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Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era

OBJECTIVE: To evaluate the survival outcomes for a cohort of nasopharyngeal cancer with intracranial extension (ICE) treated with induction chemotherapy (ICT) followed by chemo-intensity-modulated radiotherapy (CTRT) at a tertiary cancer center. METHODS: We retrospectively analyzed 45 patients with...

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Autores principales: Ghosh-Laskar, Sarbani, Pilar, Avinash, Johnny, Carlton, Prabhash, Kumar, Joshi, Amit, Agarwal, Jai Prakash, Gupta, Tejpal, Budrukkar, Ashwini, Murthy, Vedang, Swain, Monali, Noronha, Vanita, Patil, Vijay Maruthi, Pai, Prathamesh, Nair, Deepa, Chaukar, Devendra Arvind, Thiagarajan, Shivakumar, Pantvaidya, Gouri, Deshmukh, Anuja, Chaturvedi, Pankaj, Nair, Sudhir, D'Cruz, Anil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: KeAi Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221210/
https://www.ncbi.nlm.nih.gov/pubmed/32426700
http://dx.doi.org/10.1016/j.wjorl.2020.02.003
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author Ghosh-Laskar, Sarbani
Pilar, Avinash
Johnny, Carlton
Prabhash, Kumar
Joshi, Amit
Agarwal, Jai Prakash
Gupta, Tejpal
Budrukkar, Ashwini
Murthy, Vedang
Swain, Monali
Noronha, Vanita
Patil, Vijay Maruthi
Pai, Prathamesh
Nair, Deepa
Chaukar, Devendra Arvind
Thiagarajan, Shivakumar
Pantvaidya, Gouri
Deshmukh, Anuja
Chaturvedi, Pankaj
Nair, Sudhir
D'Cruz, Anil
author_facet Ghosh-Laskar, Sarbani
Pilar, Avinash
Johnny, Carlton
Prabhash, Kumar
Joshi, Amit
Agarwal, Jai Prakash
Gupta, Tejpal
Budrukkar, Ashwini
Murthy, Vedang
Swain, Monali
Noronha, Vanita
Patil, Vijay Maruthi
Pai, Prathamesh
Nair, Deepa
Chaukar, Devendra Arvind
Thiagarajan, Shivakumar
Pantvaidya, Gouri
Deshmukh, Anuja
Chaturvedi, Pankaj
Nair, Sudhir
D'Cruz, Anil
author_sort Ghosh-Laskar, Sarbani
collection PubMed
description OBJECTIVE: To evaluate the survival outcomes for a cohort of nasopharyngeal cancer with intracranial extension (ICE) treated with induction chemotherapy (ICT) followed by chemo-intensity-modulated radiotherapy (CTRT) at a tertiary cancer center. METHODS: We retrospectively analyzed 45 patients with histologically proven, non-metastatic NPC with ICE treated at our institute between October 2008 and October 2016. Patients were classified as minor ICE or major ICE, based on the extent of ICE. All the patients received 2–3 cycles of a taxane-based ICT regimen followed by CTRT. Radiotherapy was delivered with “risk-adapted” intensity-modulated radiotherapy (IMRT) technique in all patients. RESULTS: After a median follow up of 45 months (range: 8–113 months), the estimated 5-year DFS, LRFS, DMFS, and OS of the entire cohort was 58%, 82%, 67% and 74% respectively. On multivariate analysis, histological subtype was an independent predictor of LRFS, and age was an independent predictor of DFS. The extent of ICE showed only a trend towards worse DFS (P = 0.06). None of the factors significantly predicted for DMFS or OS. Gender, N-stage, and response to ICT did not significantly affect any of the outcomes. Grade 2 or worse subcutaneous fibrosis was seen in 22% of patients and grade 2 or worse xerostomia was seen in 24% of patients at last follow up. Thirty-three percent of the patients developed clinical hypothyroidism at last follow up. None of the patients experienced any neurological or vascular complications. CONCLUSIONS: Taxane-based induction chemotherapy followed by chemo-intensity modulated radiotherapy resulted in excellent locoregional control and survival with acceptable toxicities in patients of nasopharyngeal cancer with intracranial extension. Distant metastasis continues to be the predominant problem in these patients.
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spelling pubmed-72212102020-05-18 Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era Ghosh-Laskar, Sarbani Pilar, Avinash Johnny, Carlton Prabhash, Kumar Joshi, Amit Agarwal, Jai Prakash Gupta, Tejpal Budrukkar, Ashwini Murthy, Vedang Swain, Monali Noronha, Vanita Patil, Vijay Maruthi Pai, Prathamesh Nair, Deepa Chaukar, Devendra Arvind Thiagarajan, Shivakumar Pantvaidya, Gouri Deshmukh, Anuja Chaturvedi, Pankaj Nair, Sudhir D'Cruz, Anil World J Otorhinolaryngol Head Neck Surg Nasopharyngeal Carcinoma OBJECTIVE: To evaluate the survival outcomes for a cohort of nasopharyngeal cancer with intracranial extension (ICE) treated with induction chemotherapy (ICT) followed by chemo-intensity-modulated radiotherapy (CTRT) at a tertiary cancer center. METHODS: We retrospectively analyzed 45 patients with histologically proven, non-metastatic NPC with ICE treated at our institute between October 2008 and October 2016. Patients were classified as minor ICE or major ICE, based on the extent of ICE. All the patients received 2–3 cycles of a taxane-based ICT regimen followed by CTRT. Radiotherapy was delivered with “risk-adapted” intensity-modulated radiotherapy (IMRT) technique in all patients. RESULTS: After a median follow up of 45 months (range: 8–113 months), the estimated 5-year DFS, LRFS, DMFS, and OS of the entire cohort was 58%, 82%, 67% and 74% respectively. On multivariate analysis, histological subtype was an independent predictor of LRFS, and age was an independent predictor of DFS. The extent of ICE showed only a trend towards worse DFS (P = 0.06). None of the factors significantly predicted for DMFS or OS. Gender, N-stage, and response to ICT did not significantly affect any of the outcomes. Grade 2 or worse subcutaneous fibrosis was seen in 22% of patients and grade 2 or worse xerostomia was seen in 24% of patients at last follow up. Thirty-three percent of the patients developed clinical hypothyroidism at last follow up. None of the patients experienced any neurological or vascular complications. CONCLUSIONS: Taxane-based induction chemotherapy followed by chemo-intensity modulated radiotherapy resulted in excellent locoregional control and survival with acceptable toxicities in patients of nasopharyngeal cancer with intracranial extension. Distant metastasis continues to be the predominant problem in these patients. KeAi Publishing 2020-04-03 /pmc/articles/PMC7221210/ /pubmed/32426700 http://dx.doi.org/10.1016/j.wjorl.2020.02.003 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Nasopharyngeal Carcinoma
Ghosh-Laskar, Sarbani
Pilar, Avinash
Johnny, Carlton
Prabhash, Kumar
Joshi, Amit
Agarwal, Jai Prakash
Gupta, Tejpal
Budrukkar, Ashwini
Murthy, Vedang
Swain, Monali
Noronha, Vanita
Patil, Vijay Maruthi
Pai, Prathamesh
Nair, Deepa
Chaukar, Devendra Arvind
Thiagarajan, Shivakumar
Pantvaidya, Gouri
Deshmukh, Anuja
Chaturvedi, Pankaj
Nair, Sudhir
D'Cruz, Anil
Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
title Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
title_full Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
title_fullStr Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
title_full_unstemmed Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
title_short Clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
title_sort clinical outcomes for nasopharyngeal cancer with intracranial extension after taxane-based induction chemotherapy and concurrent chemo-radiotherapy in the modern era
topic Nasopharyngeal Carcinoma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221210/
https://www.ncbi.nlm.nih.gov/pubmed/32426700
http://dx.doi.org/10.1016/j.wjorl.2020.02.003
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