Osteoradionecrosis as a complication following post-operative intensity-modulated radiation therapy or proton therapy for oral cavity cancer.

Objective: To report the prevalenceof osteoradionecrosis (ORN) in oral cavity (OC) cancer patients following intensity-modulation radiation therapy (IMRT) or proton therapy (PRT).

Methods: A retrospective study was conducted on consecutive cohort of OC cancer patients treated with IMRT or PRT for squamous cell carcinoma (SCC). Patient information and treatment related variables were collected from medical records.

Concurrent chemotherapy for older patients with locoregionally advanced nasopharyngeal carcinoma: A randomized clinical trial.

Introduction: We aimed to evaluate the efficacy of two different radiotherapy strategies in elderly patients with locally advanced nasopharyngeal carcinoma (NPC) using geriatric assessment.

Materials And Methods: We conducted a randomized phase 2 trial for older patients (≥ 65 years) with stage III-IVA NPC. Patients were randomized into either intensity-modulated radiotherapy (IMRT) alone (RT Arm) or concurrent chemoradiotherapy (CCRT Arm).

Effects of Antibiotics on First-line Immunotherapy in Patients With Recurrent or Metastatic Nasopharyngeal Carcinoma.

Immunotherapy combined with chemotherapy has become the first-line treatment for recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). However, the impact of antibiotic (ATB) use on the efficacy of immunotherapy in RM-NPC remains unclear. A total of 200 patients with RM-NPC who started first-line immunotherapy between October 2021 and September 2023 were included.

Granulocyte-macrophage colony-stimulating factor for newly diagnosed glioblastoma.

Background: There is a clear need to improve the efficiency of therapeutic strategy for patients with newly diagnosed glioblastoma (GBM). The purpose of this study was to evaluate the feasibility of hypofractionated intensity-modulated radiation therapy (IMRT), temozolomide and granulocyte-macrophage colony-stimulating factor (GM-CSF) for patients with newly diagnosed GBM.

Methods: Patients were treated with hypofractionated IMRT (15 × 3.

Advances in Nasopharyngeal Carcinoma Staging: from the 7th to the 9th Edition of the TNM System and Future Outlook.

Purpose Of Review: Nasopharyngeal carcinoma (NPC), characterized by its aggressive nature and sensitivity to radiation, demands accurate staging for optimal clinical outcomes. The purpose of this review was to provides a comprehensive overview of the evolution of the TNM staging system for NPC based on recent and previously published studies, with particular emphasis on the transition from the 7th to the 9th edition.

Recent Findings: The 9th edition introduces critical changes, particularly in the N and M classifications, to enhance prognostic accuracy.

Concurrent nimotuzumab and intensity-modulated radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma.

Because of the common physical condition, reduced organ function, and comorbidities, elderly patients with nasopharyngeal carcinoma (NPC) are often underrepresented in clinical trials. The optimal treatment of elderly patients with locally advanced NPC remains unclear. The purpose of this study was to evaluate the efficacy of concurrent nimotuzumab combined with intensity-modulated radiotherapy (IMRT) in elderly patients with locally advanced NPC.

Long-term efficacy analysis of radiotherapy and local management of metastases in patients with newly diagnosed oligometastatic nasopharyngeal carcinoma: A prospective, single-arm, single-center clinical study.

Purpose: We conducted a single-center, single-arm study (NCT03129412) to prospectively analyze the long-term outcomes of newly diagnosed patients with oligometastatic nasopharyngeal carcinoma (NPC) who received radical radiotherapy and local treatment of metastases.

Patients And Methods: Patients who reached disease controll after platinum-based palliative chemotherapy continued to receive radical radiotherapy for the nasopharyngeal region and neck. Appropriate local treatments were selected to treat the metastatic lesions.

Cancer immunotherapy efficacy and machine learning.

Introduction: Immunotherapy is one of the major breakthroughs in the treatment of cancer, and it has become a powerful clinical strategy, however, not all patients respond to immune checkpoint blockade and other immunotherapy strategies. Applying machine learning (ML) techniques to predict the efficacy of cancer immunotherapy is useful for clinical decision-making.

Areas Covered: Applying ML including deep learning (DL) in radiomics, pathomics, tumor microenvironment (TME) and immune-related genes analysis to predict immunotherapy efficacy.

The impact of the COVID-19 pandemic on nasopharyngeal carcinoma extent at FDG PET/MR staging: The NPCOVIPET study.

Background: To evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on disease extent in patients with nasopharyngeal carcinoma (NPC) using 18 fuorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI).

Methods: This retrospective cohort study included biopsy-proven, newly diagnosed NPC patients using whole-body FDG PET/MR staging in two selected intervals: 1 May 2017 to 31 January 2020 (Group A, the pre-COVID-19 period), and 1 February 2020 to 30 June 2021 (Group B, the COVID-19 period).

Results: Three-hundred and ninety patients were included.

Use of 18F-FDG PET/MRI as an Initial Staging Procedure for Nasopharyngeal Carcinoma.

Background: Compared with the conventional work-up (CWU) including computed tomography (CT) of the chest and abdomen, MRI of the head and neck, and skeletal scintigraphy, positron emission tomography (PET)/MRI might improve diagnostic accuracy, shorten the work-up time, and reduce false-positive (FP) findings in patients with nasopharyngeal carcinoma (NPC). However, evidence of cost-effectiveness is needed for the adoption of PET/MRI for the initial staging in NPC.

Purpose: To evaluate the cost-effectiveness and clinical value of PET/MRI as an initial staging procedure for NPC.

Assessment of bone lesions with 18 F-FDG PET/MRI in patients with nasopharyngeal carcinoma.

Purpose: The purpose of this study is to evaluate the role of 18 fluorodeoxyglucose ( 18 F) PET/MRI ( 18 F-FDG PET/MRI) for detecting bone metastasis in nasopharyngeal carcinoma (NPC).

Patients And Methods: Between May 2017 and May 2021, 58 histologically proven NPC patients who underwent both 18 F-FDG PET/MRI and 99m Tc-MDP planar bone scintigraphy (PBS) for tumor staging were included. With the exception of the head, the skeletal system was classified into four groups: the spine, the pelvis, the thorax and the appendix.

Locoregional Extension Patterns of Nasopharyngeal Carcinoma Detected by FDG PET/MR.

Purpose: We sought to define the locoregional extension patterns of nasopharyngeal carcinomas (NPCs) by positron emission tomography (PET)/magnetic resonance imaging (MRI) and to improve clinical target volume (CTV) delineation.

Methods: Between May 2017 and March 2021, 331 consecutive patients with nonmetastatic NPCs who underwent pretreatment, simultaneous whole-body PET/MRI for staging were included in this study.

Results: The high-risk regions included the base of the sphenoid bone, the prestyloid compartment, prevertebral muscle, foramen lacerum, medial pterygoid plate, sphenoidal sinus, clivus, petrous apex, and foramen ovale.

Detection and staging of recurrent or metastatic nasopharyngeal carcinoma in the era of FDG PET/MR.

Purpose: The aim of this pilot study was to evaluate the accuracy of 18 fluorodeoxyglucose (FDG) PET/MR imaging in detection and staging of recurrent or metastatic NPC.

Patients And Methods: The PET/MR scans of 60 patients with clinically diagnosed recurrent or metastatic NPC between April 2017 and November 2019 were included in this study. Findings were evaluated according to the eighth edition of the American Joint Committee on Cancer staging system.

Nutritional Status and Its Association With Radiation-Induced Oral Mucositis in Patients With Nasopharyngeal Carcinoma During Radiotherapy: A Prospective Study.

Background And Aims: Malnutrition is a concern in patients with nasopharyngeal carcinoma (NPC) during chemoradiotherapy (CRT)/radiotherapy (RT), which is considered to be related with radiation-induced oral mucositis (ROM). The study aimed to evaluate the nutritional status of NPC patients during RT and investigate its association with ROM.

Methods: A prospective study was conducted in NPC patients.

A prospective randomized controlled trial on the value of prophylactic oral nutritional supplementation in locally advanced nasopharyngeal carcinoma patients receiving chemo-radiotherapy.

Objectives: We investigated the effect of prophylactic oral nutrition supplements (ONS) in locally advanced nasopharyngeal carcinoma patients receiving neoadjuvant chemotherapy and concurrent chemoradiotherapy (CCRT).

Methods: Eligible patients were randomly assigned to an intervention or control group. Patients in the intervention group were supported with prophylactic ONS from the beginning of CCRT.

Adding Concurrent Chemotherapy to Intensity-Modulated Radiotherapy Does Not Improve Treatment Outcomes for Stage II Nasopharyngeal Carcinoma: A Phase 2 Multicenter Clinical Trial.

To explore the efficacy of concomitant chemotherapy in intensity-modulated radiotherapy (IMRT) to treat stage II nasopharyngeal carcinoma (NPC). In this randomized phase 2 study [registered with ClinicalTrials.gov (NCT01187238)], eligible patients with stage II (2010 UICC/AJCC) NPC were randomly assigned to either IMRT alone (RT group) or IMRT combined with concurrent cisplatin (40 mg/m, weekly) (CCRT group).

Feasibility of multiparametric imaging with PET/MR in nasopharyngeal carcinoma: A pilot study.

Objective: The aim of this pilot study was to explore the integrated positron emission tomography and magnetic resonance imaging scanner (PET/MR) for biological characterization of nasopharyngeal carcinoma (NPC) and potential therapeutic applications of dose painting (DP).

Patients And Methods: Twenty-one NPC patients with PET/MR were included in this study. Overlap of tumor volumes was analyzed on T2-weighted images (volume of interest, VOI), diffusion-weighted magnetic resonance imaging (VOI) and F-fluorodeoxyglucose positron emission tomography (VOI).

Grading of MRI-detected skull-base invasion in nasopharyngeal carcinoma with skull-base invasion after intensity-modulated radiotherapy.

Background: The aim of this study is to evaluate the prognostic value of grading MRI-detected skull-base invasion in nasopharyngeal carcinoma (NPC) with skull-base invasion after intensity-modulated radiotherapy (IMRT).

Methods: This study is a retrospective chart review of 469 non-metastatic NPC patients with skull-base invasion. Patients were classified as extensive skull-base invasion (ESBI) group and limited skull-base invasion (LSBI) group.

Prognostic Value and Staging Classification of Lymph Nodal Necrosis in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy.

Purpose: The aim of the present study was to evaluate the prognostic value of magnetic resonance imaging (MRI)‒determined lymph nodal necrosis (LNN) in nasopharyngeal carcinoma (NPC) and explore the feasibility of an N-classification system based on the 8th edition of the American Joint Committee on Cancer (AJCC) system.

Materials And Methods: The MRI scans of 616 patients with newly diagnosed stage T1-4N1-3M0 NPC who were treated with definitive intensity-modulated radiotherapy (IMRT) were reviewed.

Results: Multivariate analysis showed that LNN was an independent negative prognostic predictor of distant metastasis free survival (hazard ratio, 1.

PD-1 and PD-L1 in locoregionally advanced nasopharyngeal carcinoma: Substudy of a randomized phase III trial.

Background: To evaluate the expression of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) by using immunohistochemistry analysis in locoregionally advanced nasopharyngeal carcinoma (NPC) patients receiving cisplatin, fluorouracil, and docetaxel followed by concurrent chemoradiotherapy.

Methods: As part of a previously reported trial, 108 patients were enrolled in this study.

Results: We observed that Epstein-Barr Virus (EBV) antibody levels were associated with PD-1 positive staining in NPC and PD-1 positive staining was identified as an independent prognostic factor for progression-free survival (hazard ratio 0.

Locoregional extension and patterns of failure for nasopharyngeal carcinoma with intracranial extension.

Objective: To evaluate the locoregional extension and patterns of failure for nasopharyngeal carcinoma (NPC) with intracranial extension to improve clinical target volume (CTV) delineation.

Patients And Methods: A total of 205 NPC patients with intracranial extension by magnetic resonance imaging (MRI) were retrospectively reviewed.

Results: According to the cumulative incidence rates of tumor invasion, we initially classified anatomic sites surrounding the nasopharynx into three risk grades: high risk (≥35%), medium risk (≥10-35%), and low risk (<10%).

Paranasal Sinus Invasion in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy.

Purpose: The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification.

Materials And Methods: The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively.

Results: The incidence of paranasal sinus invasion was 39.

Neoadjuvant chemotherapy with different dose regimens of docetaxel, cisplatin and fluorouracil (TPF) for locoregionally advanced nasopharyngeal carcinoma: a retrospective study.

Objective: Compare high- vs. low-dose TPF neoadjuvant chemotherapy with chemoradiotherapy in Chinese patients with locoregionally advanced nasopharyngeal carcinoma (NPC).

Materials And Methods: Retrospective analysis of 210 stage III/IV NPC patients treated between April 1, 2012 and April 1, 2014; 138 received three cycles of high-dose TPF (H-TPF) every 3 weeks at Zhejiang Cancer Hospital and 72, three cycles of low-dose TPF (L-TPF) every 3 weeks at Sun Yat-Sen University Cancer Center.

Cytomembranic PD-L1 expression in locoregionally advanced nasopharyngeal carcinoma.

Background And Objective: The aim of this study was to evaluate the expression of cytomembranic programmed death-ligand 1 (PD-L1) and its clinical significance in locoregionally advanced nasopharyngeal carcinoma (NPC).

Patients And Methods: Formalin-fixed, paraffin-embedded tissue biopsies from 85 patients with histological diagnosis of locoregionally advanced NPC treated with radical intensity-modulated radiotherapy and concurrent cisplatin-based chemotherapy were studied. By using immunohistochemistry staining, expressions of cytomembranic PD-L1 on tumor cells were detected.