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Stage IVA Pharyngeal Cancer

MedGen UID:
277735
•Concept ID:
C1336359
•
Neoplastic Process
Synonyms: Pharyngeal Cancer Stage IVA; Stage IVA Carcinoma of Pharynx; Stage IVA Carcinoma of the Pharynx; Stage IVA Pharyngeal Carcinoma; Stage IVA Pharynx Carcinoma

Definition

Stage IVA carcinoma of the pharynx according to the American Joint Committee on Cancer, 6th, 7th, and 8th editions. [from NCI]

Professional guidelines

PubMed

Distinct Failure Patterns in Hypopharyngeal Cancer Patients Receiving Surgery-Based Versus Radiation-Based Treatment.
Lin YH, Hsiao JR, Wu YH, Chang JS, Ou CY, Lee WT, Huang CC, Chang CC, Lai YH, Tsai ST, Hsueh WT, Yen CJ, Lin CL, Chen YS, Jiang SS, Su YC, Wu SY
Ann Surg Oncol 2023 Feb;30(2):1169-1181. Epub 2022 Nov 6 doi: 10.1245/s10434-022-12744-1. PMID: 36336733Free PMC Article
Recurrence risk stratification and treatment strategies of patients with stage IVa-b hypopharyngeal squamous cell carcinoma.
Heng Y, Xu C, Lin H, Zhu X, Zhou L, Zhang M, Li J, Tao L
Head Neck 2022 Sep;44(9):2030-2039. doi: 10.1002/hed.27074. PMID: 35915863
Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline.
Chen YP, Ismaila N, Chua MLK, Colevas AD, Haddad R, Huang SH, Wee JTS, Whitley AC, Yi JL, Yom SS, Chan ATC, Hu CS, Lang JY, Le QT, Lee AWM, Lee N, Lin JC, Ma B, Morgan TJ, Shah J, Sun Y, Ma J
J Clin Oncol 2021 Mar 1;39(7):840-859. Epub 2021 Jan 6 doi: 10.1200/JCO.20.03237. PMID: 33405943

Recent clinical studies

Etiology

Effect of Induction Chemotherapy With Paclitaxel, Cisplatin, and Capecitabine vs Cisplatin and Fluorouracil on Failure-Free Survival for Patients With Stage IVA to IVB Nasopharyngeal Carcinoma: A Multicenter Phase 3 Randomized Clinical Trial.
Li WZ, Lv X, Hu D, Lv SH, Liu GY, Liang H, Ye YF, Yang W, Zhang HX, Yuan TZ, Wang DS, Lu N, Ke LR, Tang WB, Tong LH, Chen ZJ, Liu T, Cao KJ, Mo HY, Guo L, Zhao C, Chen MY, Chen QY, Huang PY, Sun R, Qiu F, Luo DH, Wang L, Hua YJ, Tang LQ, Qian CN, Mai HQ, Guo X, Xiang YQ, Xia WX
JAMA Oncol 2022 May 1;8(5):706-714. doi: 10.1001/jamaoncol.2022.0122. PMID: 35323856Free PMC Article
A nomogram based on tumor response to induction chemotherapy may predict survival in locoregionally advanced nasopharyngeal carcinoma.
Jiang YT, Chen KH, Liang ZG, Yang J, Wei SQ, Qu S, Li L, Zhu XD
Head Neck 2022 Jun;44(6):1301-1312. Epub 2022 Feb 25 doi: 10.1002/hed.27020. PMID: 35212066
Phase II Randomized Trial of Transoral Surgery and Low-Dose Intensity Modulated Radiation Therapy in Resectable p16+ Locally Advanced Oropharynx Cancer: An ECOG-ACRIN Cancer Research Group Trial (E3311).
Ferris RL, Flamand Y, Weinstein GS, Li S, Quon H, Mehra R, Garcia JJ, Chung CH, Gillison ML, Duvvuri U, O'Malley BW Jr, Ozer E, Thomas GR, Koch WM, Gross ND, Bell RB, Saba NF, Lango M, Méndez E, Burtness B
J Clin Oncol 2022 Jan 10;40(2):138-149. Epub 2021 Oct 26 doi: 10.1200/JCO.21.01752. PMID: 34699271Free PMC Article
Lymph node-to-primary tumor standardized uptake value ratio on PET predicts distant metastasis in nasopharyngeal carcinoma.
Hung TM, Fan KH, Kang CJ, Huang SF, Lin CY, Ho AT, Wang HM, Hsieh JC, Cheng AJ, Ng SH, Chang JT
Oral Oncol 2020 Nov;110:104756. Epub 2020 Jul 8 doi: 10.1016/j.oraloncology.2020.104756. PMID: 32652479
Cetuximab in hemodialysis: a case report.
Aldoss IT, Plumb T, Zhen WK, Lydiatt DD, Ganti AK
Head Neck 2009 Dec;31(12):1647-50. doi: 10.1002/hed.21057. PMID: 19283845

Diagnosis

The efficacy of adjuvant chemotherapy in patients with different midpoint-radiotherapy Epstein-Barr virus DNA plasma loads.
Chen J, Cheng H, Liang Y, Lin J, Jia G, Wang T, Li Y, Chen Y, Wang P, Shen B, Liu S, Guo S, Chen Q, Tang L, Mai H, Liu L
Oral Oncol 2024 Sep;156:106938. Epub 2024 Jul 5 doi: 10.1016/j.oraloncology.2024.106938. PMID: 38970970
Effect of waiting time for radiotherapy after last induction chemotherapy on prognosis of locally advanced nasopharyngeal carcinoma.
Zhu KX, Ding T, E YM, Yang HW, Wu RP, Liu RJ, Zhou LL, Fu WJ, Jiang MP, Wang XL
Head Neck 2024 May;46(5):1189-1200. Epub 2024 Feb 17 doi: 10.1002/hed.27680. PMID: 38366691
The Prognostic Value of Deficient Mismatch Repair in Stage II-IVa Nasopharyngeal Carcinoma in the Era of IMRT.
Chen FM, Zhang YX, Li XF, Gao JF, Ma H, Wang XL, Li Y, Li C, Zhang YN, Zhang YT, Kan HX, Li H, Zhang SG, Hao FR, Wang MC
Sci Rep 2020 Jun 16;10(1):9690. doi: 10.1038/s41598-020-66678-3. PMID: 32546739Free PMC Article
Recurrent cisplatin hypersensitivity reaction after first exposure: A case report.
Solomon B, Colonna S
J Oncol Pharm Pract 2019 Mar;25(2):481-483. Epub 2017 Oct 12 doi: 10.1177/1078155217735154. PMID: 29022851
Cetuximab in hemodialysis: a case report.
Aldoss IT, Plumb T, Zhen WK, Lydiatt DD, Ganti AK
Head Neck 2009 Dec;31(12):1647-50. doi: 10.1002/hed.21057. PMID: 19283845

Therapy

Effect of Induction Chemotherapy With Paclitaxel, Cisplatin, and Capecitabine vs Cisplatin and Fluorouracil on Failure-Free Survival for Patients With Stage IVA to IVB Nasopharyngeal Carcinoma: A Multicenter Phase 3 Randomized Clinical Trial.
Li WZ, Lv X, Hu D, Lv SH, Liu GY, Liang H, Ye YF, Yang W, Zhang HX, Yuan TZ, Wang DS, Lu N, Ke LR, Tang WB, Tong LH, Chen ZJ, Liu T, Cao KJ, Mo HY, Guo L, Zhao C, Chen MY, Chen QY, Huang PY, Sun R, Qiu F, Luo DH, Wang L, Hua YJ, Tang LQ, Qian CN, Mai HQ, Guo X, Xiang YQ, Xia WX
JAMA Oncol 2022 May 1;8(5):706-714. doi: 10.1001/jamaoncol.2022.0122. PMID: 35323856Free PMC Article
Prognostic significance of wait time for radical radiotherapy in locoregionally advanced nasopharyngeal carcinoma.
Jiang YT, Chen KH, Yang J, Liang ZG, Qu S, Li L, Zhu XD
Head Neck 2022 May;44(5):1182-1191. Epub 2022 Feb 26 doi: 10.1002/hed.27011. PMID: 35218120
Phase II Randomized Trial of Transoral Surgery and Low-Dose Intensity Modulated Radiation Therapy in Resectable p16+ Locally Advanced Oropharynx Cancer: An ECOG-ACRIN Cancer Research Group Trial (E3311).
Ferris RL, Flamand Y, Weinstein GS, Li S, Quon H, Mehra R, Garcia JJ, Chung CH, Gillison ML, Duvvuri U, O'Malley BW Jr, Ozer E, Thomas GR, Koch WM, Gross ND, Bell RB, Saba NF, Lango M, Méndez E, Burtness B
J Clin Oncol 2022 Jan 10;40(2):138-149. Epub 2021 Oct 26 doi: 10.1200/JCO.21.01752. PMID: 34699271Free PMC Article
Metronomic capecitabine as adjuvant therapy in locoregionally advanced nasopharyngeal carcinoma: a multicentre, open-label, parallel-group, randomised, controlled, phase 3 trial.
Chen YP, Liu X, Zhou Q, Yang KY, Jin F, Zhu XD, Shi M, Hu GQ, Hu WH, Sun Y, Wu HF, Wu H, Lin Q, Wang H, Tian Y, Zhang N, Wang XC, Shen LF, Liu ZZ, Huang J, Luo XL, Li L, Zang J, Mei Q, Zheng BM, Yue D, Xu J, Wu SG, Shi YX, Mao YP, Chen L, Li WF, Zhou GQ, Sun R, Guo R, Zhang Y, Xu C, Lv JW, Guo Y, Feng HX, Tang LL, Xie FY, Sun Y, Ma J
Lancet 2021 Jul 24;398(10297):303-313. Epub 2021 Jun 7 doi: 10.1016/S0140-6736(21)01123-5. PMID: 34111416
Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline.
Chen YP, Ismaila N, Chua MLK, Colevas AD, Haddad R, Huang SH, Wee JTS, Whitley AC, Yi JL, Yom SS, Chan ATC, Hu CS, Lang JY, Le QT, Lee AWM, Lee N, Lin JC, Ma B, Morgan TJ, Shah J, Sun Y, Ma J
J Clin Oncol 2021 Mar 1;39(7):840-859. Epub 2021 Jan 6 doi: 10.1200/JCO.20.03237. PMID: 33405943

Prognosis

The efficacy of adjuvant chemotherapy in patients with different midpoint-radiotherapy Epstein-Barr virus DNA plasma loads.
Chen J, Cheng H, Liang Y, Lin J, Jia G, Wang T, Li Y, Chen Y, Wang P, Shen B, Liu S, Guo S, Chen Q, Tang L, Mai H, Liu L
Oral Oncol 2024 Sep;156:106938. Epub 2024 Jul 5 doi: 10.1016/j.oraloncology.2024.106938. PMID: 38970970
Prognostic significance of wait time for radical radiotherapy in locoregionally advanced nasopharyngeal carcinoma.
Jiang YT, Chen KH, Yang J, Liang ZG, Qu S, Li L, Zhu XD
Head Neck 2022 May;44(5):1182-1191. Epub 2022 Feb 26 doi: 10.1002/hed.27011. PMID: 35218120
Lymph node-to-primary tumor standardized uptake value ratio on PET predicts distant metastasis in nasopharyngeal carcinoma.
Hung TM, Fan KH, Kang CJ, Huang SF, Lin CY, Ho AT, Wang HM, Hsieh JC, Cheng AJ, Ng SH, Chang JT
Oral Oncol 2020 Nov;110:104756. Epub 2020 Jul 8 doi: 10.1016/j.oraloncology.2020.104756. PMID: 32652479
Concurrent chemoradiotherapy with/without induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma: Long-term results of phase 3 randomized controlled trial.
Li WF, Chen NY, Zhang N, Hu GQ, Xie FY, Sun Y, Chen XZ, Li JG, Zhu XD, Hu CS, Xu XY, Chen YY, Hu WH, Guo L, Mo HY, Chen L, Mao YP, Sun R, Ai P, Liang SB, Long GX, Zheng BM, Feng XL, Gong XC, Li L, Shen CY, Xu JY, Guo Y, Chen YM, Zhang F, Lin L, Tang LL, Liu MZ, Ma J, Sun Y
Int J Cancer 2019 Jul 1;145(1):295-305. Epub 2019 Jan 24 doi: 10.1002/ijc.32099. PMID: 30613964
Cetuximab in hemodialysis: a case report.
Aldoss IT, Plumb T, Zhen WK, Lydiatt DD, Ganti AK
Head Neck 2009 Dec;31(12):1647-50. doi: 10.1002/hed.21057. PMID: 19283845

Clinical prediction guides

Elective upper-neck versus whole-neck irradiation of the uninvolved neck in patients with nasopharyngeal carcinoma: an open-label, non-inferiority, multicentre, randomised phase 3 trial.
Tang LL, Huang CL, Zhang N, Jiang W, Wu YS, Huang SH, Mao YP, Liu Q, Li JB, Liang SQ, Qin GJ, Hu WH, Sun Y, Xie FY, Chen L, Zhou GQ, Ma J
Lancet Oncol 2022 Apr;23(4):479-490. Epub 2022 Feb 28 doi: 10.1016/S1470-2045(22)00058-4. PMID: 35240053
Prognostic significance of wait time for radical radiotherapy in locoregionally advanced nasopharyngeal carcinoma.
Jiang YT, Chen KH, Yang J, Liang ZG, Qu S, Li L, Zhu XD
Head Neck 2022 May;44(5):1182-1191. Epub 2022 Feb 26 doi: 10.1002/hed.27011. PMID: 35218120
Phase II Randomized Trial of Transoral Surgery and Low-Dose Intensity Modulated Radiation Therapy in Resectable p16+ Locally Advanced Oropharynx Cancer: An ECOG-ACRIN Cancer Research Group Trial (E3311).
Ferris RL, Flamand Y, Weinstein GS, Li S, Quon H, Mehra R, Garcia JJ, Chung CH, Gillison ML, Duvvuri U, O'Malley BW Jr, Ozer E, Thomas GR, Koch WM, Gross ND, Bell RB, Saba NF, Lango M, Méndez E, Burtness B
J Clin Oncol 2022 Jan 10;40(2):138-149. Epub 2021 Oct 26 doi: 10.1200/JCO.21.01752. PMID: 34699271Free PMC Article
Metronomic capecitabine as adjuvant therapy in locoregionally advanced nasopharyngeal carcinoma: a multicentre, open-label, parallel-group, randomised, controlled, phase 3 trial.
Chen YP, Liu X, Zhou Q, Yang KY, Jin F, Zhu XD, Shi M, Hu GQ, Hu WH, Sun Y, Wu HF, Wu H, Lin Q, Wang H, Tian Y, Zhang N, Wang XC, Shen LF, Liu ZZ, Huang J, Luo XL, Li L, Zang J, Mei Q, Zheng BM, Yue D, Xu J, Wu SG, Shi YX, Mao YP, Chen L, Li WF, Zhou GQ, Sun R, Guo R, Zhang Y, Xu C, Lv JW, Guo Y, Feng HX, Tang LL, Xie FY, Sun Y, Ma J
Lancet 2021 Jul 24;398(10297):303-313. Epub 2021 Jun 7 doi: 10.1016/S0140-6736(21)01123-5. PMID: 34111416
Lymph node-to-primary tumor standardized uptake value ratio on PET predicts distant metastasis in nasopharyngeal carcinoma.
Hung TM, Fan KH, Kang CJ, Huang SF, Lin CY, Ho AT, Wang HM, Hsieh JC, Cheng AJ, Ng SH, Chang JT
Oral Oncol 2020 Nov;110:104756. Epub 2020 Jul 8 doi: 10.1016/j.oraloncology.2020.104756. PMID: 32652479

Recent systematic reviews

Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline.
Chen YP, Ismaila N, Chua MLK, Colevas AD, Haddad R, Huang SH, Wee JTS, Whitley AC, Yi JL, Yom SS, Chan ATC, Hu CS, Lang JY, Le QT, Lee AWM, Lee N, Lin JC, Ma B, Morgan TJ, Shah J, Sun Y, Ma J
J Clin Oncol 2021 Mar 1;39(7):840-859. Epub 2021 Jan 6 doi: 10.1200/JCO.20.03237. PMID: 33405943
De-intensified adjuvant (chemo)radiotherapy versus standard adjuvant chemoradiotherapy post transoral minimally invasive surgery for resectable HPV-positive oropharyngeal carcinoma.
Howard J, Dwivedi RC, Masterson L, Kothari P, Quon H, Holsinger FC
Cochrane Database Syst Rev 2018 Dec 14;12(12):CD012939. doi: 10.1002/14651858.CD012939.pub2. PMID: 30550641Free PMC Article

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