Publications Repository

Publications Repository

View item 
  •   Home
  • ICR Divisions
  • Cancer Biology
  • View item
  • Home
  • ICR Divisions
  • Cancer Biology
  • View item
JavaScript is disabled for your browser. Some features of this site may not work without it.

International Recommendations on Re-irradiation by Intensity-modulated Radiotherapy for Locally Recurrent Nasopharyngeal Carcinoma.

Thumbnail
View/Open
Accepted version (1.268Mb)
Date
2021-02-02
ICR Author
Harrington, Kevin
Author
Ng, WT
Soong, YL
Chan Ahn, Y
AlHussain, H
Choi, HCW
Corry, J
Grégoire, V
Harrington, KJ
Hu, CS
Jensen, K
Kwong, DL
Langendijk, JA
Le, QT
Lee, NY
Lin, JC
Lu, TX
Mendenhall, WM
O'Sullivan, B
Ozyar, E
Pan, JJ
Peters, LJ
Poh, SS
Rosenthal, DI
Sanguineti, G
Tao, Y
Wee, JT
Yom, SS
Chua, MLK
Lee, AWM
Show allShow less
Type
Journal Article
Metadata
Show full item record
Abstract
Purpose Re-irradiation for locally recurrent nasopharyngeal carcinoma (NPC) is challenging as prior radiation dose delivered in the first course is often close to the tolerance limit of surrounding normal structures. A delicate balance between achieving local salvage and minimizing treatment toxicities is needed. However, high-level evidence is lacking as available reports are mostly retrospective studies on small series of patients. Pragmatic consensus guidelines, based on an extensive literature search and the pooling of opinions by leading specialists, will provide a useful reference to assist decision-making for these difficult decisions.Methods and materials A thorough review of available literature on recurrent NPC was conducted. A set of questions and preliminary draft guideline was circulated to a panel of international specialists with extensive experience in this field for voting on controversial areas and comments. A refined second proposal, based on a summary of the initial voting and different opinions expressed, was re-circulated to the whole panel for review and reconsideration. The current guideline was based on majority voting following repeated iteration for final agreement.Results The initial round of questions showed variations in clinical practice even among the specialists, reflecting the lack of high-quality supporting data and the difficulties in formulating clinical decisions. Through exchange of comments and iterative revisions, recommendations with high-to-moderate agreement were formulated on general treatment strategies and details of re-irradiation (including patient selection, targets contouring, dose prescription and constraints).Conclusion This paper provides useful reference on radical salvage treatment strategies for recurrent NPC and optimization of re-irradiation through review of published evidence and consensus building. However, the final decision by the attending clinician must include full consideration of an individual patient's conditions, understanding of the delicate balance between risk and benefits, and acceptance of risk of complications.
URI
https://repository.icr.ac.uk/handle/internal/4422
DOI
https://doi.org/10.1016/j.ijrobp.2021.01.041
Collections
  • Cancer Biology
  • Radiotherapy and Imaging
Research team
Targeted Therapy
Targeted Therapy
Language
eng
Date accepted
2021-01-23
License start date
2021-02-02
Citation
International journal of radiation oncology, biology, physics, 2021

Browse

All of ICR repositoryICR DivisionsBy issue dateAuthorsTitlesPublication TypesThis collectionBy issue dateAuthorsTitlesPublication Types
  • Login
  • Registered office: The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP
    A Charity, Not for Profit. Company Limited by Guarantee.
    Registered in England No. 534147. VAT Registration No. GB 849 0581 02.