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281

ICAR SINONASAL TUMORS

TABLE XXV.2 (Continued)

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Guoet al. 1636

2019 4

Retrospective case series

979NPCs

1. OS 2. PFS

Incorporating EBV DNA into staging provided better hazard consistency, hazard discrimination, outcome prediction, and sample size balance than the 8th edition of the TNM staging system Pre-DNA is a strong prognostic factor for NPC patients when complemented with TNM staging Pre-DNA load is an independent prognostic factor to the TNM staging in NPC Combined pre-DNA with staging data 1. Adjuvant chemotherapy with cisplatin and gemcitabine did not improve RFS for NPC with detectable post-DNA 2. 5-year RFS rate: 49.3% versus 54.7% ( p = 0.75) 1. Adjuvant oral tegafur-uracil can reduce recurrence and improve OS in patients with detectable post-DNA 2. Recurrent rates: 45.5% versus 71.2% ( p = 0.0323). 3. 5-year OS: 71.6% versus 28.7% ( p < 0.0001). Early PET response ( > 50% drop in sum of max SUV of target lesions) and EBV DNA clearance ( ≤ 10 days) predict improved survival and treatment response 1. Plasma EBV DNA clearance rates are significant predictors for metastatic NPC treatment outcomes 2. Half-life of EBV DNA clearance rate ≤ 4versus > 4 days: CR rate 80.0% versus 37.8% ( p = 0.001); 2-year OS 59.5% versus 24.4% ( p = 0.003) defines better risk grouping and improves risk discrimination in early-stage disease

Zhang et al. 1635

2016 4

Retrospective case series

1467NPCs

1. OS 2. PFS 3. DMFS 4. LRFS 1. DSS 2. DMFS 3. LRFS

Leung et al. 1634

2006 4

Retrospective case series

376NPCs

2-3. Adjuvant therapy for postradiation residual EBV DNA patients Chanet al. 1642 2018 2 Prospective randomized trial 216 out of 789 NPCs with detectable post-DNA; 104 out of 216 randomized to adjuvant chemotherapy × six cycles RFS

Twuet al. 1641

2014 4

Retrospective case series

85 out of 625 NPCs with detectable post-DNA; adjuvant oral

1. OS 2. Recurrence

chemotherapy for 1 year: yes/no = 33/52

2-4. Early prediction of treatment response in recurrent/metastatic and locally advanced patients Maet al. 1645 2018 3 Prospective cohort 58 NPCs (33 recur

1. OS 2. PFS 3. PET response

rent/metastatic, 25 locally advanced)

Hsuet al. 1644

2012 4

Retrospective case series

73 metastatic NPCs

1. CR 2. OS

(Continues)

cantly better local tumor control and survival compared to EBV + /HPV– NPC patients. 1657 Another study conducted in Canada noted that, among 29 HPV-associated NPC cases, mostly were White patients. Furthermore, HPV + NPC patients have larger primary tumors with greater local

symptom burden but similar outcomes compared with EBV + NPC patients. 1651 In Wu et al.’s retrospective study, among 78 NPC patients over 19 years, there were only 12 HPV + NPC patients. They found that EBV + NPC patients were younger and less frail than HPV + NPC patients, and