Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study
Abstract Background Concurrent chemoradiotherapy (CCRT) remains the cornerstone of treatment for patients with locoregionally advanced nasopharyngeal carcinoma (NPC). However, data on long-term survival, particularly 10-year outcomes, are limited. Methods This retrospective study evaluated the clini...
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Springer
2025-07-01
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| Series: | Discover Oncology |
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| Online Access: | https://doi.org/10.1007/s12672-025-03230-7 |
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| author | Xiao-li Wang Da-qing Sun Hui Yang Yang Li Xiu-feng Li Xiao-long Chang Xiang-di Meng Ya-nan Zhang Yun-xiang Zhang Fu-rong Hao Jian-wen Li |
| author_facet | Xiao-li Wang Da-qing Sun Hui Yang Yang Li Xiu-feng Li Xiao-long Chang Xiang-di Meng Ya-nan Zhang Yun-xiang Zhang Fu-rong Hao Jian-wen Li |
| author_sort | Xiao-li Wang |
| collection | DOAJ |
| description | Abstract Background Concurrent chemoradiotherapy (CCRT) remains the cornerstone of treatment for patients with locoregionally advanced nasopharyngeal carcinoma (NPC). However, data on long-term survival, particularly 10-year outcomes, are limited. Methods This retrospective study evaluated the clinical efficacy and acute hematologic toxicity of intensity-modulated radiation therapy (IMRT) in 177 newly diagnosed patients with locoregionally moderate or advanced NPC. Patients were categorized into three groups: IMRT alone; CCRT—including subgroups receiving neoadjuvant chemotherapy (NC) + CCRT, CCRT alone, and NC + CCRT + adjuvant chemotherapy (AC); and non-CCRT—including NC + IMRT + AC, and IMRT + AC. Results The median follow-up duration was 48.4 months (range, 3.0–178.9 months). Acute hematologic toxicities were generally mild, with 86.4% (153/177) of patients experiencing only grade 0–2 toxicity. The 10-year OS, PFS, LRFS, and DMFS rates were 66.6%, 75.3%, 91.9%, and 81.2%, respectively. OS differed significantly among the three treatment groups (P = 0.01). Both the CCRT and non-CCRT regimens were associated with improved 10-year OS compared to IMRT alone, with absolute increases of 29.4% and 26.1%, respectively (P = 0.01 for both comparisons). Conclusions In the era of IMRT, chemoradiotherapy was associated with manageable acute hematologic toxicity in patients with NPC. Distant metastasis, particularly in those with N3 disease, remained the predominant pattern of failure. Compared with IMRT alone, both CCRT (CCRT, NC + CCRT + AC, NC + CCRT) and non-CCRT (NC + IMRT + AC, IMRT + AC) demonstrated a potential survival benefit in newly diagnosed patients with locoregionally moderate or advanced NPC. These findings warrant further validation in prospective randomized clinical trials. |
| format | Article |
| id | doaj-art-d4cc1e64488941bc896f6749ab7cab8b |
| institution | Kabale University |
| issn | 2730-6011 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Springer |
| record_format | Article |
| series | Discover Oncology |
| spelling | doaj-art-d4cc1e64488941bc896f6749ab7cab8b2025-08-20T03:46:23ZengSpringerDiscover Oncology2730-60112025-07-0116111310.1007/s12672-025-03230-7Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective studyXiao-li Wang0Da-qing Sun1Hui Yang2Yang Li3Xiu-feng Li4Xiao-long Chang5Xiang-di Meng6Ya-nan Zhang7Yun-xiang Zhang8Fu-rong Hao9Jian-wen Li10Department of Radiation Oncology, Weifang People’s HospitalDepartment of Radiation Oncology, Weifang People’s HospitalDepartment of Medical Imaging Center, Affiliated Hospital of Shandong Second Medical UniversityDepartment of Radiation Oncology, Weifang People’s HospitalDepartment of Pathology, Weifang People’s HospitalDepartment of Radiation Oncology, Weifang People’s HospitalDepartment of Radiation Oncology, Weifang People’s HospitalDepartment of Radiation Oncology, Weifang People’s HospitalDepartment of Molecular Pathology, Qingdao Central Hospital of University of Health and Rehabilitation SciencesDepartment of Radiation Oncology, Weifang People’s HospitalDepartment of Radiation Oncology, Weifang People’s HospitalAbstract Background Concurrent chemoradiotherapy (CCRT) remains the cornerstone of treatment for patients with locoregionally advanced nasopharyngeal carcinoma (NPC). However, data on long-term survival, particularly 10-year outcomes, are limited. Methods This retrospective study evaluated the clinical efficacy and acute hematologic toxicity of intensity-modulated radiation therapy (IMRT) in 177 newly diagnosed patients with locoregionally moderate or advanced NPC. Patients were categorized into three groups: IMRT alone; CCRT—including subgroups receiving neoadjuvant chemotherapy (NC) + CCRT, CCRT alone, and NC + CCRT + adjuvant chemotherapy (AC); and non-CCRT—including NC + IMRT + AC, and IMRT + AC. Results The median follow-up duration was 48.4 months (range, 3.0–178.9 months). Acute hematologic toxicities were generally mild, with 86.4% (153/177) of patients experiencing only grade 0–2 toxicity. The 10-year OS, PFS, LRFS, and DMFS rates were 66.6%, 75.3%, 91.9%, and 81.2%, respectively. OS differed significantly among the three treatment groups (P = 0.01). Both the CCRT and non-CCRT regimens were associated with improved 10-year OS compared to IMRT alone, with absolute increases of 29.4% and 26.1%, respectively (P = 0.01 for both comparisons). Conclusions In the era of IMRT, chemoradiotherapy was associated with manageable acute hematologic toxicity in patients with NPC. Distant metastasis, particularly in those with N3 disease, remained the predominant pattern of failure. Compared with IMRT alone, both CCRT (CCRT, NC + CCRT + AC, NC + CCRT) and non-CCRT (NC + IMRT + AC, IMRT + AC) demonstrated a potential survival benefit in newly diagnosed patients with locoregionally moderate or advanced NPC. These findings warrant further validation in prospective randomized clinical trials.https://doi.org/10.1007/s12672-025-03230-7Nasopharyngeal carcinomaClinical studiesChemotherapyIntensity-modulated radiotherapyTreatment outcome |
| spellingShingle | Xiao-li Wang Da-qing Sun Hui Yang Yang Li Xiu-feng Li Xiao-long Chang Xiang-di Meng Ya-nan Zhang Yun-xiang Zhang Fu-rong Hao Jian-wen Li Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study Discover Oncology Nasopharyngeal carcinoma Clinical studies Chemotherapy Intensity-modulated radiotherapy Treatment outcome |
| title | Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study |
| title_full | Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study |
| title_fullStr | Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study |
| title_full_unstemmed | Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study |
| title_short | Ten-year outcomes of IMRT with chemotherapy versus IMRT alone for stage II–IVa nasopharyngeal carcinoma: a retrospective study |
| title_sort | ten year outcomes of imrt with chemotherapy versus imrt alone for stage ii iva nasopharyngeal carcinoma a retrospective study |
| topic | Nasopharyngeal carcinoma Clinical studies Chemotherapy Intensity-modulated radiotherapy Treatment outcome |
| url | https://doi.org/10.1007/s12672-025-03230-7 |
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