Work

Nasopharyngeal necrosis following intensity-modulated radiation therapy of primary nasopharyngeal carcinoma—incidence rate and predictors of risk

Year: 2025

Type: article

Abstract: OBJECTIVES: This study aimed to investigate the incidence of post radiation nasopharyngeal necrosis (PRNN) in primary NPC after intensity modulated radiation therapy (IMRT) and identify the predictors of risk. METHODS: Data of 5798 NPC patients who received IMRT-based treatment between April 2009 and December 2015 were retrospectively reviewed. PRNN was diagnosed by MRI or nasopharyngoscopy. Dosimetric factors were selected by the least absolute shrinkage and selection operator logistic regression and applied to Cox proportional hazards modeling with clinical predictors. RESULTS: ) should be less than 0.2% in case of increasing risk of PRNN(HR = 2.28, 95% CI: 1.26-4.41, p = 0. 01). CONCLUSION: < 0.2% to the planning treatment volume of nasopharynx. KEYPOINTS: High radiation dose may lead to devastating nasopharyngeal necrosis after primary IMRT. Real world analysis will provide valuable information for prevention. FINDINGS: < 0.2% to planning treatment volume increased the risk of nasopharyngeal necrosis. CLINICAL RELEVANCE: > 80.20 Gy is a reliable evidence-based new complement to dose constraint, especially for T3-4 disease, who received high prescribe dose in China.

Source: BMC Cancer

DOI: 10.1186/s12885-025-14086-z