Search

Background: To identify patients at low risk of synchronous bone metastasis who should not receive bone scans when initially diagnosed with nasopharyngeal carcinoma (NPC). Methods: In total, 6652 patients were enrolled in the training cohort and 1919 patients in the multicenter external validation cohort. Logistic regression analyses were performed to assess independent predictors of synchronous bone metastasis for the nomogram model. Results: After risk stratification, 46.3% (3081/6652) patients were separated into the low‐risk group with an incidence of 0.71% for synchronous bone metastasis. The odds ratio of the intermediate and high‐risk groups was 5.61 and 23.82 times that of the low‐risk group, respectively. For patients with high EBV DNA, we recommend routine screening for N2‐3 female patients, but that all male subgroups are screened. Conclusions: Bone scans should not be routine. Patients in the low‐risk group should not be screened, which would avoid excessive radiation and economize iatrical resource. [ABSTRACT FROM AUTHOR]

Background: To develop a common follow‐up strategy for appropriate imaging examination at an appropriate time for nasopharyngeal carcinoma (NPC). Methods: Independent prognostic factors were identified by Cox regression analysis, and a nomogram model was developed. Random survival forest (RSF) model was constructed to depict probability of disease failure during a 5‐year follow‐up and establish a reasonable risk‐based follow‐up strategy. Results: The nomogram model finally categorized the patients into three risk groups. RSF model demonstrated distribution trends for local and regional recurrences, bone metastasis, liver metastasis, and lung metastasis of NPC. Adequate imaging at follow‐up should be considered between 10 and 21 months for patients at moderate‐risk of recurrence or metastasis and 7–36 months for those at high‐risk. Conclusions: The temporal distribution of incidence rates of recurrence or metastasis varied among different risk groups. We recommend implementing a focused and targeted imaging surveillance intervention at appropriate times to improve its efficiency and reduce costs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between absolute neutrophils count (ANC) in different periods of treatment and the outcomes of patients and assess effect of longitudinal neutrophils variation during radiotherapy (RT) on prognosis in patients with nasopharyngeal carcinoma (NPC). Methods: A total of 1753 patients with newly diagnosed NPC were retrospectively analyzed. Complete blood counts of patients were obtained before treatment, before, during, and end of RT. The survival rate was calculated by Kaplan‐Meier method and the result was compared by the log‐rank test. The univariate and multivariate COX regression analyses were performed to investigate the association between the variation of ANC and survival for patients in different periods. Results: Higher ANC pretreatment (>4 × 109/L) and pre‐RT (>7 × 109/L) were correlated with poor OS (89.7% vs 85.6%, P =.009; 88.3% vs 77.3%, P =.002, respectively). An increase >5 × 109/L of ANC during RT was associated with adverse OS (87.9% vs 73.6%, P =.042). The multivariate Cox regression analysis showed that high ANC of pre‐RT (>7 × 109/L) and a high increase (>5 × 109/L) of ANC during RT were independent prognostic factors of patients with NPC (P =.002,.044, respectively). Conclusion: Our results demonstrated that ANC was an independent prognostic factor for survival in patients with NPC who received RT. Neutrophils may promote tumor resistance to radiotherapy in NPC. Level of Evidence: 2a. [ABSTRACT FROM AUTHOR]

Objective: To analyze the correlation between relevant factors and radiation‐induced nasopharyngeal ulcer (RINU) in primary nasopharyngeal carcinoma (NPC) treated with intensity‐modulated radiation therapy (IMRT). Methods: Clinical data were collected for 599 patients with newly diagnosed NPC who had completed IMRT. The entire cohort was randomly divided into two subgroups. The relationship between RINU and IMRT dose‐volume were statistically analyzed with ROC curves and the Chi‐square test. Nutritional status during and after treatment was compared between patients with vs without RINU. Results: The results obtained showed that dose‐volume had no effect on the incidence of RINU (P >.05). Nutrition‐related parameters differed significantly between patients with vs without RINU (P <.05). Conclusion: The results obtained show that the incidence of RINU is not related to IMRT dose‐volume in the treatment of primary NPC. The incidence of RINU was found to be related to nutritional status during and after radiation therapy. Level of Evidence: 2a [ABSTRACT FROM AUTHOR]

B Front Cover b : The cover image is based on the Original Article I Recommendation for imaging follow-up strategy based on time-specific disease failure for nasopharyngeal carcinoma i by Ye Feng MD et al., https://doi.org/10.1002/hed.27277. [Extracted from the article]