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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

With or without reirradiation in advanced local recurrent nasopharyngeal carcinoma: a case–control study

Authors: Li-Ting Liu, Qiu-Yan Chen, Lin-Quan Tang, Lu Zhang, Shan-Shan Guo, Ling Guo, Hao-Yuan Mo, Chong Zhao, Xiang Guo, Ming-Yuan Chen, Chao-Nan Qian, Mu-Sheng Zeng, Ming-Huang Hong, Jian-Yong Shao, Ying Sun, Jun Ma, Hai-Qiang Mai

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

The study aimed to evaluate the long-term outcome in patients with advanced local recurrent nasopharyngeal carcinoma (NPC) treated with or without reirradiation.

Methods

A total of 44 patients treated without reirradiation (non-RT + chemotherapy) were matched with 44 patients treated with reirradiation (re-RT+/-chemtherapy) by age, sex, Karnosky performance score (KPS), rT stage, rN stage, and time interval between initial radiation and recurrence (TI). Overall survival (OS) rate and time to progression (TTP) rate were assessed using Kaplan–Meier method, log-rank test, and Cox regression analysis.

Results

From March 2008 to December 2013, a total of 88 well-balanced rT3–4 N0-1 NPC patients were retrospectively analyzed. After a median follow-up of 27 months (range: 6–85), the 5-year OS rate and TTP rate was 23.4 %, 39.0 % in the non-RT + chemotherapy group and 27.5 %, 49.8 % in the re-RT+/-chemtherapy group, respectively. Multivariate analysis showed that significant toxic effect was the only significant prognosticator correlated with OS (HR: 2.15, 95 % CI = 1.02–4.53, p = 0.044). No statistically significant survival differences were observed between the two treatment groups in either univariate or multivariate analyses.

Conclusion

Compared with reiradiation, treating advanced local recurrent NPC with chemotherapy alone warrants further validation in the view of its similar survival and more acceptable toxicities.
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Literature
1.
Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, Forastiere AA, Adams G, Sakr WA, Schuller DE, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998;16(4):1310–7.PubMed
2.
Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, Siu L, Sze WM, Leung TW, Sham JS, et al. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol. 2005;23(28):6966–75.CrossRefPubMed
3.
Lee AW, Tung SY, Chan AT, Chappell R, Fu YT, Lu TX, Tan T, Chua DT, O'Sullivan B, Xu SL, et al. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006;66(1):142–51.CrossRefPubMed
4.
Chan AT, Teo PM, Ngan RK, Leung TW, Lau WH, Zee B, Leung SF, Cheung FY, Yeo W, Yiu HH, et al. Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial. J Clin Oncol. 2002;20(8):2038–44.CrossRefPubMed
5.
Lin JC, Jan JS, Hsu CY, Liang WM, Jiang RS, Wang WY. Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 2003;21(4):631–7.CrossRefPubMed
6.
Blanchard P, Lee A, Marguet S, Leclercq J, Ng WT, Ma J, Chan AT, Huang PY, Benhamou E, Zhu G, et al. Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol. 2015;16(6):645–55.CrossRefPubMed
7.
Lee N, Harris J, Garden AS, Straube W, Glisson B, Xia P, Bosch W, Morrison WH, Quivey J, Thorstad W, et al. Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol. 2009;27(22):3684–90.CrossRefPubMedPubMedCentral
8.
Tham IW, Hee SW, Yeo RM, Salleh PB, Lee J, Tan TW, Fong KW, Chua ET, Wee JT. Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the national cancer centre Singapore experience. Int J Radiat Oncol Biol Phys. 2009;75(5):1481–6.CrossRefPubMed
9.
Wolden SL, Chen WC, Pfister DG, Kraus DH, Berry SL, Zelefsky MJ. Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys. 2006;64(1):57–62.CrossRefPubMed
10.
Teo PM, Kwan WH, Chan AT, Lee WY, King WW, Mok CO. How successful is high-dose (> or = 60 Gy) reirradiation using mainly external beams in salvaging local failures of nasopharyngeal carcinoma? Int J Radiat Oncol Biol Phys. 1998;40(4):897–913.CrossRefPubMed
11.
Chua DT, Sham JS, Kwong DL, Wei WI, Au GK, Choy D. Locally recurrent nasopharyngeal carcinoma: treatment results for patients with computed tomography assessment. Int J Radiat Oncol Biol Phys. 1998;41(2):379–86.CrossRefPubMed
12.
Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, Wong CS, SK O. Salvage radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000;48(5):1331–8.CrossRefPubMed
13.
Hsiung CY, Yorke ED, Chui CS, Hunt MA, Ling CC, Huang EY, Wang CJ, Chen HC, Yeh SA, Hsu HC, et al. Intensity-modulated radiotherapy versus conventional three-dimensional conformal radiotherapy for boost or salvage treatment of nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2002;53(3):638–47.CrossRefPubMed
14.
Lu TX, Mai WY, Teh BS, Zhao C, Han F, Huang Y, Deng XW, Lu LX, Huang SM, Zeng ZF, et al. Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2004;58(3):682–7.CrossRefPubMed
15.
Han F, Zhao C, Huang SM, Lu LX, Huang Y, Deng XW, Mai WY, Teh BS, Butler EB, Lu TX. Long-term outcomes and prognostic factors of re-irradiation for locally recurrent nasopharyngeal carcinoma using intensity-modulated radiotherapy. Clin Oncol. 2012;24(8):569–76.CrossRef
16.
Hua YJ, Han F, Lu LX, Mai HQ, Guo X, Hong MH, Lu TX, Zhao C. Long-term treatment outcome of recurrent nasopharyngeal carcinoma treated with salvage intensity modulated radiotherapy. Eur J Cancer. 2012;48(18):3422–8.CrossRefPubMed
17.
Qiu S, Lin S, Tham IW, Pan J, Lu J, Lu JJ. Intensity-modulated radiation therapy in the salvage of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2012;83(2):676–83.CrossRefPubMed
18.
Ngan RK, Yiu HH, Lau WH, Yau S, Cheung FY, Chan TM, Kwok CH, Chiu CY, Au SK, Foo W, et al. Combination gemcitabine and cisplatin chemotherapy for metastatic or recurrent nasopharyngeal carcinoma: report of a phase II study. Ann Oncol. 2002;13(8):1252–8.CrossRefPubMed
19.
Wong ZW, Tan EH, Yap SP, Tan T, Leong SS, Fong KW, Wee J. Chemotherapy with or without radiotherapy in patients with locoregionally recurrent nasopharyngeal carcinoma. Head Neck. 2002;24(6):549–54.CrossRefPubMed
20.
Shao JY, Li YH, Gao HY, Wu QL, Cui NJ, Zhang L, Cheng G, Hu LF, Ernberg I, Zeng YX. Comparison of plasma Epstein-Barr virus (EBV) DNA levels and serum EBV immunoglobulin A/virus capsid antigen antibody titers in patients with nasopharyngeal carcinoma. Cancer. 2004;100(6):1162–70.CrossRefPubMed
21.
An X, Wang FH, Ding PR, Deng L, Jiang WQ, Zhang L, Shao JY, Li YH. Plasma Epstein-Barr virus DNA level strongly predicts survival in metastatic/recurrent nasopharyngeal carcinoma treated with palliative chemotherapy. Cancer. 2011;117(16):3750–7.CrossRefPubMed
22.
Wang J, Li J, Hong X, Tang W, Hu X, Wang B, Guo Y. Retrospective case series of gemcitabine plus cisplatin in the treatment of recurrent and metastatic nasopharyngeal carcinoma. Oral Oncol. 2008;44(5):464–70.CrossRefPubMed
23.
Wang Y, Wang ZQ, Jiang YX, Wang FH, Luo HY, Liang Y, Wang DS, Li YH. A triplet chemotherapy regimen of cisplatin, fluorouracil and paclitaxel for locoregionally recurrent nasopharyngeal carcinoma cases contraindicated for re-irradiation/surgery. Expert Opin Pharmacother. 2016;17(12):1585–90.CrossRefPubMed
24.
Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45((2):228–47.CrossRefPubMed
25.
Hwang JM, Fu KK, Phillips TL. Results and prognostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1998;41(5):1099–111.CrossRefPubMed
26.
Oksuz DC, Meral G, Uzel O, Cagatay P, Turkan S. Reirradiation for locally recurrent nasopharyngeal carcinoma: treatment results and prognostic factors. Int J Radiat Oncol Biol Phys. 2004;60(2):388–94.CrossRefPubMed
27.
Chang JT, See LC, Liao CT, Ng SH, Wang CH, Chen IH, Tsang NM, Tseng CK, Tang SG, Hong JH. Locally recurrent nasopharyngeal carcinoma. Radiother Oncol. 2000;54(2):135–42.CrossRefPubMed
28.
Teh BS, Woo SY, Butler EB. Intensity modulated radiation therapy (IMRT): a new promising technology in radiation oncology. Oncologist. 1999;4(6):433–42.PubMed
29.
Tian YM, Tian YH, Zeng L, Liu S, Guan Y, Lu TX, Han F. Prognostic model for survival of local recurrent nasopharyngeal carcinoma with intensity-modulated radiotherapy. Br J Cancer. 2014;110(2):297–303.CrossRefPubMed
30.
Yu KH, Leung SF, Tung SY, Zee B, Chua DT, Sze WM, Law SC, Kam MK, Leung TW, Sham JS, et al. Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck. 2005;27(5):397–405.CrossRefPubMed
Metadata
Title
With or without reirradiation in advanced local recurrent nasopharyngeal carcinoma: a case–control study
Authors
Li-Ting Liu
Qiu-Yan Chen
Lin-Quan Tang
Lu Zhang
Shan-Shan Guo
Ling Guo
Hao-Yuan Mo
Chong Zhao
Xiang Guo
Ming-Yuan Chen
Chao-Nan Qian
Mu-Sheng Zeng
Ming-Huang Hong
Jian-Yong Shao
Ying Sun
Jun Ma
Hai-Qiang Mai
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2803-2

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