Evidence map›Paper›PMID 41361781›Full record

ArticleRadiation oncology (London, England)2025

Outcomes and recurrence pattern analysis of intensity modulated chemoradiotherapy in nasopharyngeal cancer: a retrospective study from Heidelberg University Hospital.

Lukas Bauer, Sebastian Regnery, Maximilian Y Deng, Florian Stritzke, Philipp Schröter, Henrik Franke, Nils B Netzer, Kristin Uzun-Lang, Katharina Weusthof, Rubens Thoelken and 2 more

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Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lukas BauerDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. lukas.bauer@med.uni-heidelberg.de.ORCID https://orcid.org/0009-0000-7711-934X
Sebastian RegneryDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Maximilian Y DengDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Florian StritzkeDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Philipp SchröterDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Henrik FrankeDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Nils B NetzerDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Kristin Uzun-LangDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Katharina WeusthofDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Rubens ThoelkenDepartment of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany.
Jürgen DebusDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Thomas HeldDepartment of Radiation Oncology, Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate treatment outcomes, toxicity, and recurrence patterns by dose level in nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT) and weekly cisplatin.

methodsWe retrospectively analyzed 48 NPC patients treated between 2005 and 2019 with IMRT and weekly cisplatin (40 mg/m²). The planning target volume (PTV) received a median total dose of 57.6 Gy (1.8 Gy/fraction) with a simultaneous integrated boost to the primary tumor and nodal metastases up to 70.4 Gy. To assess recurrence patterns, follow-up imaging was deformably co-registered with planning CTs (pCT), and recurrent gross tumor volumes (rGTVs) were delineated and mapped to pCTs. Recurrences were categorized using a centroid-based system into five types: A (central high-dose), B (peripheral high-dose), C (central intermediate-/low-dose), D (peripheral intermediate-/low-dose), and E (extraneous dose).

resultsWith a median follow-up of 73 months (range 24-156), 9 patients (19%) had died. The 3-, 5-, and 10-year overall survival rates were 98%, 96%, and 67%, respectively. Local control rates (LCR) at 2, 3, and 5 years were 92%, 89%, and 89%; regional control was 96%, 94%, and 94%; and distant control was 92%, 89%, and 89%. Treatment was well tolerated, with no grade ≥ 4 toxicities. Grade 3 acute toxicities occurred in 23 patients (48%), most commonly dysphagia, with nearly all resolving within 90 days. Among treatment failures, distant metastases (13%) and local relapses (10%) were most frequent. Of 8 local and/or regional recurrences analyzed, 2 were type A (central high-dose), 3 type B ("marginal"), 2 type C (central intermediate-/low-dose), and 1 type E ("out-of-field").

conclusionIMRT with weekly cisplatin yields excellent survival and locoregional control with acceptable toxicity in NPC. Distant metastasis as one of the predominant failure patterns highlights the need for more effective systemic therapies. Most local recurrences arose within high-dose areas, suggesting a potential opportunity for treatment optimization.

Indexed as

ChemoradiotherapyNasopharyngeal CarcinomaNasopharyngeal NeoplasmsNeoplasm Recurrence, LocalRadiotherapy, Intensity-ModulatedAdultAgedCisplatinFemaleFollow-Up StudiesHospitals, UniversityHumansMaleMiddle AgedPrognosisRadiotherapy DosageCisplatinIntensity-modulated radiotherapyLocoregional recurrenceNasopharyngeal carcinomaToxicityTreatment failure patterns

Identifiers

PMID41361781
PMCPMC12690790

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.