xRead - Nasal Obstruction (September 2024) Full Articles

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285

ICAR SINONASAL TUMORS

TABLE XXV.4 Evidence surrounding nasopharyngectomy in nasopharyngeal carcinoma (NPC) treatment.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Newton et al. 1741 2021

OS

1. Surgery and re-RT for recurrent NPC have similar long-term survival 2. Surgical approaches to rNPC may offer similar survival while 1. ENPG significantly improved 3-year OS compared with IMRT 2. Pharyngeal mucositis: 5% ENPG, 26%IMRT 1. ENPG + LDRT provided satisfactory survival outcomes, improved QOL, and reduced the incidence of RT-related sequelae 2. Xerostomia: 24.3% 3. ENPG + LDRT, 46.2% IMRT 1. 5-year LRFS and OS were 53.9% and84.6% 2. Minor complication rate 52.6% 3. Major operative complication rate0.0% 4. Late complication rate 23.1% 2-year OS and LRFS were 76.2% and 53.6%, respectively 1-, 3-, and 5-year OS rates were 82.2%, 59.5%, and 43.6%, respectively 1. 2-year OS, PFS, LRFS, and DMFS were 88.7%, 72.0%, 72.0%, and 97.3%, respectively 2. Postoperative complications: Grade 1–2 16.2%, grade 3–5 13.5%. 1. 5-year OS, DFS, and DSS were 50.0%, 25.0%, and 58.3%, respectively 2. No severe operative complications were reported 1. 1-year OS and LRFS were 98% and 93%, respectively 2. One (1.8%) patient had ICA injury intraoperatively 3. No major postoperative complications 1. 2-year OS and DFS were 64.8% and 57.5%, respectively 2. 5-year OS and DFS were 38.3% and 30.2%, respectively 3. No serious complications were reported avoiding RT-associated morbidity and mortality.

2

Systematic review

Review of 66 previously published studies

Liuet al. 1668

2021

2

RCT

Recurrent T1–3 NPC who underwent: (1) ENPG( n = 100) or (2) IMRT( n = 100) Recurrent T1–2 NPC who underwent: (1) ENPG + LDRT ( n = 37) or (2) IMRT ( n = 132) Recurrent T1–2 NPC who underwent ENPG( n = 13) Recurrent T1–4 NPC who underwent ENPG( n = 101) Recurrent T1–4 NPC who underwent ENPG( n = 189) Recurrent T2–3 NPC who underwent ENPG with ICA pretreatment ( n = 37) Recurrent T3–4 NPC who underwent ENPG( n = 12)

OS

Zhang et al. 1742

1. Survival 2. QOL 3. Late

2021

4

Retrospective

case–control

RT-related sequelae

Thamboo et al. 1743

2021

4

Retrospective case series

1. OS 2. LRFS 3. Complication rates

Liuet al. 1665

1. OS 2. LRFS

2021

4

Retrospective case series

Li et al. 1744

2021

4

Retrospective case series

OS

Wanget al. 1745

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

2021

4

Retrospective case series

Wonget al. 1746

2020 4

Retrospective case series

1. OS 2. DFS 3. DSS

Tanget al. 1747

1. OS 2. LRFS

2019 4

Retrospective case series

Recurrent T1–4 NPC who underwent ENPG( n = 55)

Liuet al. 1748

2017 4

Retrospective case series

Recurrent T1–4 NPC who underwent ENPG( n = 91)

1. OS 2. DFS

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