xRead - Nasal Obstruction (September 2024) Full Articles

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287

ICAR SINONASAL TUMORS

TABLE XXV.5 Evidence surrounding radiation therapy in NPC treatment.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Duet al. 1672

1. IMRT was associated with a better 5-year OS, LRFS, and PFS compared to 2DRT group 2. IMRT was associated with significantly lower rate of late 1. IMRT showed better yet statistically insignificant results than 2DRT in terms of LRC and regional control 2. However, differences were only observed in T4, N2, and stage III disease 3. Xerostomia was better in IMRT than in conventional 2DRT 1. 3-year RRFS was similar in UNI and WNI groups 2. No significant difference between UNI versus WNI group in 3-year OS 3. No statistically significant difference in acute RT-related toxic effect between the groups 4. Incidence of late toxicity was lower in UNI group than WNI group, including hypothyroidism, skin toxicity, dysphagia, and neck tissue damage xerostomia, trismus, and temporal lobe neuropathy

1. 5-year OS 2. 5-year PFS,

13,304 NPC patients

2019 1

Systematic

from 10 studies (two RCTs + eight nonrandomized trial)

reviewand meta analysis

LRFS,DMFS

3. Toxicities

IMRT versus 2DRT

Coet al. 1671

2016 1

Systematic

717 patients from three RCTs IMRT versus 2DRT

1. 1-year LRC, DMFS,OS 2. Xerostomia

reviewand meta analysis

Tanget al. 1674

1. RRFS 2. OS,DMFS 3. Acute and

446 NPC patients with N0-N1 disease (UICC/AJCC 7th edition) of WHO type II or III IMRT to primary, RP LN, and neck disease IC + CRTorCRT alone in patients with stage II-IVA WNI group: both the upper neck (levels II, III and VA) and lower neck (levels IV and VB) were encompassed by low-dose target volume in the uninvolved neck UNI group: elective irradiation to bilateral upper neck lymphatic areas only in case of neck-node negative disease; WNI to ipsilateral neck and UNI to contralateral neck in case of unilateral neck nodal disease

2022 2

Open-label,

noninferior ity, phase III RCT

late toxicities

(Continues)