Elective upper-neck versus whole-neck irradiation of the uninvolved neck in patients with nasopharyngeal carcinoma

In The Lancet Oncology, Ling-Long Tang and colleagues 1 Tang LL Huang CL Zhang N et al. 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. Lancet Oncol. 2022; 23: 479-490 Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar reported that elective ipsilateral upper-neck irradiation of the uninvolved neck provides similar regional control and results in less radiation toxic effects than standard whole-neck irradiation in patients with N0–N1 nasopharyngeal carcinoma. Elective upper-neck versus whole-neck irradiation of the uninvolved neck in patients with nasopharyngeal carcinomaWe would like to congratulate Ling-Long Tang and colleagues1 for their recently published trial on de-escalation strategies to decrease radiation volume in patients with early-stage nasopharyngeal cancer. In the Results section of their Article, omission of part of the neck in the radiotherapy field did not increase the risk of neck nodal relapse and resulted in fewer toxic effects than whole-neck irradiation. However, from a radiobiological standpoint, we would like to highlight concerns about the prescription of elective irradiation. Full-Text PDF 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 trialElective UNI of the uninvolved neck provides similar regional control and results in less radiation toxicity compared with standard WNI in patients with N0–N1 nasopharyngeal carcinoma. Full-Text PDF Elective upper-neck versus whole-neck irradiation of the uninvolved neck in patients with nasopharyngeal carcinoma – Authors' replyWe thank Yu-Ming Wang and colleagues for their comments on our Article.1 In this trial, patients in the upper-neck irradiation group without cervical lymph node involvement received elective irradiation to the bilateral upper-neck only (ie, sparing the bilateral lower neck), and the doses plummeted to 0 Gy in the lower neck (appendix p 1). Full-Text PDF