Late toxicities of the vital organs at risk after intensity-modulated radiotherapy for nasopharyngeal carcinoma_West China Medical Journal

Authors：

QIN Lei , LI Yan ,  CHEN Nianyong

Comprehensive Ward of Oncology, Oncology Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHEN Nianyong, Email: n_ychen@hotmail.com

Keywords：

Nasopharyngeal carcinoma; Intensity-modulated radiotherapy; Organ at risk; Late radiotherapy-related toxicity

DOI：

10.7507/1002-0179.201706117

Video：

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Abstract Full text Figures/Tables Video References Cited by

Nasopharyngeal carcinoma (NPC) is rather common in Southeast Asia and Southern China. The standard treatment for NPC is intensity-modulated radiotherapy (IMRT). A large number of the NPC survivors benefit from the IMRT, while some suffer from the late toxicities which can be life-threatening or significantly erode the patients’ quality of life and functional status, especially in the locally advanced NPC. Nowadays the late radiotherapy-related toxicities have been the most important concern for the radiotherapists and patients, who look forward to the better long-term tumor local control and overall survival. Therefore, we carried out a review about the late radiotherapy-related toxicities of the vital organs at risk after IMRT for NPC patients.

Citation： QIN Lei, LI Yan, CHEN Nianyong. Late toxicities of the vital organs at risk after intensity-modulated radiotherapy for nasopharyngeal carcinoma. West China Medical Journal, 2018, 33(4): 449-453. doi: 10.7507/1002-0179.201706117 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	Zhang B, Mo Z, Du W, et al. Intensity-modulated radiation therapy versus 2D-RT or 3D-CRT for the treatment of nasopharyngeal carcinoma: a systematic review and meta-analysis. Oral Oncol, 2015, 51(11): 1041-1046.
3.	Wang F, Jiang C, Ye Z, et al. Treatment outcomes of 257 patients with locoregionally advanced nasopharyngeal carcinoma treated with nimotuzumab plus intensity-modulated radiotherapy with or without chemotherapy: a single-institution experience. Transl Oncol, 2017, 11(1): 65-73.
4.	Lin S, Lu JJ, Han L, et al. Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma: experience of 370 consecutive cases. BMC Cancer, 2010, 10: 39.
5.	Pan XB, Chen KH, Huang ST, et al. Comparison of the efficacy between intensity-modulated radiotherapy and two-dimensional conventional radiotherapy in stage Ⅱ nasopharyngeal carcinoma. Oncotarget, 2017, 8(44): 78096-78104.
6.	Lee N, Harris J, Garden AS, et al. Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase Ⅱ trial 0225. J Clin Oncol, 2009, 27(22): 3684-3690.
7.	Kam MK, Wong FC, Kwong DL, et al. Current controversies in radiotherapy for nasopharyngeal carcinoma (NPC) Oral Oncol, 2014, 50(10): 907-912.
8.	Agulnik M, Siu LL. State-of-the-art management of nasopharyngeal carcinoma: current and future directions. Br J Cancer, 2005, 92(5): 799-806.
9.	Zeng L, Tian YM, Sun XM, et al. Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors. Br J Cancer, 2014, 110(1): 49-54.
10.	苏胜发, 赵充, 韩非, 等. 鼻咽癌适形调强放疗远期疗效分析. 中华肿瘤防治杂志, 2013, 20(11): 853-858.
11.	Kong FF, Ying H, Du CR, et al. Effectiveness and toxicities of intensity-modulated radiation therapy for patients with T4 nasopharyngeal carcinoma. PLoS One, 2014, 9(3): e91362.
12.	Sun X, Su S, Chen C, et al. Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol, 2014, 110(3): 398-403.
13.	Wu F, Wang R, Lu H, et al. Concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: treatment outcomes of a prospective, multicentric clinical study. Radiother Oncol, 2014, 112(1): 106-111.
14.	Xiao WW, Huang SM, Han F, et al. Local control, survival, and late toxicities of locally advanced nasopharyngeal carcinoma treated by simultaneous modulated accelerated radiotherapy combined with cisplatin concurrent chemotherapy: long-term results of a phase 2 study. Cancer, 2011, 117(9): 1874-1883.
15.	Zheng YJ, Han F, Xiao WW, et al. Analysis of late toxicity in nasopharyngeal carcinoma patients treated with intensity modulated radiation therapy. Radiat Oncol, 2015, 10: 17.
16.	Sun Y, Yu XL, Luo W, et al. Recommendation for a contouring method and Atlas of organs at risk in nasopharyngeal carcinoma patients receiving intensity-modulated radiotherapy. Radiother Oncol, 2014, 110(3): 390-397.
17.	Wang SZ, Li J, Miyamoto CT, et al. A study of middle ear function in the treatment of nasopharyngeal carcinoma with IMRT technique. Radiother Oncol, 2009, 93(3): 530-533.
18.	Walker GV, Ahmed S, Allen P, et al. Radiation-induced middle ear and mastoid opacification in skull base tumors treated with radiotherapy. Int J Radiat Oncol Biol Phys, 2011, 81(5): e819-e823.
19.	Peng G, Wang T, Yang KY, et al. A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol, 2012, 104(3): 286-293.
20.	Petsuksiri J, Sermsree A, Thephamongkhol K, et al. Sensorineural hearing loss after concurrent chemoradiotherapy in nasopharyngeal cancer patients. Radiat Oncol, 2011, 6: 19.
21.	Xu YD, Ou YK, Zheng YQ, et al. The treatment for postirradiation otitis media with effusion: a study of three methods. Laryngoscope, 2008, 118(11): 2040-2043.
22.	Su SF, Huang SM, Han F, et al. Analysis of dosimetric factors associated with temporal lobe necrosis (TLN) in patients with nasopharyngeal carcinoma (NPC) after intensity modulated radiotherapy. Radiat Oncol, 2013, 8: 17.
23.	Zhou GQ, Yu XL, Chen M, et al. Radiation-induced temporal lobe injury for nasopharyngeal carcinoma: a comparison of intensity-modulated radiotherapy and conventional two-dimensional radiotherapy. PLoS One, 2013, 8(7): e67488.
24.	Sun Y, Zhou GQ, Qi ZY, et al. Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis. BMC Cancer, 2013, 13: 397.
25.	Chen J, Dassarath M, Yin Z, et al. Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management. Radiat Oncol, 2011, 6: 128.
26.	Su SF, Huang Y, Xiao WW, et al. Clinical and dosimetric characteristics of temporal lobe injury following intensity modulated radiotherapy of nasopharyngeal carcinoma. Radiother Oncol, 2012, 104(3): 312-316.
27.	Zhao Z, Lan Y, Bai S, et al. Late-onset radiation-induced optic neuropathy after radiotherapy for nasopharyngeal carcinoma. J Clin Neurosci, 2013, 20(5): 702-706.
28.	Danesh-Meyer HV. Radiation-induced optic neuropathy. J Clin Neurosci, 2008, 15(2): 95-100.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Zhang B, Mo Z, Du W, et al. Intensity-modulated radiation therapy versus 2D-RT or 3D-CRT for the treatment of nasopharyngeal carcinoma: a systematic review and meta-analysis. Oral Oncol, 2015, 51(11): 1041-1046.
3. Wang F, Jiang C, Ye Z, et al. Treatment outcomes of 257 patients with locoregionally advanced nasopharyngeal carcinoma treated with nimotuzumab plus intensity-modulated radiotherapy with or without chemotherapy: a single-institution experience. Transl Oncol, 2017, 11(1): 65-73.
4. Lin S, Lu JJ, Han L, et al. Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma: experience of 370 consecutive cases. BMC Cancer, 2010, 10: 39.
5. Pan XB, Chen KH, Huang ST, et al. Comparison of the efficacy between intensity-modulated radiotherapy and two-dimensional conventional radiotherapy in stage Ⅱ nasopharyngeal carcinoma. Oncotarget, 2017, 8(44): 78096-78104.
6. Lee N, Harris J, Garden AS, et al. Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase Ⅱ trial 0225. J Clin Oncol, 2009, 27(22): 3684-3690.
7. Kam MK, Wong FC, Kwong DL, et al. Current controversies in radiotherapy for nasopharyngeal carcinoma (NPC) Oral Oncol, 2014, 50(10): 907-912.
8. Agulnik M, Siu LL. State-of-the-art management of nasopharyngeal carcinoma: current and future directions. Br J Cancer, 2005, 92(5): 799-806.
9. Zeng L, Tian YM, Sun XM, et al. Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors. Br J Cancer, 2014, 110(1): 49-54.
10. 苏胜发, 赵充, 韩非, 等. 鼻咽癌适形调强放疗远期疗效分析. 中华肿瘤防治杂志, 2013, 20(11): 853-858.
11. Kong FF, Ying H, Du CR, et al. Effectiveness and toxicities of intensity-modulated radiation therapy for patients with T4 nasopharyngeal carcinoma. PLoS One, 2014, 9(3): e91362.
12. Sun X, Su S, Chen C, et al. Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol, 2014, 110(3): 398-403.
13. Wu F, Wang R, Lu H, et al. Concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: treatment outcomes of a prospective, multicentric clinical study. Radiother Oncol, 2014, 112(1): 106-111.
14. Xiao WW, Huang SM, Han F, et al. Local control, survival, and late toxicities of locally advanced nasopharyngeal carcinoma treated by simultaneous modulated accelerated radiotherapy combined with cisplatin concurrent chemotherapy: long-term results of a phase 2 study. Cancer, 2011, 117(9): 1874-1883.
15. Zheng YJ, Han F, Xiao WW, et al. Analysis of late toxicity in nasopharyngeal carcinoma patients treated with intensity modulated radiation therapy. Radiat Oncol, 2015, 10: 17.
16. Sun Y, Yu XL, Luo W, et al. Recommendation for a contouring method and Atlas of organs at risk in nasopharyngeal carcinoma patients receiving intensity-modulated radiotherapy. Radiother Oncol, 2014, 110(3): 390-397.
17. Wang SZ, Li J, Miyamoto CT, et al. A study of middle ear function in the treatment of nasopharyngeal carcinoma with IMRT technique. Radiother Oncol, 2009, 93(3): 530-533.
18. Walker GV, Ahmed S, Allen P, et al. Radiation-induced middle ear and mastoid opacification in skull base tumors treated with radiotherapy. Int J Radiat Oncol Biol Phys, 2011, 81(5): e819-e823.
19. Peng G, Wang T, Yang KY, et al. A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol, 2012, 104(3): 286-293.
20. Petsuksiri J, Sermsree A, Thephamongkhol K, et al. Sensorineural hearing loss after concurrent chemoradiotherapy in nasopharyngeal cancer patients. Radiat Oncol, 2011, 6: 19.
21. Xu YD, Ou YK, Zheng YQ, et al. The treatment for postirradiation otitis media with effusion: a study of three methods. Laryngoscope, 2008, 118(11): 2040-2043.
22. Su SF, Huang SM, Han F, et al. Analysis of dosimetric factors associated with temporal lobe necrosis (TLN) in patients with nasopharyngeal carcinoma (NPC) after intensity modulated radiotherapy. Radiat Oncol, 2013, 8: 17.
23. Zhou GQ, Yu XL, Chen M, et al. Radiation-induced temporal lobe injury for nasopharyngeal carcinoma: a comparison of intensity-modulated radiotherapy and conventional two-dimensional radiotherapy. PLoS One, 2013, 8(7): e67488.
24. Sun Y, Zhou GQ, Qi ZY, et al. Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis. BMC Cancer, 2013, 13: 397.
25. Chen J, Dassarath M, Yin Z, et al. Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management. Radiat Oncol, 2011, 6: 128.
26. Su SF, Huang Y, Xiao WW, et al. Clinical and dosimetric characteristics of temporal lobe injury following intensity modulated radiotherapy of nasopharyngeal carcinoma. Radiother Oncol, 2012, 104(3): 312-316.
27. Zhao Z, Lan Y, Bai S, et al. Late-onset radiation-induced optic neuropathy after radiotherapy for nasopharyngeal carcinoma. J Clin Neurosci, 2013, 20(5): 702-706.
28. Danesh-Meyer HV. Radiation-induced optic neuropathy. J Clin Neurosci, 2008, 15(2): 95-100.

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