title: Clinical outcomes for early-stage nasopharyngeal carcinoma with predominantly WHO II histology treated by intensity-modulated radiation therapy with or without chemotherapy in nonendemic region of China.
abstract: BACKGROUND
  The clinical outcomes for early-stage nasopharyngeal carcinoma (NPC) in northwest China were evaluated.
  
  
  METHODS
  A retrospective study was performed from 69 patients with NPC patients treated with intensity-modulated radiation therapy (IMRT) with or without chemotherapy.
  
  
  RESULTS
  Median follow-up was 34 months. World Health Organization (WHO) type II was the predominant histology (71%). All treatment failures occurred in T2N1 NPCs (14.5%), with metastasis the major reason. The 3-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 93.3%, 94.1%, and 94.8% respectively. The 3-year survival rate for T2N1 and IMRT alone group were both significantly poorer than the T1N0, T2N0, and T1N1 groups and the chemoradiation group, respectively (p < .05). N1 classification, T2N1 classification, and addition of chemoradiation were significant independent predictors (p < .05). No grade IV toxicities were observed.
  
  
  CONCLUSIONS
  T2N1 classification is a unique subgroup with higher risk of distant metastasis. Improved outcomes of T2N1 NPC with predominantly WHO II histology after chemoradiation has not been reported.
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Shanquan
authors.initials: S
authors.lastname: Luo
authors.forename: Lina
authors.initials: L
authors.lastname: Zhao
authors.forename: Jianhua
authors.initials: J
authors.lastname: Wang
authors.forename: Man
authors.initials: M
authors.lastname: Xu
authors.forename: Jianping
authors.initials: J
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Zhou
authors.forename: Feng
authors.initials: F
authors.lastname: Xiao
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Long
authors.forename: Mei
authors.initials: M
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002681:China; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D009367:Neoplasm Staging; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: IMRT; WHO type II; clinical outcome; nasopharyngeal carcinoma; nonendemic region