On February 20, 2025, a groundbreaking study led by Prof. Jun Ma, Academician of the Chinese Academy of Sciences, and Prof. Ying Sun and Prof. Linglong Tang from Sun Yat-sen University Cancer Center (SYSUCC) was published in CA: A Cancer Journal for Clinicians (IF: 503.1), marking the first-ever publication of original clinical trial research in the journal’s history. Titled “Reduced-volume radiotherapy versus conventional-volume radiotherapy after induction chemotherapy in nasopharyngeal carcinoma: An open-label, noninferiority, multicenter, randomized phase 3 trial”, this landmark study redefines precision radiotherapy standards and shifts the paradigm from “ensuring survival” to “optimizing survival” for cancer patients worldwide.

Traditionally known for publishing cancer epidemiological reports and reviews, CA—revered as a “sacred journal” in oncology—has now embraced clinical trial research for the first time. After a year-long deliberation to expand its scope, the journal selected this revolutionary study as its inaugural clinical research article, underscoring its global significance.

This open-label, non-inferiority, phase III randomized controlled trial, led by SYSUCC and conducted in collaboration with Zhongshan People’s Hospital and the First People’s Hospital of Foshan, enrolled 445 patients with advanced nasopharyngeal carcinoma (NPC). Participants were randomized to receive radiotherapy targeting either post-chemotherapy or pre-chemotherapy tumor volumes.

• Efficacy: The 3-year local-regional recurrence-free survival rate remained high at 91.5% (non-inferior to conventional therapy).
• Safety: Severe toxicities were dramatically reduced:
   40% decrease in severe oral mucositis.
   50% reduction in late severe otitis media.
   60% improvement in xerostomia (chronic dry mouth).

• Quality of Life: Patients reported significant enhancements in overall health, physical function, emotional well-being, and reduced salivary gland damage.

NPC, which accounts for 47% of global new cases in China, has long required extensive radiotherapy targeting pre-chemotherapy tumor volumes, often causing irreversible damage to critical organs like the inner ear and salivary glands. This study demonstrates that focusing radiation solely on post-chemotherapy tumor volumes maintains curative efficacy while drastically improving patients’ long-term quality of life.

The trial was co-corresponding authored by Academician Jun Ma, Prof. Ying Sun, Prof. Linglong Tang, Prof. Rui Guo, and Prof. Fangyun Xie. Co-first authors included Prof. Linglong Tang, Dr. Lin Chen, Pro. Guiqiong Xu (Zhongshan People’s Hospital), Prof. Ning Zhang (the First People’s Hospital of Foshan), and Dr. Chenglong Huang.

This study represents a transformative leap in precision radiotherapy. By prioritizing both survival and survivorship, we are setting a new global benchmark for NPC treatment—one that balances efficacy with humanity. This pioneering work not only consolidates SYSUCC’s leadership in nasopharyngeal carcinoma research but also indicates a patient-centric future for oncology worldwide.

Link to the article: 

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21881

Written by: Liao Shuang, Zhai Huiwen

International Office at SYSUCC