{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:14:38Z","timestamp":1790356478083,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study evaluates the outcomes of omitting the high\u2010 and low\u2010risk clinical tumor volume (CTV1 and CTV2) radiation in de novo metastatic nasopharyngeal carcinoma (dnm\u2010NPC) patients in the immunotherapy era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 45 consecutive dnm\u2010NPC patients receiving chemotherapy and immunotherapy combined with radiotherapy (CIR) from October 9, 2018 to June 1, 2022. Irradiation was only delivered to the primary tumor and retropharyngeal nodes (GTVnx+rn) and gross cervical lymph nodes (GTVnd).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up was 45 (range, 15\u201367) months. There was no recurrence in the omitted elective regions. The 36\u2010month LRRFS, PFS, and OS were 95.4%, 44.6%, and 90.8%, respectively. The main grade 3\/4 hematologic toxicities were neutropenia (42.2%), anemia (20.0%), and thrombocytopenia (13.3%). The incidence of acute grade 3\/4 dermatitis, mucositis, and xerostomia were 4.4%, 8.9%, and 4.4%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Omitting CTV1 and CTV2 was well\u2010tolerated and provided favorable clinical outcomes in the era of immunotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27931","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T07:55:53Z","timestamp":1727250953000},"page":"559-566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the reduction of elective radiotherapy fields for de novo metastatic nasopharyngeal carcinoma in the immunotherapy era"],"prefix":"10.1002","volume":"47","author":[{"given":"Ting","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences  Hangzhou China"},{"name":"Key Laboratory of Head &amp; Neck Cancer Translational Research of Zhejiang Province  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6576-1383","authenticated-orcid":false,"given":"Pei\u2010Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences  Hangzhou China"},{"name":"Key Laboratory of Head &amp; Neck Cancer Translational Research of Zhejiang Province  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi\u2010Feng","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences  Hangzhou China"},{"name":"Key Laboratory of Head &amp; Neck Cancer Translational Research of Zhejiang Province  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Hong","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences  Hangzhou China"},{"name":"Key Laboratory of Head &amp; Neck Cancer Translational Research of Zhejiang Province  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1306-601X","authenticated-orcid":false,"given":"Xiao\u2010Zhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences  Hangzhou China"},{"name":"Key Laboratory of Head &amp; Neck Cancer Translational Research of Zhejiang Province  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66698-6"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.08.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.9347"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31388-5"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.00396"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.1808"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01444-0"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00256"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-3427"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-000867"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2020.09.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.177.2.2217772"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2478\/raon-2014-0011"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-021-07192-8"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-015-0501-6"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12935-019-0863-5"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0000000000000449"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.124507"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2020.101056"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2022.09.020"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)70122-1"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00302-8"},{"issue":"10","key":"e_1_2_11_26_1","first-page":"450","article-title":"Subdivision of M category for nasopharyngeal carcinoma with synchronous metastasis: time to expand the M categorization system","volume":"34","author":"Shen LJ","year":"2015","journal-title":"Chin J Cancer"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2017.02.029"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.03.019"}],"container-title":["Head &amp; 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