Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram

Frontiers in Oncology

Oncology

Marta Maddalo¹  Michela Buglione di Monale Bastia¹  Davide Tomasini¹  Francesco Dionisi²  Daniela Alterio³  Paolo Bossi⁴  Alberto Deganello⁵  Marco Cianchetti⁶  Ester Orlandi⁷  Barbara Vischioni⁷  Pierluigi Bonomo⁸  Nicola Alessandro Iacovelli⁹  Elisa D’Angelo^1,10  Stefano Taboni^1,11  Marco Ferrari^1,11  Piero Nicolai^1,11  Maurizio Bignami^1,12  Paolo Battaglia^1,12  Mario Turri-Zanoni^1,12  Alessia Lambertoni^1,12  Paolo Castelnuovo^1,12  Davide Mattavelli^1,13  Vittorio Rampinelli^1,13  Alberto Schreiber^1,13  Cesare Piazza^1,13  Marco Alparone^1,13  Roberta Rosati^1,13  Michele Tomasoni^1,13 

[1] Department of Radiation Oncology, Brescia University, Brescia, Italy;Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy;Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy;Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy;Otolaryngology Head and Neck Surgery, IRCCS National Cancer Institute (INT), Milan, Italy;Proton Therapy Unit, Azienda Provinciale Per i Servizi Sanitari, Trento, Italy;Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy;Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy;Radiotherapy 2 Unit, Fondazione IRCCS IstitutoTumori, Milan, Italy;Radiotherapy Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy;Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy;Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy;Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy;

关键词: nasopharyngeal carcinoma;    salvage treatment;    non-endemic cancer;    recurrent tumor;    proton therapy;    IMRT;   

DOI  :  10.3389/fonc.2023.1157584

 received in 2023-02-02, accepted in 2023-05-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionThe study assessed outcomes and toxicities of different treatment modalities for local and/or regional recurrent nasopharyngeal carcinoma (NPC) in a non-endemic area.MethodsPatients treated with curative intent for recurrent NPC with salvage surgery, photon-based radiotherapy, proton therapy (PT), with or without chemotherapy, at different Italian referral centers between 1998 and 2020 were included. Adverse events and complications were classified according to the Common Terminology Criteria for Adverse Events. Characteristics of the patients, tumors, treatments, and complications are presented along with uni- and multivariate analysis of prognostic factors. A survival predictive nomogram is also provided.ResultsA total of 140 patients treated from 1998 to 2020 were retrospectively assessed. Cases with lower age, comorbidity rate, stage, and shorter disease-free interval (DFI) preferentially underwent endoscopic surgery. More advanced cases underwent re-irradiation, fairly distributed between photon-based radiotherapy and PT. Age and DFI were independent factors influencing overall survival. No independent prognostic effect of treatment modality was observed. No significant difference in the morbidity profile of treatments was observed, with 40% of patients experiencing at least one adverse event classified as G3 or higher.ConclusionRecurrent NPC in a non-endemic area has dissimilar aspects compared to its endemic counterpart, suggesting the need for further studies that can guide the choice of the best treatment modality.

【 授权许可】

Unknown   
Copyright © 2023 Rampinelli, Ferrari, Mattavelli, Bonomo, Lambertoni, Turri-Zanoni, D’Angelo, Alterio, Cianchetti, Vischioni, Rosati, Tomasoni, Alparone, Taboni, Tomasini, Maddalo, Bastia, Iacovelli, Dionisi, Bignami, Battaglia, Bossi, Deganello, Piazza, Schreiber, Nicolai, Castelnuovo and Orlandi