Upfront Neck Dissection Before Radiotherapy in Stage N3 Nasopharyngeal Carcinoma: A Retrospective Study

NCT07180173 | Completed

• 1 other identifier: CE25786B
• Study Type: observational
• Target: 7
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective observational study aims to evaluate the association between neck tumor burden and high-risk imaging features with locoregional recurrence and distant metastasis in patients with stage N3 nasopharyngeal carcinoma, and to explore the potential benefits of neck dissection, with or without re-irradiation or systemic therapy, in improving regional control and survival. The key questions addressed are whether high N burden and high-risk imaging features are significantly correlated with neck recurrence and distant metastasis, and whether salvage neck treatment (such as neck dissection ± re-irradiation/systemic therapy) can improve regional control and survival outcomes in this high-risk population.

Conditions

Radiology; Oncology

Keywords

Prognosis; Treatment failure; Nasopharyngeal carcinoma; Intensity-modulated radiotherapy

Outcome Measures

Primary Outcomes (1)

• Progression-Free Survival (PFS)

  PFS is defined as the time from treatment completion to the first documented disease progression (locoregional recurrence or distant metastasis) or death, whichever occurs first.

  From completion of primary treatment (CCRT or induction chemotherapy plus RT/CCRT) to disease progression, recurrence, or death from any cause, up to 5 years.

Secondary Outcomes (4)

• Overall Survival (OS)

  From treatment completion to death from any cause, up to 5 years.

• Locoregional Recurrence-Free Survival (LRRFS)

  From treatment completion to the first occurrence of locoregional recurrence, up to 5 years.

• Patterns of Failure

  From treatment completion to recurrence/metastasis, up to 5 years.

• Adverse Events of Salvage Treatment

  From initiation of salvage therapy to 90 days post-treatment.

Interventions

Salvage Neck Treatment RADIATION

Salvage neck treatment, including neck dissection with or without re-irradiation and/or systemic therapy, administered to patients with stage N3 nasopharyngeal carcinoma after completion of definitive concurrent chemoradiotherapy (CCRT) or induction chemotherapy followed by radiotherapy/CCRT.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population includes adult patients aged 18 years or older with pathologically confirmed nasopharyngeal carcinoma (NPC), staged as Stage IV (Tany N3) according to the 8th edition of the AJCC staging system. All participants have completed definitive concurrent chemoradiotherapy (CCRT) or induction chemotherapy (IC) followed by radiotherapy/CCRT, and have complete clinical imaging and medical records before and after treatment for subsequent efficacy and prognostic analysis. This cohort represents high-risk patients with advanced nodal disease, characterized by increased risks of both locoregional recurrence and distant metastasis, making them suitable for evaluating current treatment outcomes and subsequent management strategies.

You may qualify if:

• Age ≥ 18 years.
• Pathologically confirmed diagnosis of nasopharyngeal carcinoma (NPC).
• Stage IV disease (Tany N3) according to the 8th edition of the AJCC staging system.
• Completion of definitive concurrent chemoradiotherapy (CCRT), or induction chemotherapy (IC) followed by radiotherapy/CCRT.
• Availability of complete clinical imaging and medical records before and after treatment for efficacy and prognostic analysis.

You may not qualify if:

• Presence of distant metastasis at initial diagnosis.
• Prior history of treatment for other head and neck malignancies, aside from definitive therapy for NPC (to avoid confounding prognosis).
• Incomplete or prematurely discontinued definitive radiotherapy, resulting in failure to complete the planned curative treatment.
• Lack of complete pathology report, clinical imaging, or treatment records, making effective analysis impossible.

Sponsors & Collaborators

• Taichung Veterans General Hospital: lead

Study Sites (1)

Taichung Veterans General Hospital

Taichung, Taiwan

Location

Related Publications (2)

• Chiang CL, Guo Q, Ng WT, Lin S, Ma TSW, Xu Z, Xiao Y, Li J, Lu T, Choi HCW, Chen W, Chau ESC, Luk PHY, Huang SH, O'Sullivan B, Pan J, Lee AWM. Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature. Front Oncol. 2021 Sep 2;11:703995. doi: 10.3389/fonc.2021.703995. eCollection 2021.

  PMID: 34540670 RESULT

• Huang CL, Guo R, Li JY, Xu C, Mao YP, Tian L, Lin AH, Sun Y, Ma J, Tang LL. Nasopharyngeal carcinoma treated with intensity-modulated radiotherapy: clinical outcomes and patterns of failure among subsets of 8th AJCC stage IVa. Eur Radiol. 2020 Feb;30(2):816-822. doi: 10.1007/s00330-019-06500-5. Epub 2019 Oct 24.

  PMID: 31650266 RESULT

MeSH Terms

Conditions

Neoplasms; Nasopharyngeal Carcinoma

Condition Hierarchy (Ancestors)

Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Nasopharyngeal Neoplasms; Pharyngeal Neoplasms; Otorhinolaryngologic Neoplasms; Head and Neck Neoplasms; Neoplasms by Site; Nasopharyngeal Diseases; Pharyngeal Diseases; Stomatognathic Diseases; Otorhinolaryngologic Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 11, 2025
• First Posted: September 18, 2025
• Study Start: April 1, 2007
• Primary Completion: May 31, 2024
• Study Completion: December 15, 2025
• Last Updated: March 24, 2026

Record last verified: 2026-03

Locations

TW (1)