DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy
Yecai Huang,1,2 Mei Feng,1,2 Xuegang Yang,3 Jie Zhou,2 Lu Li,2 Ke Xu,2 Guohui Xu,1,3,* Jinyi Lang1,2,* 1School of Medicine, University of Electronic Science and Technology of China , Chengdu, People’s Republic of China; 2Department of Radiation Oncology, Sichuan Cancer Hospital and Institu...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-05-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/dw-mri-guided-dose-escalation-improves-local-control-of-locally-advanc-peer-reviewed-article-CMAR |
| _version_ | 1818386159340879872 |
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| author | Huang Y Feng M Yang X Zhou J Li L Xu K Xu G Lang J |
| author_facet | Huang Y Feng M Yang X Zhou J Li L Xu K Xu G Lang J |
| author_sort | Huang Y |
| collection | DOAJ |
| description | Yecai Huang,1,2 Mei Feng,1,2 Xuegang Yang,3 Jie Zhou,2 Lu Li,2 Ke Xu,2 Guohui Xu,1,3,* Jinyi Lang1,2,* 1School of Medicine, University of Electronic Science and Technology of China , Chengdu, People’s Republic of China; 2Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People’s Republic of China; 3Department of Interventional Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guohui Xu; Jinyi LangSichuan Cancer Hospital& Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, No. 55, South Renmin Road, Wuhou District, Chengdu 610000, People’s Republic of ChinaTel +86-28-85420152Email xgh0913@hotmail.com; langjy610@163.comBackground: Nasopharyngeal carcinoma (NPC) is one of the most highly radiosensitive malignancies; however, some locally advanced NPC patients experienced local recurrence even though they received aggressive treatment regimens. Defining the tumor volume precisely is important to escalate the total dose required for the primary tumor. In this study, we aimed to investigate the feasibility and efficacy of dose escalation guided by DW-MRI in patients with locally advanced NPC.Patients and Methods: A total of 230 patients with locally advanced NPC treated with intensive modulated radiotherapy (IMRT) at Sichuan Cancer Hospital between January 2010 and January 2015 were enrolled in this retrospective study. All the patients were treated with all-course of simultaneous integrated boost-IMRT. DW-MRI-guided dose escalation with 2.2– 2.5 Gy/F, qd for 1– 3 days or 1.2– 1.5 Gy/F, bid for 1– 3 days were prescribed to 123 patients. Survival and complication of the patients were evaluated, and multivariate analysis was performed.Results: The median follow-up of patients in the DW-MRI-guided dose-escalation group and the conventional group was 48 months (range 8– 88 months) and 52 months (range 6– 90 months), respectively. The 5-year overall survival rate, distant metastasis-free survival rate, progression-free survival, and local recurrence-free survival (LRFS) of patients in the dose-escalation group and the conventional group were 88% vs 82.5% (p = 0.244), 86.1% vs 83.3% (p = 0.741), 82.2% vs 76.6% (p = 0.286), and 89.1% vs 80.1% (p = 0.029), respectively. Multivariate analysis showed that dose escalation was independent prognostic factor for LRFS (HR 0.386, 95% CI 0.163– 0.909, p = 0.03).Conclusion: DW-MRI-guided dose escalation is a feasible strategy to improve local control of patients with locally advanced NPC. The treatment-related complications are tolerable.Keywords: nasopharyngeal carcinoma, DW-MRI, dose escalation, locally advanced |
| first_indexed | 2024-12-14T03:49:37Z |
| format | Article |
| id | doaj.art-bce8f23b46d342cd978c53b5ab63eb80 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-14T03:49:37Z |
| publishDate | 2020-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-bce8f23b46d342cd978c53b5ab63eb802022-12-21T23:18:16ZengDove Medical PressCancer Management and Research1179-13222020-05-01Volume 123107311653595DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with ChemoradiotherapyHuang YFeng MYang XZhou JLi LXu KXu GLang JYecai Huang,1,2 Mei Feng,1,2 Xuegang Yang,3 Jie Zhou,2 Lu Li,2 Ke Xu,2 Guohui Xu,1,3,* Jinyi Lang1,2,* 1School of Medicine, University of Electronic Science and Technology of China , Chengdu, People’s Republic of China; 2Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People’s Republic of China; 3Department of Interventional Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guohui Xu; Jinyi LangSichuan Cancer Hospital& Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, No. 55, South Renmin Road, Wuhou District, Chengdu 610000, People’s Republic of ChinaTel +86-28-85420152Email xgh0913@hotmail.com; langjy610@163.comBackground: Nasopharyngeal carcinoma (NPC) is one of the most highly radiosensitive malignancies; however, some locally advanced NPC patients experienced local recurrence even though they received aggressive treatment regimens. Defining the tumor volume precisely is important to escalate the total dose required for the primary tumor. In this study, we aimed to investigate the feasibility and efficacy of dose escalation guided by DW-MRI in patients with locally advanced NPC.Patients and Methods: A total of 230 patients with locally advanced NPC treated with intensive modulated radiotherapy (IMRT) at Sichuan Cancer Hospital between January 2010 and January 2015 were enrolled in this retrospective study. All the patients were treated with all-course of simultaneous integrated boost-IMRT. DW-MRI-guided dose escalation with 2.2– 2.5 Gy/F, qd for 1– 3 days or 1.2– 1.5 Gy/F, bid for 1– 3 days were prescribed to 123 patients. Survival and complication of the patients were evaluated, and multivariate analysis was performed.Results: The median follow-up of patients in the DW-MRI-guided dose-escalation group and the conventional group was 48 months (range 8– 88 months) and 52 months (range 6– 90 months), respectively. The 5-year overall survival rate, distant metastasis-free survival rate, progression-free survival, and local recurrence-free survival (LRFS) of patients in the dose-escalation group and the conventional group were 88% vs 82.5% (p = 0.244), 86.1% vs 83.3% (p = 0.741), 82.2% vs 76.6% (p = 0.286), and 89.1% vs 80.1% (p = 0.029), respectively. Multivariate analysis showed that dose escalation was independent prognostic factor for LRFS (HR 0.386, 95% CI 0.163– 0.909, p = 0.03).Conclusion: DW-MRI-guided dose escalation is a feasible strategy to improve local control of patients with locally advanced NPC. The treatment-related complications are tolerable.Keywords: nasopharyngeal carcinoma, DW-MRI, dose escalation, locally advancedhttps://www.dovepress.com/dw-mri-guided-dose-escalation-improves-local-control-of-locally-advanc-peer-reviewed-article-CMARnasopharyngeal carcinomadw-mridose escalationlocally advanced |
| spellingShingle | Huang Y Feng M Yang X Zhou J Li L Xu K Xu G Lang J DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy Cancer Management and Research nasopharyngeal carcinoma dw-mri dose escalation locally advanced |
| title | DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy |
| title_full | DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy |
| title_fullStr | DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy |
| title_full_unstemmed | DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy |
| title_short | DW-MRI-Guided Dose Escalation Improves Local Control of Locally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy |
| title_sort | dw mri guided dose escalation improves local control of locally advanced nasopharyngeal carcinoma treated with chemoradiotherapy |
| topic | nasopharyngeal carcinoma dw-mri dose escalation locally advanced |
| url | https://www.dovepress.com/dw-mri-guided-dose-escalation-improves-local-control-of-locally-advanc-peer-reviewed-article-CMAR |
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