDF model significantly improved the segmentation performance of MRI lesions in NPC patients, which provided a reference for the diagnosis of NPC.
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13
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Ben-Ami T, Kontny U, Surun A, Brecht IB, Almaraz RL, Dragomir M, Pourtsidis A, Casanova M, Fresneau B, Bisogno G, Schneider DT, Reguerre Y, Bien E, Stachowicz-Stencel T, Österlundh G, Wygoda M, Janssens GO, Zsiros J, Jehanno N, Brisse HJ, Gandola L, Christiansen H, Claude L, Ferrari A, Rodriguez-Galindo C, Orbach D. Nasopharyngeal carcinoma in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29018. [PMID: 33844410 DOI: 10.1002/pbc.29018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 01/25/2023]
Abstract
Nasopharyngeal carcinoma (NPC) is a rare pediatric tumor. Collaborative studies performed over the last decades showed improved results compared to historical data, but standardized guidelines for diagnosis and management of pediatric NPC are still unavailable. This study presents a European consensus guideline for the diagnosis and treatment of pediatric NPC developed by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT). Main recommendations include induction chemotherapy with cisplatin and 5-flurouracil, concomitant chemoradiotherapy in advanced disease, and to consider maintenance treatment with interferon beta (IFN-β) for selected high-risk patients. Dose adjustments of radiotherapy based on response to induction chemotherapy may decrease the rates of long-term treatment-related complications that affect most of the survivors.
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Affiliation(s)
- Tal Ben-Ami
- Pediatric Hematology-Oncology Unit, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Udo Kontny
- Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Ines B Brecht
- Pediatric Hematology and Oncology, University Children's Hospital, Eberhard-Karls-Universitaet, Tuebingen, Germany
| | - Ricardo López Almaraz
- Pediatric Hematology and Oncology Unit, Hospital Universitario de Cruces, Barakaldo-Bizkaia, Spain
| | - Monica Dragomir
- Department of Pediatric Oncology, Oncology Institute "Prof. Dr. Al. Trestioreanu,", Bucharest, Romania
| | - Apostolos Pourtsidis
- Pediatric and Adolescents Oncology Clinic Children's Hospital MITERA, Athens, Greece
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Brice Fresneau
- Gustave Roussy, Department of Pediatric Oncology, Université Paris-Saclay, Villejuif, France.,Paris-Saclay University, Paris-Sud University, Paris, France
| | - Gianni Bisogno
- Hematology Oncology Division, Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | | | - Yves Reguerre
- Department of Pediatric Hematology and Oncology, Félix Guyon University Hospital, St. Denis, Réunion Island, France
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | | | - Gustaf Österlundh
- Department of Pediatric Hematology and Oncology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marc Wygoda
- Department of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Geert O Janssens
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - József Zsiros
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Nina Jehanno
- Department of Nuclear Medicine, Institut Curie, Paris, France
| | - Herve J Brisse
- Department of Radiology, Institut Curie, Paris University, Paris, France
| | - Lorenza Gandola
- Pediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Hans Christiansen
- Department of Radiation Oncology, Hannover Medical School, Hanover, Germany
| | - Line Claude
- Department of Radiation Oncology, Léon Bérard Center, Lyon, France
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
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Chen C, Chen Q, Xu Y, Zheng W, Lin Z, Wu Z, Ye W, Huang X, Lin X, Bai P. Comparison of Prognosis Between Juvenile and Adult Nasopharyngeal Carcinoma: A Propensity Score-Matched Analysis. Cancer Manag Res 2020; 12:8613-8621. [PMID: 32982452 PMCID: PMC7509313 DOI: 10.2147/cmar.s260402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate whether juvenile patients with nasopharyngeal carcinoma (NPC) in China have better prognosis than their adult counterparts in the intensity-modulated radiation therapy (IMRT) era, after controlling for potential confounding variables. Methods Data pertaining to 1139 patients with newly diagnosed NPC without metastasis, who were treated with IMRT at our hospital, were retrospectively analyzed. Of these, 60 patients were juvenile (age ≤18 years) diagnosed between January 2003 and December 2018, while 1079 patients were adults (≤65 years) diagnosed between January 2013 and December 2014. To minimize the influence of selection and confounding bias, 1:2 propensity score matching (PSM) was used. Overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were estimated using the Kaplan–Meier method and between-group differences assessed using the Log rank test. The long-term toxicity of the juvenile patients was evaluated according to the criteria of the Radiation Therapy Oncology Group (RTOG) and the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results Five-year OS of juvenile and adult patients were 88.07% and 85.08%, respectively. Before PSM, OS, PFS, DMFS, or LRFS were comparable in the two groups (all P > 0.05). After PSM, OS, DFS, and LRFS in the juvenile group were markedly longer than that in adults (P = 0.005, P = 0.027, and P = 0.024, respectively). With respect to long-term toxicity, the most common adverse effects in juvenile patients were cervix fibrosis, ototoxicity, and xerostomia. However, except for two patients who developed grade 3 ototoxicity, all adverse effects were within grade 2. Conclusion In the IMRT era, juvenile Chinese patients with NPC had better 5-year OS, DFS, and LRFS than their adult counterparts. The adverse events in the juvenile cohort were relatively mild; however, the risk of severe ototoxicity should not be neglected.
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Affiliation(s)
- Chuanben Chen
- Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, People's Republic of China
| | - Qinyan Chen
- Graduate School, Fujian Medical University, Fuzhou 350000, Fujian Province, People's Republic of China
| | - Yuanji Xu
- Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, People's Republic of China
| | - Wei Zheng
- Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, People's Republic of China
| | - Zhizhong Lin
- Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, People's Republic of China
| | - Zijie Wu
- Graduate School, Fujian Medical University, Fuzhou 350000, Fujian Province, People's Republic of China
| | - Wangzhong Ye
- Graduate School, Fujian Medical University, Fuzhou 350000, Fujian Province, People's Republic of China
| | - Xinyi Huang
- Graduate School, Fujian Medical University, Fuzhou 350000, Fujian Province, People's Republic of China
| | - Xiurong Lin
- Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, People's Republic of China
| | - Penggang Bai
- Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, People's Republic of China
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Villela VA, Morales-León JF, Cavigli A, Palacios E. Pediatric EBV+ Nasopharyngeal Carcinoma With Complete ICA Occlusion. EAR, NOSE & THROAT JOURNAL 2020; 101:228-230. [PMID: 32862722 DOI: 10.1177/0145561320954121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Vidal A Villela
- Department of Radiology/Neuroradiology, 12255Tulane University School of Medicine, New Orleans, LA, USA
| | - Juan F Morales-León
- Department of Radiology/Neuroradiology, 12255Tulane University School of Medicine, New Orleans, LA, USA
| | - Amy Cavigli
- Department of Radiology/Neuroradiology, 12255Tulane University School of Medicine, New Orleans, LA, USA
| | - Enrique Palacios
- Department of Radiology/Neuroradiology, 12255Tulane University School of Medicine, New Orleans, LA, USA
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16
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Orman G, Tran BH, Desai N, Meoded A, Kralik S, Smith V, Hicks J, Kirsch C, Huisman TAGM. Neuroimaging Characteristics of Nasopharyngeal Carcinoma in Children. J Neuroimaging 2020; 31:137-143. [PMID: 32862510 DOI: 10.1111/jon.12780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Pediatric nasopharyngeal carcinoma (NPC) is a rare epithelial origin tumor associated with undifferentiated histology, Epstein-Barr virus (EBV) infection, and genetic risk factors. Childhood NPC is usually clinically silent, often presenting with advanced locoregional compromise, including skull base invasion and cervical lymphadenopathy, and has a better prognosis than adult NPC. This article describes computed tomography (CT) and magnetic resonance imaging (MRI) features in a cohort of 28 pediatric NPC patients. METHODS A retrospective review was performed among children with histopathology proven NPC diagnoses between 1996 and 2019 for this study. The electronic medical records were reviewed to determine demographics, EBV serology, and World Health Organization (WHO) type. Nasopharyngeal CT and/or MRI at presentation for tumor spread as well as density and/or intensity, lymphadenopathy, postcontrast enhancement and diffusion characteristics before treatment were evaluated. RESULTS Twenty-eight patients (21 males, 7 females) were included. The mean patient age at diagnosis was 13.3 (range 7 to 17) years. EBV was positive in 71.4% of patients. The majority of patients (78.6%) had a WHO type III tumor, unilateral fossa of Rosenmuller involvement (71.4%). Neuroimaging features were CT isodensity, T1-isointensity, T2-hyperintensity, and heterogeneous postcontrast enhancement for all patients (100%) and restricted diffusion (90%). CONCLUSIONS Although uncommon in pediatric patients, NPC should be in the differential diagnosis of adolescents presenting with a nasopharyngeal mass. Recognizing key imaging characteristics is helpful in the diagnosis of NPC.
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Affiliation(s)
- Gunes Orman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Brandon H Tran
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Nilesh Desai
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Avner Meoded
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Stephen Kralik
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Valeria Smith
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - John Hicks
- Department of Pathology, Baylor College of Medicine, One Baylor Plaza, Houston, TX
| | - Claudia Kirsch
- Department of Radiology, Northwell Health Zucker Hofstra School of Medicine at Northwell North Shore University Hospital, Manhasset, NY
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Chua ML, Sun Y, Supiot S. Advances in nasopharyngeal carcinoma -"West meets East". Br J Radiol 2019; 92:20199004. [PMID: 31526301 DOI: 10.1259/bjr.20199004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Melvin Lk Chua
- Divisions of Radiation Oncology and Medical Sciences, National Cancer Centre Singapore, Singapore.,Oncology Academic Programme, Duke-NUS Medical School, Singapore
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China.,Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes, St-Herblain, France.,University of Nantes, Nantes, France
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