鼻咽癌 z-bio 2025-03-25 268

　　Research Design and Survival and Toxicity Comparison of Reduced Volume Radiotherapy and Traditional Volume Radiotherapy

　　With funding from the National Natural Science Foundation of China (Grant No. 82172870) and other sources, Professor Ma Jun's research team at Sun Yat sen University has made progress in the study of "attenuated" radiotherapy for nasopharyngeal carcinoma. The research results are titled "Reduced volume radiotherapy versus conventional volume radiotherapy: an open label, non inferiority, multicenter, randomized phase 3 clinical trial" and were published on February 19, 2025 in the Journal of Clinical Oncology. CA: A Cancer Journal for Clinicians. The link to the paper is: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21881 .

　　Nasopharyngeal cancer is highly prevalent in China, with new cases accounting for 47% of the world's total. The "induction chemotherapy+concurrent chemoradiotherapy" proposed by Professor Ma Jun's team has been adopted by international guidelines and applied globally. Although induction chemotherapy can significantly reduce the tumor volume in 90% of patients, the current international expert consensus still recommends that regardless of how the tumor volume shrinks after chemotherapy, the scope of radiotherapy should include the tumor area before chemotherapy. This treatment method leads to a high incidence of postoperative complications in surrounding normal tissues, seriously affecting the quality of life of patients.

　　To address this issue, the research team conducted a randomized controlled clinical trial of reduced volume radiotherapy versus traditional volume radiotherapy using internationally recognized standard multicenter, randomized, parallel controlled designs. A total of 445 patients with advanced nasopharyngeal carcinoma were included in the study and randomly divided into two groups: those who received radiotherapy based on the tumor range after and before chemotherapy, respectively, to explore whether volume reduction radiotherapy can reduce radiotherapy toxicity while ensuring efficacy. The research results showed that there was no significant difference in the local recurrence free survival rate and overall survival rate between the two groups of patients, indicating that reduced volume radiotherapy has no difference in efficacy compared to traditional radiotherapy. Correspondingly, the toxicity and side effects of the reduced volume group were significantly reduced, including a 40% decrease in severe radiation-induced oral mucositis, a 50% sharp decrease in the incidence of advanced severe otitis media, and a 60% improvement in dry mouth symptoms. At the same time, the overall health status, physical condition, and emotional function of the patients were significantly improved (Figure).

　　This study provides an innovative and effective new approach for radiation therapy of locally advanced nasopharyngeal carcinoma, achieving a breakthrough from "survival preservation" to "optimal survival" in the diagnosis and treatment of nasopharyngeal carcinoma in China.