{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:18:47Z","timestamp":1789193927744,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CA A Cancer J Clinicians"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nearly 90% locoregionally advanced nasopharyngeal carcinoma (LANPC) responds to induction chemotherapy (IC) with significant tumor volume shrinkage. Radiotherapy always follows IC, and reduced volume has been proposed. However, the efficacy and safety of reduced\u2010volume radiotherapy is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multi\u2010center, noninferiority, randomized, controlled trial, patients with LANPC who completed IC were randomly assigned (1:1) to receive reduced\u2010volume radiotherapy based on post\u2010IC tumor volume (Post\u2010IC group) or conventional volume radiotherapy based on pre\u2010IC tumor volume (Pre\u2010IC group). The primary endpoint was locoregional relapse\u2010free survival, with a noninferiority margin of 8%. Secondary endpoints comprised adverse events, and quality of life (QoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between August 7, 2020, and May 27, 2022, 445 patients were randomly assigned to Post\u2010IC (\n                      <jats:italic>n<\/jats:italic>\n                      = 225) or Pre\u2010IC (\n                      <jats:italic>n<\/jats:italic>\n                      = 220) groups. The average volume receiving radical dose was 66.6 cm\n                      <jats:sup>3<\/jats:sup>\n                      in Post\u2010IC group versus 80.9 cm\n                      <jats:sup>3<\/jats:sup>\n                      . After a median follow\u2010up of 40.4 months, the 3\u2010year locoregional relapse\u2010free survival was 91.5% in the Post\u2010IC group versus 91.2%, with a difference of 0.3% (95% confidence interval \u22124.9% to 5.5%). The incidence of grade 3\u20104 radiation\u2010related toxicity was lower in the Post\u2010IC group including: acute mucositis (19.8% vs 34.1%), late otitis media (9.5% vs 20.9%) and late dry month (3.6% vs 9.5%). The Post\u2010IC group had better QoL for global health status, physical functioning, emotional functioning, dry mouth and sticky saliva.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this trial, reduced\u2010volume radiotherapy was noninferior to conventional volume radiotherapy in locoregional relapse\u2010free survival, and was associated with lower toxicities and improved QoL. (ClinicalTrials.gov identifier NCT04384627).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3322\/caac.21881","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T17:00:32Z","timestamp":1739984432000},"page":"203-215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Reduced\u2010volume radiotherapy versus conventional\u2010volume radiotherapy after induction chemotherapy in nasopharyngeal carcinoma: An open\u2010label, noninferiority, multicenter, randomized phase 3 trial"],"prefix":"10.3322","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-1454","authenticated-orcid":false,"given":"Ling\u2010Long","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Guangdong Provincial Clinical Research Center 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