Nutritional outcomes after radiotherapy target volume reduction for nasopharyngeal cancer: a Phase III trial

Nutritional outcomes after radiotherapy target volume reduction for nasopharyngeal cancer: a Phase III trial: Future Oncology, Ahead of Print.



Aim: This study aimed to assess the nutritional status of patients with locoregionally advanced nasopharyngeal cancer, for whom intensity-modulated radiotherapy (IMRT) was planned using their pre- or post-induction chemotherapy (IC) nasopharyngeal gross tumor volume. Materials & methods: Two-hundred twelve cases of stage III–IVb nasopharyngeal cancer were randomized into groups A (n = 97) and B (n = 115). IMRT was planned for groups A and B using pre-IC and post-IC images, respectively. Results: There was a significant decrease in the nutritional parameters of group B compared with those of group A during radiotherapy. Multivariate analysis indicated that the T stage and nasopharyngeal gross tumor volume IMRT-planning protocol were prognostic factors of poor nutritional status. Conclusion: Decreasing the IMRT target volume through IC can improve nutritional status.



Lay abstract

This prospective clinical trial is the first to compare the nutritional status of patients with locoregionally advanced nasopharyngeal cancer for whom intensity-modulated radiotherapy (IMRT) was planned using the pre- or post-induction chemotherapy (IC) nasopharyngeal gross tumor volume (GTVnx). Our results indicate that patients for whom IMRT planned with post-IC GTVnx have a better survival rate and lower risk of malnutrition than that of IMRT planned with pre-IC GTVnx. We can conclude that a reduction of the target volumes according to the post-IC tumor extension could not only yield excellent long-term locoregional control but also decrease the risk of malnutrition and the incidence of radiation-related toxicities, especially grade 3 oral mucositis.



Keywords:

advanced NPCIMRTinduction chemotherapynutritional outcomestarget volume reduction