ArticleBMC cancer2025
The prognostic value of boost dose in residual cervical lymph nodes in nasopharyngeal carcinoma patients after intensity-modulated radiotherapy: a retrospective study.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Risk stratification and boost dose optimization for locoregionally advanced nasopharyngeal carcinoma with residual lesions based on clinical stage and post-radiotherapy EBV DNA.Therapeutic advances in medical oncology · 2026Article
- Mendelian randomization analysis reveals potential association between allergic rhinitis and nasopharyngeal carcinoma.Discover oncology · 2025Article
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5 authors.
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Abstract
backgroundThe administration of a boost dose to residual cervical lymph nodes (RCLN) following radiotherapy for nasopharyngeal carcinoma (NPC) remains a controversial contentious issue. This study explored the prognosis of NPC patients with such residuals and evaluated the impact of an intensity-modulated radiotherapy (IMRT) boost on outcome.
methodsTwo thousand six hundred thirty-three NPC patients following radical IMRT were retrospectively conducted. Clinical data of 1057 NPC patients with RCLN after radical IMRT were analyzed and 199 patients received boost radiation. To balance possible confounders between groups, propensity score matching (PSM) was carried out (ratio: 1:2). Risk classification was according to postradiotherapy Epstein-Barr virus (EBV) DNA and N category.
resultsPatients with positive RCLN findings exhibited considerably lower 3-year relapse-free survival (RRFS), overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) rates compared to those with negative findings (98.0% vs. 92.8%; 93.5% vs. 85.0%; 87.0% vs. 68.4%; 92.8% vs. 81.9%, all P < 0.001). Multivariate analysis indicated that N category and postradiotherapy EBV DNA levels as high-risk factors for RCLN. In the matched cohort, the boost radiation group showed improved 3-year OS (89.4% vs. 80.0%, P < 0.001), RRFS (95.0% vs. 89.8%, P = 0.019), PFS (73.8% vs. 63.7%, P = 0.004), and DMFS (85.2% vs. 74.2%, P = 0.001). Multivariate analysis confirmed boost radiation as a critical protective prognostic factor.
conclusionFor NPC patients with RCLN, adding a boost dosage following radical IMRT results in desirable tumor control and a positive clinical outcome. Individuals with detectable EBV DNA and N2-3 category may benefit from the boost radiation.
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