![]() 1 Intensity-modulated radiotherapy (IMRT), a precision radiotherapy technique enabling conformation of high doses to concave-shaped tumors while protecting normal tissues, is now the standard of care for NPC. Zhang jing actuary maryland trial#The IMRT-alone group had significantly better QOL scores during radiotherapy including the domains of global health status, social functioning, fatigue, nausea and vomiting, pain, insomnia, appetite loss, and constipation.Ĭoncurrent chemoradiotherapy is recommended for patients with stage II nasopharyngeal carcinoma (NPC) based on a single randomized clinical trial using 2-dimensional conventional radiotherapy. The IMRT-alone group experienced a significantly lower incidence of grade 3 to 4 adverse events (17% vs 46% difference, −29% ), including hematologic toxicities (leukopenia, neutropenia) and nonhematologic toxicities (nausea, vomiting, anorexia, weight loss, mucositis). No significant differences were observed between groups in overall survival, locoregional relapse, or distant metastasis. Three-year failure-free survival was 90.5% for the IMRT-alone group vs 91.9% for the concurrent chemoradiotherapy group (difference, −1.4% 1-sided 95% CI, −7.4% to ∞ P value for noninferiority, <.001). Median follow-up was 46 months (IQR, 34-58). The Results of QOL Assessments Evolved Over TimeĪmong 341 randomized patients (mean age, 48 years 30% women), 334 (98.0%) completed the trial. Kaplan–Meier Analysis of Failure-Free Survival in the 2 Groups Stratified by Different CenterĮFigure 5. Kaplan–Meier Analysis of Failure-Free Survival in the 2 Groups Stratified by Different Disease StagesĮFigure 4. ![]() Kaplan–Meier Analysis of Failure-Free Survival in the 2 Groups Stratified by Different Node CategoriesĮFigure 3. ![]() Kaplan–Meier Analysis of Failure-Free Survival in the 2 Groups Stratified by Different Tumor CategoriesĮFigure 2. Mean Differences in Quality-of-Life Scores Between Treatment GroupsĮFigure 1. Pretreatment Quality-of-Life Scores of PatientsĮTable 8. Baseline Characteristics Among Patients Who Were Analyzed for EORTC QLQ-C30 QuestionnairesĮTable 7. Zhang jing actuary maryland full#Multivariable Analyses of Prognostic Factors by Outcome for Patients in Full SetĮTable 6. Radiotherapy for 2 Groups and Compliance to CCRTĮTable 5. Salvage Treatments After Disease FailureĮTable 3. Description of the Guidelines for IMRT in This TrialĮAppendix 3. Quantification of Plasma EBV DNAĮAppendix 2. ![]() We also thank Hui-Xia Feng, BN, (no compensation), Rui-Yao Ou, M.D (received compensation), and Ying Wang, BN, (received compensation), Department of Radiation Oncology, Sun Yat-sen University Cancer Center for their assistance with the data management and logistic support and the staff of the National Clinical Study Center for Anticancer Drugs, Sun Yat-sen University Cancer Center for trial monitoring, data management, and statistical analysis. Meeting Presentation: The trial was selected for Oral Presentation at American Society of Clinical Oncology (ASCO) Annual Meeting (abstract ID: 6000): JChicago, Illinois.ĭata Sharing Statement : See Supplement 3.Īdditional Contributions: We thank the patients who participated in this study, their families, and the medical, nursing, and research staff at the study centers. Role of the Funder/Sponsor: All funding organizations had no role in the design and conduct of the study collection, management, analysis, and interpretation of the data preparation, review, or approval of the manuscript and decision to submit the manuscript for publication. Zhang, Ma.Ĭonflict of Interest Disclosures: None reported.įunding/Support: This study was supported by grants from the National Natural Science Foundation of China ( 81930072, 82172870, 82172668), Natural Science Foundation of Guangdong Province ( 2017A030312003), Key-Area Research and Development Program of Guangdong Province ( 2019B020230002), Overseas Expertise Introduction Project for Discipline Innovation ( 111 Project, B14035) and the Sun Yat-Sen University Clinical Research 5010 Program ( 2016011). Liu, Ma.Īdministrative, technical, or material support: Tang, Guo, Deng, Cheng, J. Zhang, Ma.Ĭritical revision of the manuscript for important intellectual content: Tang, Guo, N. Zhang, Ma.ĭrafting of the manuscript: Tang, Guo, Deng, Cheng, Hu, Luo, Liang, Zheng, F. Drs Sun and Ma contributed equally.Īcquisition, analysis, or interpretation of data: Tang, Guo, N. 651 Dongfeng Rd E, Guangzhou 510060, PR China ( for Publication: July 26, 2022.Īuthor Contributions: Jun Ma and Ying Sun had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Corresponding Author: Jun Ma, MD, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, No. ![]()
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