Analysis of patients with parotid recurrence after parotid-sparing IMRT for nasopharyngeal carcinoma: case series and review of the literature.

Autor: Yuce Sari S; Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey. sezin.yuce@hacettepe.edu.tr., Yilmaz MT; Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Yazici G; Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Mohammadipour S; Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Ozyigit G; Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Gullu I; Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Cengiz M; Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] [Strahlenther Onkol] 2024 Dec; Vol. 200 (12), pp. 1057-1065. Date of Electronic Publication: 2024 Oct 25.
DOI: 10.1007/s00066-024-02309-4
Abstrakt: Purpose: Intensity-modulated radiotherapy (IMRT) is the standard treatment approach for nasopharyngeal cancer (NPC). IMRT enables effective sparing of the parotid glands and reduces the risk of xerostomia, a common complication of head and neck irradiation. Nevertheless, it is essential to determine whether the parotid-sparing IMRT (ps-IMRT) technique yields increased intra-/periparotid recurrence rates, which constitutes the main purpose of this study.
Methods: Patients with a diagnosis of NPC that received definitive chemoradiotherapy/radiotherapy (CRT/RT) between 1991 and 2021 were evaluated retrospectively. Patients with intra-/periparotid recurrence were detected and prognostic factors for recurrence were sought.
Results: A total of 746 patients were evaluated. Two-dimensional (2D)-RT was applied to 541, 3D conformal RT (3D-CRT) to 10, and ps-IMRT to 195 patients. After a median 85-month follow-up, one (0.18%) patient who received 2D-RT and four (2%) patients who received ps-IMRT experienced an intra-/periparotid recurrence. The median time to intra-/periparotid recurrence was 11.9 months. All patients had been diagnosed with a metastatic lymph node > 2 cm at level II of the ipsilateral neck. In addition, all recurrences occurred on the same side as the positive neck at the time of diagnosis. The 3‑year overall survival, locoregional recurrence-free survival, and distant metastasis-free survival rates were 80%, 40%, and 60%, respectively.
Conclusion: Intra-/periparotid recurrence is extremely rare in NPC. However, it is still possible to identify and characterize particular risk factors, which include a metastatic lymph node at level II, particularly > 2 cm, and multinodal disease at the time of diagnosis.
Competing Interests: Declarations. Conflict of interest: S. Yuce Sari, M.T. Yilmaz, G. Yazici, S. Mohammadipour, G. Ozyigit, I. Gullu, and M. Cengiz declare that they have no competing interests. Ethical standards: All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the 1975 Helsinki declaration and its later amendments or comparable ethical standards and ethical approval was obtained from the institutional review board (1 Nov 2022, project number: GO 22/1103, decision number: 2022/18-06). Informed consent was obtained from all individual participants included in the study. Consent to publish: The authors affirm that human research participants provided informed consent to publication of the images in Fig. 1, Fig. 2, and Fig. 3.
(© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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