REVIEW article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1456724
Feasibility of Elective Neck Irradiation in Treating Node-Negative Nasopharyngeal Carcinoma Patients: A Meta-Analysis
Provisionally accepted
Jianfeng Zhou1
Hongyong Wang2*- 1Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong Province, China
- 2Second Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
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Purpose ： Intensity modulated radiation therapy (IMRT) has replaced conventional twodimensional radiation therapy as the mainstream radiation therapy for nasopharyngeal carcinoma.However, side effects continue to be a significant concern during the radiotherapy process for nasopharyngeal carcinoma patients. The recognized target area for cervical prophylaxis in nasopharyngeal carcinoma is whole neck irradiation (WNI) ， Currently, some studies have confirmed that upper neck irradiation (UNI) may be feasible as a preventive measure for NPC patients with negative neck lymph nodes. This meta-analysis aimed to comprehensively investigate and compare the efficacy of selective UNI and WNI in improving survival outcomes and regional control in patients with lymph node-negative NPC.Materials and Methods ： A systematic search was conducted in PubMed, EMBASE, The Cochrane Library, and CNKI from inception to October 27, 2023, using a combination of Medical Subject Headings (MeSH) terms and free-text keywords related to "nasopharyngeal carcinoma," "lymph node negative," and "neck irradiation." The titles and abstracts of the retrieved articles were reviewed Results：Our meta-analysis of 11 studies revealed no significant differences in overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), or lymph node recurrence between the UNI and WNI groups for patients with cervical lymph node-negative nasopharyngeal carcinoma. These findings suggest that UNI is a safe and feasible treatment option for this patient population.Conclusion：UNI is a safe and feasible option for nasopharyngeal carcinoma patients with negative cervical lymph nodes or only retropharyngeal lymph node (RLN) metastases. UNI may reduce the radiation dose to normal tissues, potentially decreasing long-term adverse effects and improving quality of life.
Keywords: Intensity modulated radiation therapy, nasopharyngeal carcinoma, node-negative, whole neck irradiation, upper neck irradiation
Received: 29 Jun 2024; Accepted: 28 Apr 2025.
Copyright: © 2025 Zhou and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongyong Wang, Second Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
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