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Song JM, Mo N, Lv YQ, Huang LL, Wen YJ, Liu T, Li ZR, Wang RS, Zhang TT. Effects of concurrent chemoradiotherapy with or without Endostar on the regression of retropharyngeal lymph node and prognosis of patients with locally advanced nasopharyngeal carcinoma: a retrospective study. J Cancer Res Clin Oncol 2024; 150:232. [PMID: 38703186 PMCID: PMC11069474 DOI: 10.1007/s00432-024-05762-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND AND PURPOSE To investigate the effect of combining Endostar with concurrent chemoradiotherapy (ECCRT) compared to concurrent chemoradiotherapy (CCRT) on the regression rate of retropharyngeal lymph nodes (RLNs) and the relationship between regression rate of RLNs and prognosis of patients with locally advanced nasopharyngeal carcinoma (LANPC). METHODS A total of 122 LANPC patients with RLNs metastasis were included. Metastatic RLNs were delineated both before and after treatment slice by slice on the magnetic resonance images cross-section. The regression rate of RLNs, adverse effects (AE) were evaluated. The median regression rate of RLNs was taken as the cut-off value, and the patients were furtherly divided into high regression rate (HRR) group and low regression rate (LRR) group, then survival times were evaluated. RESULTS The median regression rates of RLNs in the ECCRT and CCRT groups were 81% and 50%, respectively (P < 0.001). There was no statistically significant difference in the incidence of grade 3/4 AEs between the two groups, except for oral mucositis (ECCRT 26.23% vs. CCRT 44.26%, P = 0.037). The 3-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS) and locoregional failure-free survival (LRFFS) rates in the HRR and LRR groups were 85.48% and 86.67% (P = 0.983), 80.65% and 68.33% (P = 0.037), 83.87% and 85% (P = 0.704), 93.55% and 81.67% (P = 0.033), respectively. CONCLUSIONS Patients in the ECCRT group had higher regression rates of RLNs and lower incidence of severe oral mucositis. Furthermore, patients in the HRR group had a better 3-year PFS and LRFFS rate than those in the LRR group.
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Affiliation(s)
- Jun-Mei Song
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Oncology Department, Nanchong Central Hospital, The Second Clinical Institute of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Ning Mo
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Yu-Qing Lv
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Lu-Lu Huang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Ya-Jing Wen
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Ting Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Zhi-Ru Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Ren-Sheng Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Ting-Ting Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Meng Z, Li P, Yang D, Huang H, Dong H, Qin Y, Bin Y, Li R, Wang S, Chen X, Kang M. The feasibility of level Ib-sparing intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma and high-risk factors classified based on the International Guideline. Radiother Oncol 2024; 191:110027. [PMID: 38008418 DOI: 10.1016/j.radonc.2023.110027] [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: 04/06/2023] [Revised: 10/08/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND AND PURPOSE To examine the feasibility of level Ib-sparing intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) who had high-risk factors classified based on the International Guideline (IG). MATERIALS AND METHODS We evaluated 961 non-metastatic NPC cases based on IG recommendations for prophylactic Ib irradiation. Four high-risk factors were used to categorise patients into three cohorts: A, B, and C. Propensity score matching was used to balance baseline characteristics in Cohort C, resulting in a matched Cohort C. Recurrence rates at level Ib and regional relapse-free survival (RRFS) rates were evaluated. RESULTS Among patients with negative Ib lymph nodes (LNs), 18, 54, 420, and 444 exhibited involvement of structures that drain to level Ib as the first echelon (FES), involvement of the submandibular gland (SMG), level II LNs with radiologic extranodal extension (rENE), and level II nodes with a maximal axial diameter (MAD) ≥ 2 cm, respectively. The recurrence rate was highest in Cohort A (11.1 %). Cohort B had no level Ib recurrence. In matched Cohort C, recurrence rates were low in both groups (Ib-sparing group: 0.6 % vs. Ib-covering group: 0.6 %, P > 0.999). No significant differences were observed in 5-year RRFS rates between the two groups in cohort A (p = 0.208), cohort B (p = 0.905), and matched cohort C (p = 0.423). CONCLUSIONS Level Ib-sparing IMRT could be performed safely for NPC patients with level II LNs who had rENE and/or MAD ≥ 2 cm. Further research should determine the necessity of level Ib prophylactic irradiation for patients with FES or SMG involvement.
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Affiliation(s)
- Zhen Meng
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Department of Oncology, The First Affiliated Hospital of Guangxi Chinese Medical University, No. 327 Xianhu Avenue, Xianhu Economic Development Zone, Nanning, Guangxi, People's Republic of China
| | - Pian Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; The First Affiliated Hospital, Department of Oncology Radiotherapy, Hengyang Medical School, University of South China, Hengyang 421001, Hunan, People's Republic of China
| | - Dong Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; The First Affiliated Hospital, Department of Oncology Radiotherapy, Hengyang Medical School, University of South China, Hengyang 421001, Hunan, People's Republic of China
| | - Heqing Huang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi, China
| | - Huan Dong
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Department of Radiotherapy and Chemotherapy, The Second People's Hospital of Yichang, No. 21, Xiling 1st Road, Yichang 443000, Hubei, People's Republic of China
| | - Yating Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi, China
| | - Ying Bin
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi, China
| | - Rong Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi, China
| | - Shuangyue Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi, China
| | - Xinghua Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China
| | - Min Kang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, People's Republic of China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi, China.
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Levyn H, Yang F, Lee NY. Radiation oncology for the rhinologist. Curr Opin Otolaryngol Head Neck Surg 2024; 32:5-13. [PMID: 38116957 DOI: 10.1097/moo.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW This comprehensive review explores evolving treatment strategies for sinonasal and nasopharyngeal malignancies. It analyzes the role of adjuvant radiotherapy, the potential of intensity-modulated proton therapy (IMPT), and the relevance of de-escalation strategies nasopharyngeal carcinoma (NPC). Additionally, it discusses hyperfractionation in re-irradiation in NPC. RECENT FINDINGS Adjuvant radiotherapy remains pivotal for sinonasal tumors, improving locoregional control and survival, notably in squamous cell carcinomas, adenocarcinomas, and adenoid cystic carcinomas. IMPT promises enhanced outcomes by sparing healthy tissues, potentially improving patients' quality of life. For select stage II/T3N0 NPC, radiotherapy alone offers comparable outcomes to concurrent chemoradiotherapy, with fewer adverse events and improved quality of life. Selective neck irradiation in NPC patients with uninvolved necks maintains oncologic outcomes while reducing late toxicity. Hyperfractionation in re-irradiation shows promise in lowering late toxicities and improving overall survival, particularly in undifferentiated sinonasal carcinomas. SUMMARY This review underscores the significance of adjuvant radiotherapy and the potential of advanced radiation techniques in optimizing sinonasal and nasopharyngeal malignancy outcomes. It emphasizes evolving de-escalation methods and individualized, evidence-based approaches. Future research will further refine strategies for these challenging malignancies.
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Affiliation(s)
| | - Fan Yang
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Eggmann F, Hwang JD, Ayub JM, Mante FK. Impact of Irradiation on the Adhesive Performance of Resin-Based Dental Biomaterials: A Systematic Review of Laboratory Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2580. [PMID: 37048873 PMCID: PMC10095157 DOI: 10.3390/ma16072580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Head and neck cancers are a significant global health burden, with radiation therapy being a frequently utilized treatment. The aim of this systematic review was to provide a critical appraisal of laboratory studies that assessed the effect of irradiation on the adhesive performance of resin-based biomaterials. The analysis included 23 laboratory studies obtained from five databases, with most studies using human enamel, dentin, or both, and bonding procedures involving the fabrication of direct restorations, standardized specimens, bonding of orthodontic brackets, and luting of endodontic fiber posts. The protocols used for irradiation varied, with most studies exposing specimens made from extracted teeth to irradiation using cabinet irradiators to simulate treatment of head and neck cancer. The findings indicate that irradiation reduces the bond strength of dental adhesives and resin-based composites on flat, ground enamel and dentin specimens, with different adhesives and timing of irradiation having a significant impact on adhesive performance. Irradiation also increased microleakage in most studies. The effect of irradiation on marginal adaptation of direct resin-based composite restorations was inconclusive. This systematic review indicates that irradiation has detrimental effects on the adhesive performance of resin-based biomaterials and highlights the need for further clinical and laboratory studies evaluating the performance of adhesive materials and approaches to improve it.
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Affiliation(s)
- Florin Eggmann
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, CH-4058 Basel, Switzerland
| | - Jonathan D. Hwang
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jose M. Ayub
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Francis K. Mante
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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