Anne Lee (The University of Hong Kong, Hong Kong SAR China & The University of Hong Kong at Shunzen)
“Challenges and Novel Approaches in Radiotherapy for Nasopharyngeal Carcinoma”
- HKNPC1301 study on IMRT (2001-2010) to further improve tomorrow control for poor risk group
- IMRT: parotid sparing (randomized trials on IMRT (late toxicity following IRT)
- Radiotherapy – does response relationship
- Fundamental + Novel to achieve “personalized NPC treatment”
- Further development of IMRT
- Radiotherapy set-up with image
- Accurate delineation of GTV
- GTC; fusion of MRI and PET-CT
- Technological advance: MRI-simulation, MRI-Linac
- RT technology evolution (particle beam RT hydro therapy)
- Intensity modulated proton therapy
- IMPT vs IMRT for NPC: decreases in radiation does to normal structures
- carbon Ion radiotherapy for recurrent NPC
- Boron Neutron Capture Therapy (BNCT)
- Approach 1B: adaptive RT to ensure continual conformity re-planning
- re-planning in fractionated IMRT
- Approach 2A:
- marked variations in philosophies and practice ( == clinical target volumes (CTV) for nasopharyngeal carcinoma R&O 2018
- Atlas of illustrative case of a T1N1M). —> international consensus
- Approach 2B: to improve consistency and efficiency; development of artificial intelligence
- AI in precision oncology
- Nomogram fro reining risk assessment
- – Prognostic utility of 18
- – Pre-RT EBV-DNA
- – Prognostication of EBV DNA at midpoint of RT
- – ASCO 2017 (from Taiwan guideline)
- Genome/Genetic profile to predict RT and chemo sensitivity
- RSI a hub of ten genes for NPC
- Radionics
- Head and neck cancer meeting 2018 O’Suillvin et al (?)