Response to the letter by Dr Sari regarding the article "The feasibility of reduced-dose radiotherapy in childhood nasopharyngeal carcinoma with favorable response to neoadjuvant chemotherapy"

We appreciate the comments from Sari et al. on our manuscript [ [1] Yao J.J. Jin Y.N. Lin Y.J. et al. The feasibility of reduced-dose radiotherapy in childhood nasopharyngeal carcinoma with favorable response to neoadjuvant chemotherapy. Radiother Oncol. 2022; 11109414https://doi.org/10.1016/j.radonc.2022.11.003 Abstract Full Text Full Text PDF Scopus (3) Google Scholar ]. First, we agree that the absence of the details on the number and volume of gross lymph nodes was a limitation of the study. In this research, all patients received at least 60 Gy of radiation to the primary tumor and enlarged lymph nodes. After treatment, only 5 patients (3.8%; 5/132) had locoregional relapse during the follow-up period, with a 5-year locoregional relapse-free survival (LRFS) rate up to 97.4%. We further analyzed the effect of a high radiation dose (using 66 Gy as the cut-off point) on the risk of locoregional relapse, however, did not observe any significant difference in LRFS between the high- and low- dose groups. Given the limited risk of locoregional relapse, we did not further analyze the effect of lymph nodes number and volume on the risk of locoregional relapse. In regard to Yao et al.Radiotherapy and OncologyVol. 181PreviewWe read the article titled ‘The feasibility of reduced-dose radiotherapy in childhood nasopharyngeal carcinoma with favorable response to neoadjuvant chemotherapy’ with great interest [1]. The current study is noteworthy as reducing the toxicity rate without compromising the oncologic outcomes is of great importance in this age group. However, there are some issues to be further clarified. Full-Text PDF