Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram
IntroductionThe study assessed outcomes and toxicities of different treatment modalities for local and/or regional recurrent nasopharyngeal carcinoma (NPC) in a non-endemic area.MethodsPatients treated with curative intent for recurrent NPC with salvage surgery, photon-based radiotherapy, proton the...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1157584/full |
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| author | Vittorio Rampinelli Marco Ferrari Davide Mattavelli Pierluigi Bonomo Alessia Lambertoni Mario Turri-Zanoni Elisa D’Angelo Daniela Alterio Marco Cianchetti Barbara Vischioni Roberta Rosati Michele Tomasoni Marco Alparone Stefano Taboni Davide Tomasini Marta Maddalo Michela Buglione di Monale Bastia Nicola Alessandro Iacovelli Francesco Dionisi Maurizio Bignami Paolo Battaglia Paolo Bossi Alberto Deganello Cesare Piazza Alberto Schreiber Piero Nicolai Paolo Castelnuovo Ester Orlandi |
| author_facet | Vittorio Rampinelli Marco Ferrari Davide Mattavelli Pierluigi Bonomo Alessia Lambertoni Mario Turri-Zanoni Elisa D’Angelo Daniela Alterio Marco Cianchetti Barbara Vischioni Roberta Rosati Michele Tomasoni Marco Alparone Stefano Taboni Davide Tomasini Marta Maddalo Michela Buglione di Monale Bastia Nicola Alessandro Iacovelli Francesco Dionisi Maurizio Bignami Paolo Battaglia Paolo Bossi Alberto Deganello Cesare Piazza Alberto Schreiber Piero Nicolai Paolo Castelnuovo Ester Orlandi |
| author_sort | Vittorio Rampinelli |
| collection | DOAJ |
| description | IntroductionThe study assessed outcomes and toxicities of different treatment modalities for local and/or regional recurrent nasopharyngeal carcinoma (NPC) in a non-endemic area.MethodsPatients treated with curative intent for recurrent NPC with salvage surgery, photon-based radiotherapy, proton therapy (PT), with or without chemotherapy, at different Italian referral centers between 1998 and 2020 were included. Adverse events and complications were classified according to the Common Terminology Criteria for Adverse Events. Characteristics of the patients, tumors, treatments, and complications are presented along with uni- and multivariate analysis of prognostic factors. A survival predictive nomogram is also provided.ResultsA total of 140 patients treated from 1998 to 2020 were retrospectively assessed. Cases with lower age, comorbidity rate, stage, and shorter disease-free interval (DFI) preferentially underwent endoscopic surgery. More advanced cases underwent re-irradiation, fairly distributed between photon-based radiotherapy and PT. Age and DFI were independent factors influencing overall survival. No independent prognostic effect of treatment modality was observed. No significant difference in the morbidity profile of treatments was observed, with 40% of patients experiencing at least one adverse event classified as G3 or higher.ConclusionRecurrent NPC in a non-endemic area has dissimilar aspects compared to its endemic counterpart, suggesting the need for further studies that can guide the choice of the best treatment modality. |
| first_indexed | 2024-04-09T12:30:43Z |
| format | Article |
| id | doaj.art-52e6e303a5e24423bca4434e528e9799 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T12:30:43Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-52e6e303a5e24423bca4434e528e97992023-05-16T05:25:38ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11575841157584Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogramVittorio Rampinelli0Marco Ferrari1Davide Mattavelli2Pierluigi Bonomo3Alessia Lambertoni4Mario Turri-Zanoni5Elisa D’Angelo6Daniela Alterio7Marco Cianchetti8Barbara Vischioni9Roberta Rosati10Michele Tomasoni11Marco Alparone12Stefano Taboni13Davide Tomasini14Marta Maddalo15Michela Buglione di Monale Bastia16Nicola Alessandro Iacovelli17Francesco Dionisi18Maurizio Bignami19Paolo Battaglia20Paolo Bossi21Alberto Deganello22Cesare Piazza23Alberto Schreiber24Piero Nicolai25Paolo Castelnuovo26Ester Orlandi27Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalySection of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, ItalyUnit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalyRadiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, ItalyUnit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, ItalyUnit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, ItalyRadiotherapy Unit, Azienda Ospedaliero Universitaria di Modena, Modena, ItalyDivision of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, ItalyProton Therapy Unit, Azienda Provinciale Per i Servizi Sanitari, Trento, ItalyRadiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, ItalyUnit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalyUnit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalyUnit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalySection of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, ItalyDepartment of Radiation Oncology, Brescia University, Brescia, ItalyDepartment of Radiation Oncology, Brescia University, Brescia, ItalyDepartment of Radiation Oncology, Brescia University, Brescia, Italy0Radiotherapy 2 Unit, Fondazione IRCCS IstitutoTumori, Milan, Italy1Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, ItalyUnit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, ItalyUnit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy2Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy3Otolaryngology Head and Neck Surgery, IRCCS National Cancer Institute (INT), Milan, ItalyUnit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalyUnit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, ItalySection of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, ItalyUnit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, ItalyRadiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, ItalyIntroductionThe study assessed outcomes and toxicities of different treatment modalities for local and/or regional recurrent nasopharyngeal carcinoma (NPC) in a non-endemic area.MethodsPatients treated with curative intent for recurrent NPC with salvage surgery, photon-based radiotherapy, proton therapy (PT), with or without chemotherapy, at different Italian referral centers between 1998 and 2020 were included. Adverse events and complications were classified according to the Common Terminology Criteria for Adverse Events. Characteristics of the patients, tumors, treatments, and complications are presented along with uni- and multivariate analysis of prognostic factors. A survival predictive nomogram is also provided.ResultsA total of 140 patients treated from 1998 to 2020 were retrospectively assessed. Cases with lower age, comorbidity rate, stage, and shorter disease-free interval (DFI) preferentially underwent endoscopic surgery. More advanced cases underwent re-irradiation, fairly distributed between photon-based radiotherapy and PT. Age and DFI were independent factors influencing overall survival. No independent prognostic effect of treatment modality was observed. No significant difference in the morbidity profile of treatments was observed, with 40% of patients experiencing at least one adverse event classified as G3 or higher.ConclusionRecurrent NPC in a non-endemic area has dissimilar aspects compared to its endemic counterpart, suggesting the need for further studies that can guide the choice of the best treatment modality.https://www.frontiersin.org/articles/10.3389/fonc.2023.1157584/fullnasopharyngeal carcinomasalvage treatmentnon-endemic cancerrecurrent tumorproton therapyIMRT |
| spellingShingle | Vittorio Rampinelli Marco Ferrari Davide Mattavelli Pierluigi Bonomo Alessia Lambertoni Mario Turri-Zanoni Elisa D’Angelo Daniela Alterio Marco Cianchetti Barbara Vischioni Roberta Rosati Michele Tomasoni Marco Alparone Stefano Taboni Davide Tomasini Marta Maddalo Michela Buglione di Monale Bastia Nicola Alessandro Iacovelli Francesco Dionisi Maurizio Bignami Paolo Battaglia Paolo Bossi Alberto Deganello Cesare Piazza Alberto Schreiber Piero Nicolai Paolo Castelnuovo Ester Orlandi Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram Frontiers in Oncology nasopharyngeal carcinoma salvage treatment non-endemic cancer recurrent tumor proton therapy IMRT |
| title | Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram |
| title_full | Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram |
| title_fullStr | Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram |
| title_full_unstemmed | Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram |
| title_short | Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram |
| title_sort | treatment of loco regional recurrence of nasopharyngeal carcinoma in a non endemic area oncologic outcomes morbidity and proposal of a prognostic nomogram |
| topic | nasopharyngeal carcinoma salvage treatment non-endemic cancer recurrent tumor proton therapy IMRT |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1157584/full |
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