{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:58:43Z","timestamp":1792403923501,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["20214Y0025"],"award-info":[{"award-number":["20214Y0025"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["20204Y0283"],"award-info":[{"award-number":["20204Y0283"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare survival outcomes and toxic effects among patients with newly diagnosed nonmetastatic nasopharyngeal carcinoma (NPC) when treated with intensity\u2010modulated radiotherapy (IMRT) versus IMRT\u2009+\u2009carbon\u2010ion radiotherapy (CIRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective propensity score matching analysis (1:1) of patients treated with IMRT and IMRT\u2009+\u2009CIRT. Descriptive statistics were used to examine the baseline characteristics of the patients. Survival was estimated using the Kaplan\u2013Meier method. Univariate and multivariable logistic regression analysis were used to identify the independent predictors of survival. We examined the association between risk factors and adverse events (AEs) using chi\u2010square tests. Cox model and logistic regression were used to analyze AEs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hundred and nine patients who received IMRT\u2009+\u2009CIRT were included and the median follow\u2010up time was 20.6\u2009months (range: 4.6\u201382\u2009months). There were no statistically significant differences in locoregional failure\u2013free survival, distant metastasis\u2013free survival, disease\u2010free survival, or overall survival between the two groups, but potentially better in IMRT\u2009+ CIRT group (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05, respectively). Nodal boost was the only significant factor associated with LRFS and DFS on multivariable analysis. Thirty\u2010seven patients (34.0%) developed grade 3 acute OMs and no grade 4 acute OMs were observed in IMRT\u2009+\u2009CIRT group. All patients in IMRT\u2009+\u2009CIRT group developed grade 1 dermatitis; while in the match group, 76 patients developed grade 1 dermatitis, 27 patients developed grade 2 dermatitis, 5 patients developed grade 3 dermatitis, 1 patient developed grade 4 dermatitis. IMRT\u2009+\u2009CIRT treatment was associated with a significant trend of lower grades of OM and dermatitis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, respectively). Any severe (i.e., grade 3) chronic AEs, such as xerostomia, skin fibrosis, temporal lobe necrosis, osteoradionecrosis, or radiation\u2010induced optic neuropathy, was not observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, IMRT\u2009+\u2009CIRT was associated with significantly reduced acute toxicity burden compared with full course of IMRT, with excellent survival outcomes. Patients with persistent disease after treatment and treated with nodal boost had a worse outcome. More accurate assessments of IMRT\u2009+\u2009CIRT to primary nonmetastatic NPC patients will be imperative.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27771","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T08:41:53Z","timestamp":1712652113000},"page":"1766-1776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Survival outcomes and toxicity profiles among patients with nonmetastatic nasopharyngeal carcinoma treated with intensity\u2010modulated radiotherapy (<scp>IMRT<\/scp>) versus <scp>IMRT<\/scp> + carbon\u2010ion radiotherapy: A propensity score\u2010matched analysis"],"prefix":"10.1002","volume":"46","author":[{"given":"Yujiao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center Fudan University Cancer Hospital  Shanghai China"},{"name":"Shanghai Key Laboratory of Radiation Oncology (20dz2261000)  Shanghai China"},{"name":"Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy  Shanghai China"},{"name":"Department of Radiation Oncology Fudan University Shanghai Cancer Center  Shanghai China"},{"name":"Department of Oncology Shanghai Medical College  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyin","family":"Guan","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Radiation Oncology (20dz2261000)  Shanghai China"},{"name":"Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy  Shanghai China"},{"name":"Department of Radiation Oncology Shanghai Proton and Heavy Ion Center  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center Fudan University Cancer Hospital  Shanghai China"},{"name":"Shanghai Key Laboratory of Radiation Oncology (20dz2261000)  Shanghai China"},{"name":"Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy  Shanghai China"},{"name":"Department of Radiation Oncology Fudan University Shanghai Cancer Center  Shanghai China"},{"name":"Department of Oncology Shanghai Medical College  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6407-3311","authenticated-orcid":false,"given":"Chaosu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center Fudan University Cancer Hospital  Shanghai China"},{"name":"Shanghai Key Laboratory of Radiation Oncology (20dz2261000)  Shanghai China"},{"name":"Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy  Shanghai China"},{"name":"Department of Radiation Oncology Fudan University Shanghai Cancer Center  Shanghai China"},{"name":"Department of Oncology 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