ESTRO meets Asia 2024 Congress Report

Induction chemotherapy (ICT) has become a recognised standard of care for locoregionally advanced nasopharyngeal carcinoma (NPC) over the past decade. Despite this progress, there remains a notable gap in clear guidelines regarding the appropriate target volumes and dose prescriptions for patients who have undergone ICT. To address this issue, we have convened a multinational cooperative group that comprises experts from NPC-endemic countries, with the goal of developing consensus guidelines through a modified Delphi process.

We began with a comprehensive systematic review of the relevant literature to evaluate existing data. This review created the groundwork for the identification of gaps and to highlight grey areas in radiotherapy volume delineation and dose prescription. Following this foundation work, we drafted a series of consensus statements that reflected the best available evidence and expert opinions. These statements were then subjected to two rounds of voting by a multidisciplinary international panel of experts from NPC-endemic regions.

The outcomes of our efforts and the conclusion in terms of the Delphi voting process have been documented and presented in a manuscript. The manuscript was forwarded to international head-and-neck cancer experts and international societies to gain external feedback. The manuscript is undergoing external review, which is currently close to completion; It will then be finalised for publication.

We are committed to fostering open dialogue about these guidelines. The manuscript has been made available to conference attendees so that they can engage with the material and share their perspectives directly with the authors. This collaborative approach not only enriches our work but also ensures that the guidelines we propose reflect a diverse range of experiences and practices in the management of NPC.

In summary, the development of consensus guidelines for ICT in locoregionally advanced NPC represents a significant step toward the standardisation of care in this challenging field. By harnessing the expertise of a multinational panel and engaging with the broader medical community, we aim to create a resource that enhances the quality of care for patients affected by NPC. As we continue to refine these guidelines based on feedback and ongoing research, we remain dedicated to improving outcomes, especially in NPC-endemic areas.

Michael Benedict A Mejia, MD

Chair, Department of Radiation Oncology

University of Santo Tomas Hospital

Manila, Philippines

Email: dro_mbamejia@benavidescancerinstitute.org

Twitter/X: @mikemejiamd

Collaborators:

Nejla FOURATI, Warren BACORRO, Omar NOURI, Ryan Anthony AGAS, Audrey LARNAUDIE, Lester Bryan CO, Hela Hammami TURKI, Clevelinda CALMA, Melvin L.K. CHUA, Chong ZHAO, Jamel DAOUD