ArticleTherapeutic advances in medical oncology2026
Risk stratification and boost dose optimization for locoregionally advanced nasopharyngeal carcinoma with residual lesions based on clinical stage and post-radiotherapy EBV DNA.
Article in Therapeutic advances in medical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Residual locoregionally advanced nasopharyngeal carcinoma (LA-NPC) after definitive chemoradiation leads to poor outcomes, but current treatments lack standardized, evidence-based guidance for individualized dose escalation, causing varied practices. Objective: To develop a risk-stratification model to personalize boost doses for these patients. Design: A retrospective study. Methods: In this retrospective study, 364 LA-NPC patients with post-radiotherapy (post-RT) residual disease were enrolled. Patients were stratified into high-dose (≥600 cGy, n=201) and low-dose (<600 cGy, n=163) boost groups. Independent prognostic factors were identified via Cox regression. A risk stratification model was constructed using these factors, and its utility in guiding boost dose selection was evaluated. Results: Multivariate analysis confirmed that clinical stage (HR=2.012, 95% CI: 1.100-3.682, p=0.023) and detectable post-RT EBV DNA (HR=1.997, 95% CI: 1.129-3.535, p=0.018) were independent prognostic factors for LA-NPC patients with residual disease after definitive chemoradiotherapy. Based on these variables, a three-tiered risk model was established: low-risk (Stage III with undetectable post-RT EBV DNA), middle-risk (Stage III with detectable post-RT EBV DNA or Stage IVA with undetectable post-RT EBV DNA), and high-risk (Stage IVA with detectable post-RT EBV DNA). This model effectively stratified patients for overall survival (OS) (P<0.05). Crucially, a high-dose boost (≥600 cGy) was associated with improved OS in the high-risk group (HR=0.344, 95% CI: 0.122-0.967, P=0.043), whereas no survival advantage was identified in the low- or middle-risk groups. Among high-risk patients, no statistically significant differences in acute or late toxicities were observed between the high-dose and low-dose boost groups. Conclusion: We developed a clinically applicable risk stratification model integrating clinical stage and post-RT EBV DNA status. Our findings suggest that only high-risk patients may derive an OS benefit from a boost dose of ≥600 cGy, whereas low- and middle-risk patients do not appear to benefit from further dose escalation. This risk-adapted boost strategy provides a preliminary framework requiring prospective validation. Given the retrospective single-center design of this study, prospective multicenter studies are warranted before routine clinical implementation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.