De-escalating elective nodal irradiation for nasopharyngeal carcinoma
Mené en Chine entre 2016 et 2018 sur 446 patients atteints d'un carcinome rhinopharyngé métastatique non traité (durée médiane de suivi : 53 mois), cet essai randomisé multicentrique de phase III évalue la non-infériorité, du point de vue de la survie sans récidive locorégionale à 3 ans, et la toxicité d'une irradiation ipsilatérale du haut du cou par rapport à une irradiation standard du cou entier
Treatment outcomes for endemic nasopharyngeal carcinoma have steadily improved over the past two decades with routine use of intensity-modulated radiotherapy (IMRT), concurrent chemotherapy, and MRI staging. In the past decade, trials have primarily focused on treatment escalation with induction and consolidative chemotherapy. However, with modern treatment, fewer than 20 % of patients with nonmetastatic nasopharyngeal carcinoma develop disease recurrence. In this population with few competing risks, these excellent outcomes have promoted renewed interest in individualised treatment de-intensification.
The Lancet Oncology , commentaire en libre accès, 2021