Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study

Abstract To address whether the addition of intensity-modulated radiotherapy (IMRT) compared to three-dimensional conformal radiotherapy (3D-CRT) aggravate radiation-induced acute injury of locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with induction chemotherapy (IC) followed by...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Zexin Yao, Bing Zhang, Jialin Huang, Lei Shi, Biao Cheng
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b4d83fe0f7cc476c821266e67cd9b8ce
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b4d83fe0f7cc476c821266e67cd9b8ce
record_format	dspace
spelling	oai:doaj.org-article:b4d83fe0f7cc476c821266e67cd9b8ce2021-12-02T14:37:07ZRadiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study10.1038/s41598-021-87170-62045-2322https://doaj.org/article/b4d83fe0f7cc476c821266e67cd9b8ce2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87170-6https://doaj.org/toc/2045-2322Abstract To address whether the addition of intensity-modulated radiotherapy (IMRT) compared to three-dimensional conformal radiotherapy (3D-CRT) aggravate radiation-induced acute injury of locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT). We conducted a prospective study of 182 patients in the stage III to IVb with biopsy-proven nonmetastatic LANPC who newly underwent radiotherapy and sequentially received IC, followed by CCRT at our institution. Occurring time of radiation-induced toxicities were estimated and compared using the Kaplan–Meier method and Log-rank test. The most severe acute toxicities included oral mucositis in 97.25% and dermatitis in 90.11%. Subset analysis revealed that Grade 3–4 acute dermatitis were significantly higher in the IMRT than 3D-CRT. Oral mucositis and dermatitis were the earliest occurrence of acute injuries (2 years: 60.44% and 17.58%). Patients in IMRT group achieved significantly lower risk of bone marrow toxicity, but higher risk of leukopenia and gastrointestinal injury. Multivariate analyses also demonstrated that IMRT, female gender and hepatitis were the independent prognostic factors for bone marrow toxicity. In a combined regimen of IC followed by CCRT for the treatment of LANPC, IMRT seems to be an aggressive technique with a trend towards increased gastrointestinal and hematological toxicities, but decreased bone marrow toxicity than those treated with 3D-CRT. This study provides a comprehensive summary of prospective evidence reporting the side effects in the management of LANPC patients. We quantify the occurrence risks of chemoradiotherapy-induced acute injuries through analysis of time-to-event.Zexin YaoBing ZhangJialin HuangLei ShiBiao ChengNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zexin Yao Bing Zhang Jialin Huang Lei Shi Biao Cheng Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
description	Abstract To address whether the addition of intensity-modulated radiotherapy (IMRT) compared to three-dimensional conformal radiotherapy (3D-CRT) aggravate radiation-induced acute injury of locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT). We conducted a prospective study of 182 patients in the stage III to IVb with biopsy-proven nonmetastatic LANPC who newly underwent radiotherapy and sequentially received IC, followed by CCRT at our institution. Occurring time of radiation-induced toxicities were estimated and compared using the Kaplan–Meier method and Log-rank test. The most severe acute toxicities included oral mucositis in 97.25% and dermatitis in 90.11%. Subset analysis revealed that Grade 3–4 acute dermatitis were significantly higher in the IMRT than 3D-CRT. Oral mucositis and dermatitis were the earliest occurrence of acute injuries (2 years: 60.44% and 17.58%). Patients in IMRT group achieved significantly lower risk of bone marrow toxicity, but higher risk of leukopenia and gastrointestinal injury. Multivariate analyses also demonstrated that IMRT, female gender and hepatitis were the independent prognostic factors for bone marrow toxicity. In a combined regimen of IC followed by CCRT for the treatment of LANPC, IMRT seems to be an aggressive technique with a trend towards increased gastrointestinal and hematological toxicities, but decreased bone marrow toxicity than those treated with 3D-CRT. This study provides a comprehensive summary of prospective evidence reporting the side effects in the management of LANPC patients. We quantify the occurrence risks of chemoradiotherapy-induced acute injuries through analysis of time-to-event.
format	article
author	Zexin Yao Bing Zhang Jialin Huang Lei Shi Biao Cheng
author_facet	Zexin Yao Bing Zhang Jialin Huang Lei Shi Biao Cheng
author_sort	Zexin Yao
title	Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
title_short	Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
title_full	Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
title_fullStr	Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
title_full_unstemmed	Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
title_sort	radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b4d83fe0f7cc476c821266e67cd9b8ce
work_keys_str_mv	AT zexinyao radiationinducedacuteinjuryofintensitymodulatedradiotherapyversusthreedimensionalconformalradiotherapyininductionchemotherapyfollowedbyconcurrentchemoradiotherapyforlocoregionallyadvancednasopharyngealcarcinomaaprospectivecohortstudy AT bingzhang radiationinducedacuteinjuryofintensitymodulatedradiotherapyversusthreedimensionalconformalradiotherapyininductionchemotherapyfollowedbyconcurrentchemoradiotherapyforlocoregionallyadvancednasopharyngealcarcinomaaprospectivecohortstudy AT jialinhuang radiationinducedacuteinjuryofintensitymodulatedradiotherapyversusthreedimensionalconformalradiotherapyininductionchemotherapyfollowedbyconcurrentchemoradiotherapyforlocoregionallyadvancednasopharyngealcarcinomaaprospectivecohortstudy AT leishi radiationinducedacuteinjuryofintensitymodulatedradiotherapyversusthreedimensionalconformalradiotherapyininductionchemotherapyfollowedbyconcurrentchemoradiotherapyforlocoregionallyadvancednasopharyngealcarcinomaaprospectivecohortstudy AT biaocheng radiationinducedacuteinjuryofintensitymodulatedradiotherapyversusthreedimensionalconformalradiotherapyininductionchemotherapyfollowedbyconcurrentchemoradiotherapyforlocoregionallyadvancednasopharyngealcarcinomaaprospectivecohortstudy
_version_	1718391029156020224

Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study

Ejemplares similares