Delayed clinical complete response to intensity-modulated radiotherapy in nasopharyngeal carcinoma
| Autor: | Li Tian, Li Zhi Liu, Yuan Zhang, Jun Ma, Ying Sun, Ling Long Tang, Xu Liu, Rui Guo, Wen Fei Li |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Time Factors medicine.medical_treatment Tumor response 030218 nuclear medicine & medical imaging 03 medical and health sciences Mri image 0302 clinical medicine Clinical complete response medicine Humans In patient Aged Retrospective Studies Nasopharyngeal Carcinoma integumentary system Locoregional failure business.industry Carcinoma fungi Nasopharyngeal Neoplasms hemic and immune systems Middle Aged Prognosis medicine.disease Survival Analysis Surgery Radiation therapy Treatment Outcome Oncology Nasopharyngeal carcinoma 030220 oncology & carcinogenesis Female Radiotherapy Intensity-Modulated Radiology Intensity modulated radiotherapy Oral Surgery business |
| Zdroj: | Oral Oncology. 75:120-126 |
| ISSN: | 1368-8375 |
| Popis: | Twelve weeks after radiotherapy is the recommended time-point for assessing tumor response in nasopharyngeal carcinoma (NPC); however, regression after 12 weeks remains unclear. We explored NPC regression and the prognosis of patients with delayed clinical complete response (cCR).MRI images of 556 NPC patients treated with intensity-modulated radiotherapy (IMRT) between 2009 and 2012 were retrospectively reviewed. Clinical tumor response was assessed at 3-4 (assessment 1) and 6-9 months (assessment 2) after IMRT, and survival rates were compared.Of the 556 patients, 463 (83.3%) had cCR at assessment 1 (early cCR). Of the 93 patients with partial response at assessment 1, 45 (48.4%) achieved cCR at assessment 2 (delayed cCR), and 48 did not have cCR at assessment 2 (non-cCR). Locoregional failure rate was lower in patients with a cCR than those without a cCR at assessment 1 (7.1% vs. 26.9%, P .001) and assessment 2 (7.1% vs. 45.8%, P .001). Multivariate analysis showed cCR was a favorable prognostic factor for locoregional failure-free survival (LRFFS), failure-free survival (FFS), and overall survival (OS). Early and delayed cCR groups had better 5-year LRFFS (92.6% vs. 93.3% vs. 54.2%), FFS (83.8% vs. 84.4% vs. 48.5%) and OS (92.1% vs. 90.6% vs. 65.4%) than the non-cCR group (all P .001).Nearly half of the patients with partial response at 3-4 months achieve cCR by 6-9 months; delayed cCR is not a poor prognosticator. We suggest later assessment of cCR at 6-9 months after IMRT is acceptable in responding NPC. |
| Databáze: | OpenAIRE |
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