Mixed Photon and Carbon-Ion Beam Radiotherapy in the Management of Non-Metastatic Nasopharyngeal Carcinoma

Jiyi Hu; Jiyi Hu; Jiyi Hu; Qingting Huang; Qingting Huang; Qingting Huang; Jing Gao; Jing Gao; Jing Gao; Weixu Hu; Weixu Hu; Weixu Hu; Jing Yang; Jing Yang; Jing Yang; Xiyin Guan; Xiyin Guan; Xiyin Guan; Xianxin Qiu; Xianxin Qiu; Xianxin Qiu; Wenna Zhang; Wenna Zhang; Wenna Zhang; Lin Kong; Lin Kong; Lin Kong; Jiade J. Lu; Jiade J. Lu; Jiade J. Lu

doi:10.3389/fonc.2021.653050

Frontiers in Oncology (Jul 2021)

Mixed Photon and Carbon-Ion Beam Radiotherapy in the Management of Non-Metastatic Nasopharyngeal Carcinoma

Jiyi Hu,
Jiyi Hu,
Jiyi Hu,
Qingting Huang,
Qingting Huang,
Qingting Huang,
Jing Gao,
Jing Gao,
Jing Gao,
Weixu Hu,
Weixu Hu,
Weixu Hu,
Jing Yang,
Jing Yang,
Jing Yang,
Xiyin Guan,
Xiyin Guan,
Xiyin Guan,
Xianxin Qiu,
Xianxin Qiu,
Xianxin Qiu,
Wenna Zhang,
Wenna Zhang,
Wenna Zhang,
Lin Kong,
Lin Kong,
Lin Kong,
Jiade J. Lu,
Jiade J. Lu,
Jiade J. Lu

Affiliations

Jiyi Hu: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Jiyi Hu: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Jiyi Hu: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Qingting Huang: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Qingting Huang: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Qingting Huang: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Jing Gao: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Jing Gao: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Jing Gao: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Weixu Hu: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Weixu Hu: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Weixu Hu: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Jing Yang: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Jing Yang: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Jing Yang: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Xiyin Guan: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Xiyin Guan: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Xiyin Guan: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Xianxin Qiu: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Xianxin Qiu: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Xianxin Qiu: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Wenna Zhang: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Wenna Zhang: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Wenna Zhang: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Lin Kong: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Lin Kong: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Lin Kong: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
Jiade J. Lu: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Jiade J. Lu: Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Jiade J. Lu: Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China

DOI: https://doi.org/10.3389/fonc.2021.653050
Journal volume & issue: Vol. 11

Abstract

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BackgroundCarbon-ion radiotherapy (CIRT) may further increase the therapeutic ratio for patients with newly diagnosed nasopharyngeal carcinoma (NPC). The purpose of the current study is to examine the effectiveness and toxicity profile of photon-based intensity-modulated radiotherapy (IMRT) plus CIRT boost in a relatively large cohort of NPC patients.MethodsIn the current study, non-metastatic NPC patients treated with IMRT plus CIRT boost at Shanghai Proton and Heavy Ion Center between June, 2015 and June, 2018 were included. Overall survival (OS), progression-free survival (PFS), local control, regional control, and distant control were calculated with Kaplan–Meier method. Acute and late toxicities were graded using CTCAE 4.03.ResultsA total of 69 patients were included in the analysis. Among those, 74% of the patients had locoregionally advanced (stage III/IV) disease, and 92.8% had cervical lymphadenopathy. With a median follow-up of 31.9 months, the 3-year OS, PFS, local control, regional control, and distant control rates were 94.9, 85.2, 96.9, 98.4, and 89.7%, respectively. Mixed treatment of IMRT with CIRT boost was well tolerated. Severe acute toxicities induced by radiation therapy were observed in only two patients (dermatitis). No severe radiation-induced late toxicity was observed at the time of analysis. Univariable analysis showed N2/3 disease was correlated with an inferior distant control (p = 0.040).ConclusionMixed treatment of IMRT plus CIRT boost provides an excellent disease control and a favorable toxicity profile for patients with non-metastatic NPC. Further follow-up is necessary to evaluate the long-term survivals and toxicities more accurately.

Published in Frontiers in Oncology

ISSN: 2234-943X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.frontiersin.org/journals/oncology/

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