Yang H, et al. – Study's objective was to figure out whether reducing the target volume of intensity–modulated radiotherapy (IMRT) after induction chemotherapy (IC) improved the quality of life (QOL) in locoregionally advanced nasopharyngeal carcinoma (NPC) without decreasing the local control and survival rate. The local control and survival rate in locoregionally advanced NPC were not reduced by reducing the IMRT target volume after IC. However, doses received by normal tissues were decreased, and the QOL scores were improved.

Methods

• The clinicians randomly assigned 212 NPC patients staged as III–IVb to group A (n=97) or group B (n=115) in this prospective clinical trial.
• Followed by cisplatin concurrent with IMRT, all patients received IC.
• By using the images of pre-IC in group A and post-IC in group B, IMRT was planned.

Results

• In comparison to the group A (P<0.05), the dose received by normal tissues in group B was lower.
• Results revealed significantly improved recovery of the dry mouth symptoms in group B than group B.
• Higher quality of life (QOL) scores were observed in group B than group A.
• Moreover, with a median follow-up of 35 months, the 1-year estimated overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS) in group A versus group B were 97.9% vs 97.3%, 90.7% vs 92,2%, 99.0% vs 98.2%, 91.8% vs 94.8%.
• In addition, the 2-year OS, PFS, LRFFS, DMFS in group A versus group B were 93.7% vs 92.9%, 83.4% vs 84.3%, 96.8% vs 95.5%, 86.5% vs 89.5%.
• In group A versus group B, the 3-year OS, PFS, LRFFS, DMFS were 82.3% vs 87%, 74.7% vs 83.4%, 91.8 vs 93.9%, 81.3% vs 88.6%.