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Medial retropharyngeal nodal region sparing radiotherapy in nasopharyngeal carcinoma: five year analysis of open label, non-inferiority, multicentre, randomised phase 3 trial.

Name: Adcurare Rigor Record — Medial retropharyngeal nodal region sparing radiotherapy in nasopharyngeal carcinoma: five year analysis of open label, non-inferiority, multicentre, randomised phase 3 trial.
Item: Medial retropharyngeal nodal region sparing radiotherapy in nasopharyngeal carcinoma: five year analysis of open label, non-inferiority, multicentre, randomised phase 3 trial.
Rating: 96
Author: Adcurare

Wang SX, Tao YL, Gao TS, Zhang N, Zhou GQ, Xie FY, Zhang Y, Guo R, Yang Y, Li YJ, Liang SQ, Zeng YC, Lin L, Li WF, Liu X, Xu C, Chen YP, Lv JW, Liu LZ, Li HJ, Li JB, Wen HM, Sun Y, Tang LL, Liang XY, Ma J, Mao YP

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Adcurare Rigor Review — 3.75★ (Adequate), 0 critical, 5 high issues for “Medial retropharyngeal nodal region sparing radiotherapy in nasopharyngeal carcinoma: five year analysis of open label, non-inferiority, multicentre, randomised phase 3 trial.”

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Adcurare Editorial

This rigor review was examined and confirmed by Adcurare Editorial · July 6, 2026

Adcurare Rigor Review

Rigor Reviewed

3.75 / 5

Adequate — real issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×2−1★
ReportingKey resources partially met−0.25★

Model-reported confidence: moderateReviewer agreement: moderateEngine: 7.6.0Source: full text

Problems surfaced2 types

Key resources under-identified (antibodies, cell lines, RRIDs)
Internal contradictions in the reported numbers

This Adcurare Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

This is a well-designed phase 3 trial with a strong scientific premise, rigorous randomization, and adequate statistical reporting. The main weaknesses are incomplete specification of biological variables (missing weight and race/ethnicity), insufficient identification of the investigational products (chemotherapy regimen and radiotherapy equipment), and a typographical error in Table 1. The paper is close to submission-ready after a few targeted corrections.

Three independent reviewers (all using the same model) evaluated the full text. The reviewers diverged on biological variables (one warn, two pass) and statistical analysis (one fail, two pass), but the synthesized judgment weighs the specific evidence. The citation check found no retracted or missing references. The statistics verification recomputed 8 tests consistently (coverage limited to tests with test statistics/df or effect+CI).

12 major claims checked against the paper's own evidence: all adequately supported.

Recomputed 8 tests: 8 consistent, 0 inconsistent, 8 via agent-written checks.

2 integrity concerns flagged (0 high).

Reporting

Eight Dimensions7 pass · 1 warn

The paper cites prior studies on retropharyngeal lymph node involvement, MRI-based evidence of low medial node metastasis, and the rationale for sparing the MRLN region. It acknowledges that no other prospective studies have explored this question, justifying the need for the trial. Limitations of earlier approaches (2D-era guidelines) are noted, and the hypothesis follows logically from cited evidence.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The scientific premise is well-established with clear rationale, prior literature cited, and limitations of prior work acknowledged.

Evidence

direct quote[Introduction, paragraph 1]

“several magnetic resonance imaging (MRI) based studies have shown that retropharyngeal lymph node involvement primarily occurs in the lateral group, with a metastasis rate of less than 0.6% in the medial group.”

direct quote[Introduction, paragraph 2]

“These findings suggested the potential feasibility of sparing the MRLN region.”

direct quote[Introduction, paragraph 2]

“So far, no other prospective studies have explored this question.”

PASSReviewer 2· 95% conf

The study clearly establishes its scientific foundation by citing prior MRI-based studies showing low MRLN involvement and the rationale for sparing, and acknowledges that no other prospective studies have explored this question.

Evidence

direct quote[Introduction, paragraph 2]

“the guideline recommended target delineation for nasopharyngeal carcinoma was still based on two dimensional era experience, which involved covering both the MRLN and lateral retropharyngeal lymph nodes regions”

direct quote[Introduction, paragraph 2]

“These findings suggested the potential feasibility of sparing the MRLN region”

PASSReviewer 3· 95% conf

The paper clearly establishes the scientific premise by citing prior research showing low MRLN metastasis rates and high dysphagia rates from standard treatment, and provides a logical rationale for sparing the MRLN region.

Evidence

direct quote[Introduction, paragraph 1-2]

“recently, several magnetic resonance imaging (MRI) based studies have shown that retropharyngeal lymph node involvement primarily occurs in the lateral group, with a metastasis rate of less than 0.6% in the medial group.”

direct quote[Introduction, paragraph 2]

“These findings suggested the potential feasibility of sparing the MRLN region.”

direct quote[Introduction, paragraph 3]

“Nevertheless, the long term effect of MRLN sparing radiotherapy on survival outcomes and swallowing function remained unknown, and the rationale of decreasing dysphagia by using MRLN sparing radiotherapy needed to be explored.”

Randomization used computer-generated random lists with block size of four and stratification by institution and treatment modality. Power analysis was performed (80% power, one-sided alpha 0.025, 550 patients). Inclusion/exclusion criteria are clearly defined. The primary analysis population is ITT. Blinding: open-label but central radiologists and statistician were masked. Missing data handling (last observation carried forward) is stated. All applicable criteria are adequately reported.

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsADEQUATE

outlier handlingADEQUATE

randomization unitADEQUATE

inclusion exclusionADEQUATE

randomization methodADEQUATE

replicate distinctionN/A

independent replicationN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The study design is rigorous with adequate randomization, sample size justification, pre-specified eligibility criteria, and intention-to-treat analysis.

Evidence

direct quote[Methods, Randomisation and masking]

“Patients were randomly assigned 1:1 to MRLN sparing radiotherapy or standard radiotherapy by use of a computer generated random list in a block size of four per stratum.”

direct quote[Methods, Statistical analysis]

“To achieve 80% power at a one sided type I error of 0.025, approximately 550 patients (275 per group) were needed.”

direct quote[Methods, Statistical analysis]

“We did updated efficacy analyses for the intention-to-treat population (including all randomised patients).”

PASSReviewer 2· 90% conf

Core methodological design components are adequately reported: randomisation via computer-generated list with block size of four, stratification by institution and treatment modality, a priori power analysis (80% power, one-sided α=0.025, n≈550), and prespecified inclusion/exclusion criteria. Blinding is partially described (open-label but masked radiologists and statistician). Analysis population (ITT) and handling of missing data (last observation carried forward for censoring) are specified.

Evidence

direct quote[Methods: Randomisation and masking]

“Patients were randomly assigned 1:1 to MRLN sparing radiotherapy or standard radiotherapy by use of a computer generated random list in a block size of four per stratum.”

direct quote[Methods: Statistical analysis]

“To achieve 80% power at a one sided type I error of 0.025, approximately 550 patients (275 per group) were needed.”

direct quote[Methods: Randomisation and masking]

“The study was open label and allocation was unmasked to physicians and patients, although the central responsible radiologists and the statistician were masked.”

PASSReviewer 3· 95% conf

The study design is rigorous with adequate randomization, partial blinding, pre-specified power analysis, clear inclusion/exclusion criteria, and appropriate handling of missing data.

Evidence

direct quote[Methods, Randomisation and masking]

“Patients were randomly assigned 1:1 to MRLN sparing radiotherapy or standard radiotherapy by use of a computer generated random list in a block size of four per stratum.”

direct quote[Methods, Randomisation and masking]

“The study was open label and allocation was unmasked to physicians and patients, although the central responsible radiologists and the statistician were masked.”

direct quote[Methods, Statistical analysis]

“To achieve 80% power at a one sided type I error of 0.025, approximately 550 patients (275 per group) were needed.”

Table 1 provides sex, age, performance status, histology, tumour and nodal categories, stage, treatment modality, and EBV DNA test results. These are adequate for a human trial. Housing conditions, species/strain are not applicable. Sex justification is not required as both sexes are enrolled.

Sub-criteria

demographicsADEQUATE

sex reportedADEQUATE

sex justifiedN/A

age weight healthADEQUATE

housing conditionsN/A

species strain sourceN/A

Per reviewer (3) — the votes behind the verdict

WARNReviewer 1· 80% conf

Sex and health status are reported, but weight is missing and race/ethnicity is not reported, leading to incomplete demographics.

Evidence

direct quote[Table 1]

“Male sex | 215 (75) | 209 (74)”

absence[Table 1]

Weight is not reported.

absence[Table 1, Methods]

Race/ethnicity not reported.

PASSReviewer 2· 95% conf

All applicable sub-criteria are adequately reported: sex (Table 1: 75% male in sparing group, 74% in standard group), age (median and range), demographics (Karnofsky performance score, histology, tumour category, nodal category, stage, treatment modality, EBV DNA). Sex is reported for both sexes, so sex_justified is not applicable.

Evidence

direct quote[Results, Table 1]

“Male sex: 215 (75) [MRLN sparing] vs 209 (74) [standard]”

direct quote[Results, Table 1]

“Median (range) age, years: 46 (19-64) vs 49 (23-65)”

direct quote[Results, Table 1]

“Table 1 includes Karnofsky performance score, histology, tumour category, nodal category, stage, treatment modality, and EBV DNA test”

PASSReviewer 3· 85% conf

Sex, age, health status, and key demographic and clinical variables are reported, but race/ethnicity is not explicitly stated, which is a minor omission.

Evidence

direct quote[Results, Table 1]

“Male sex: 215 (75) v 209 (74); Median (range) age, years: 46 (19-64) v 49 (23-65)”

direct quote[Results, Table 1]

“Karnofsky performance score: 90-100: 276 (97) v 275 (97); Stage: III: 123 (43) v 126 (45)”

absence[Results, Table 1]

Race/ethnicity not reported.

The study protocol was approved by the institutional review board or ethics committee at each site, with a protocol number (5010-2017-04-02) provided. All patients provided written informed consent. The study complied with the Declaration of Helsinki and ICH Good Clinical Practice guidelines.

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Ethics approval with protocol number, written informed consent, and regulatory compliance are adequately reported.

Evidence

direct quote[Methods, Study design and participants; Ethics statements]

“This study was approved by the institutional review board or ethics committee at each site (5010-2017-04-02)”

direct quote[Methods, Study design and participants]

“all patients provided written informed consent for participation”

direct quote[Methods, Study design and participants]

“The study complied with the Declaration of Helsinki and the International Conference on Harmonization Good Clinical Practice Guideline.”

PASSReviewer 2· 95% conf

Ethical compliance is adequately reported: named institutional ethics committees approved the protocol (with protocol number 5010-2017-04-02), written informed consent was obtained from all participants, and compliance with the Declaration of Helsinki and Good Clinical Practice is stated.

Evidence

direct quote[Ethics statements]

“This study was approved by the institutional review board or ethics committee at each site (5010-2017-04-02)”

direct quote[Methods: Study design and participants]

“all patients provided written informed consent for participation.”

direct quote[Methods: Study design and participants]

“The study complied with the Declaration of Helsinki and the International Conference on Harmonization Good Clinical Practice Guideline.”

PASSReviewer 3· 98% conf

Ethical approval from named committees, written informed consent, and compliance with international guidelines are clearly stated.

Evidence

direct quote[Methods, Study design and participants; Ethics statements]

“The study protocol (web appendix 1) was approved by institutional ethics committees in each centre, and all patients provided written informed consent for participation.”

The radiotherapy technique is described as intensity-modulated radiation therapy with target delineation guidelines in an appendix, but the prescribed radiation dose (e.g., total Gy and fractionation) is not reported in the main methods. Statistical software (SPSS, R) is adequately identified. Code is provided in a web appendix rather than a public version-controlled repository with a persistent identifier.

Sub-criteria

mycoplasma testingN/A

reagents identifiedINADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (3) — the votes behind the verdict

WARNReviewer 1· 70% conf

Software tools are identified, but the investigational products (radiotherapy technique details and chemotherapy regimen) are not fully specified. Reagents identification is inadequate.

Evidence

direct quote[Methods, Procedures]

“Standard-of-care chemotherapy (induction, concurrent, or both) was administered according to the extent of disease.”

direct quote[Methods, Statistical analysis]

“We used SPSS software (version 25.0) and R (version 4.3.1) for all statistical analyses.”

WARNReviewer 2· 80% conf

The investigational product (radiotherapy and chemotherapy) is not fully identified: radiotherapy is described only as 'intensity modulated radiation therapy' without manufacturer or specifications, and chemotherapy is referred to as 'standard-of-care' without naming drugs, doses, or manufacturers. Statistical software is adequately identified (SPSS 25.0, R 4.3.1).

Evidence

direct quote[Methods: Procedures]

“Standard-of-care chemotherapy (induction, concurrent, or both) was administered according to the extent of disease.”

direct quote[Methods: Statistical analysis]

“We used SPSS software (version 25.0) and R (version 4.3.1) for all statistical analyses.”

direct quote[Methods: Procedures]

“All patients received intensity modulated radiation therapy, with target delineation following the guidelines detailed in web appendix 2”

WARNReviewer 3· 85% conf

Radiotherapy is the investigational product, but the prescribed dose/fractionation is not explicitly stated in the main text, and code is not deposited in a public version-controlled repository.

Evidence

absence[Methods, Procedures]

Radiotherapy dose not explicitly stated in main text.

direct quote[Methods, Statistical analysis]

“We used SPSS software (version 25.0) and R (version 4.3.1) for all statistical analyses.”

direct quote[Data availability statement]

“The code used to analyse the data can be found in web appendix 3.”

All statistical tests are named (Kaplan-Meier, stratified Cox, χ², Fisher's exact, Mann-Whitney U, GEE). Exact p-values and effect sizes with 95% CIs are reported. Assumptions are reasonably addressed. Software versions are given. Data presentation includes Kaplan-Meier curves, tables with counts and percentages. A typo in Table 1 ('124 (448)') does not constitute a mathematical error but is a copyediting issue.

Sub-criteria

tests namedADEQUATE

exact p valuesADEQUATE

effect sizes ciADEQUATE

data presentationADEQUATE

software identifiedADEQUATE

assumptions verifiedADEQUATE

mathematical plausibilityN/A

Per reviewer (3) — the votes behind the verdict

FAILReviewer 1· 85% conf

Most statistical criteria are met, but a demonstrable arithmetic error in Table 1 (percentage 448% for stage IVa in standard group) leads to a fail according to the scoring rule.

Evidence

direct quote[Table 1]

“IVa | 117 (41%) | 124 (448)”

direct quote[Results, Efficacy outcomes]

“P=0.90”

direct quote[Results, Efficacy outcomes]

“stratified hazard ratio 1.03 (95% CI 0.61 to 1.74)”

PASSReviewer 2· 85% conf

Statistical tests are named (Cox proportional hazards, Kaplan-Meier, Pearson χ², Fisher's exact, Mann-Whitney U, GEE), exact p-values and 95% confidence intervals are reported for primary and many secondary outcomes, effect sizes with CIs are provided, software is identified, and data presentation is clear (Kaplan-Meier curves, tables with n and percentages, means and SDs). Assumptions verification is not explicitly reported but is acceptable in the context of a large clinical trial using standard methods. No arithmetical impossibilities were detected.

Evidence

direct quote[Results, Efficacy outcomes]

“five year local relapse-free survival ... stratified hazard ratio 1.03 (95% CI 0.61 to 1.74); P=0.90”

direct quote[Methods: Statistical analysis]

“We calculated ... using the Kaplan-Meier method, with hazard ratios ... estimated using a stratified Cox proportional hazards model ... Pearson’s χ2 test or Fisher’s exact test ... Mann-Whitney U test ... generalised estimating equations”

direct quote[Methods: Statistical analysis]

“We used SPSS software (version 25.0) and R (version 4.3.1) for all statistical analyses.”

PASSReviewer 3· 90% conf

Statistical methods are thoroughly described, exact p-values and CIs are reported, and software is identified. A minor typo in a table does not affect mathematical plausibility.

Evidence

direct quote[Abstract; Results, Efficacy outcomes]

“stratified hazard ratio 1.03 (95% CI 0.61 to 1.74); P=0.90”

direct quote[Methods, Statistical analysis]

“We used SPSS software (version 25.0) and R (version 4.3.1) for all statistical analyses.”

direct quote[Results, Table 1]

“IVa: 124 (448)”

Data availability statement names concrete repositories (Mendeley Data and RDDA). Repository deposit is present. Accession numbers are provided (RDDA2026205661, NCT03346109). Code is shared in web appendix 3, but not in a version-controlled public repo with permanent ID => inadequate. 3 of 4 applicable criteria adequate, meeting the threshold for pass.

Sub-criteria

code sharingINADEQUATE

accession numbersADEQUATE

repository depositADEQUATE

data availability statementADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

Data are deposited in public repositories with DOIs and accession numbers. Code is provided in supplementary materials, though not in a version-controlled public repository with a permanent identifier, but the overall criteria are met.

Evidence

direct quote[Data availability statement]

“The data underlying the findings in this paper are openly and publicly available and can be found at https://data.mendeley.com/datasets/vvnswtgdz8/1”

direct quote[Data availability statement]

“The raw data were also uploaded to the Research Data Deposit public platform (RDDA2026205661).”

direct quote[Data availability statement]

“The code used to analyse the data can be found in web appendix 3.”

WARNReviewer 2· 85% conf

A data availability statement is present and adequate (data openly available on Mendeley and RDDA). The analysis code is placed in a web appendix, which lacks a persistent, version-controlled repository identifier, making it reported_but_inadequate for code_sharing. Repository deposit for data is adequate.

Evidence

direct quote[Data availability statement]

“The data underlying the findings in this paper are openly and publicly available and can be found at https://data.mendeley.com/datasets/vvnswtgdz8/1 . ... The raw data were also uploaded to the Research Data Deposit public platform (RDDA2026205661).”

direct quote[Data availability statement]

“The code used to analyse the data can be found in web appendix 3.”

PASSReviewer 3· 90% conf

Data are openly deposited with persistent identifiers, and a data availability statement is present. Code is provided as a web appendix but not in a version-controlled repository, which is a minor limitation.

Evidence

direct quote[Data availability statement]

“The data underlying the findings in this paper are openly and publicly available and can be found at https://data.mendeley.com/datasets/vvnswtgdz8/1 . The raw data were also uploaded to the Research Data Deposit public platform (RDDA2026205661).”

direct quote[Data availability statement]

“The code used to analyse the data can be found in web appendix 3.”

Methods are detailed enough for replication. Trial registration (NCT03346109) is provided. All outcomes including negative results are reported. Limitations are discussed in a dedicated section. Conclusions do not overclaim. Funding and COI statements are present. The only gap is that no reporting guideline checklist (e.g., CONSORT) is explicitly referenced, though a trial profile (Figure 1) is included. 6 of 7 applicable criteria adequate.

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineINADEQUATE

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

The manuscript is largely transparent: methods are complete, trial is registered, outcomes are reported, limitations are discussed, conclusions are proportional, and funding/COI are disclosed. Only reporting guideline adherence (e.g., CONSORT) is not explicitly stated.

Evidence

direct quote[Abstract, Methods]

“ClinicalTrials.gov NCT03346109”

direct quote[Discussion, Limitations of study]

“Our study has certain limitations. Firstly... Secondly... Thirdly... Fourthly...”

absence[Methods]

No mention of CONSORT or other reporting checklist.

PASSReviewer 2· 90% conf

Methods are sufficiently detailed for replication; the trial is registered (NCT03346109); all pre-specified outcomes are reported including negative/null results; limitations are discussed; conclusions are proportional; funding sources and conflicts of interest are disclosed. The only missing element is a reference to a formal reporting guideline (e.g., CONSORT), which is a minor omission.

Evidence

direct quote[Abstract, Trial registration]

“ClinicalTrials.gov NCT03346109”

direct quote[Discussion, Limitations of study]

“Our study has certain limitations. Firstly, ... Secondly, ... Thirdly, ... Fourthly, ...”

direct quote[Funding and Competing interests sections]

“This study was supported by grants from ... All authors have completed the ICMJE uniform disclosure form ...”

PASSReviewer 3· 90% conf

The manuscript is comprehensive, reports all outcomes, discusses limitations, and provides funding/COI. It does not explicitly reference a reporting guideline, but the trial is registered.

Evidence

direct quote[Abstract; Methods, Study design and participants]

“Trial registration ClinicalTrials.gov NCT03346109”

direct quote[Discussion, Limitations of study]

“Our study has certain limitations. Firstly, as noted in our initial report, these findings were derived primarily from Epstein-Barr virus associated nasopharyngeal carcinoma in endemic regions...”

absence[Methods; throughout]

Reporting guideline not referenced.

8 copyedit issues flagged (1 major): mostly typo, consistency, clarity.

Checked 37 references: 35 verified — 2 not checked.

Reproducibility

2 data/code links checked; 2 live.

Registered (1 ID: ClinicalTrials.gov). No reporting guideline cited.

Adcurare Rigor Action ItemsFinal pass before journal submission

The paper is ready to submit after addressing the critical typo in Table 1 and the high-priority actions (specifying chemotherapy, depositing code, reporting race/ethnicity and weight). The other actions are minor improvements. No validity-threatening issues were identified.

1.
HIGHcopyedit
Correct the typo in Table 1 for the standard group Stage IVa: change '124 (448)' to '124 (44)' or '124 (44%)' and verify the percentage.
An impossible percentage (448%) is a clear error that will be caught by reviewers and undermines trust in the data.
2.
HIGHrigor
Specify the exact chemotherapy drugs, doses, and schedules used (e.g., cisplatin 100 mg/m², gemcitabine, etc.) in the Methods, Procedures section.
The current description 'standard-of-care chemotherapy' is insufficient for replication and violates the key resources reagent identification criterion.
3.
HIGHdata code
Deposit the analysis code in a version-controlled public repository (e.g., GitHub, Zenodo) with a persistent DOI, and update the Data Availability Statement to reference the repository link.
Code in a web appendix is not version-controlled and lacks a permanent identifier, limiting reproducibility and long-term access.
4.
HIGHreporting
Report patient weight (or BMI) at baseline in Table 1 to meet the age_weight_health criterion.
Weight is a standard baseline variable in clinical trials; its absence is a gap in biological variable reporting.
5.
HIGHreporting
Report the race/ethnicity of participants in Table 1, or explicitly state that all participants were of Chinese Han ethnicity if homogeneous.
Race/ethnicity is a standard demographic variable; its absence limits assessment of generalizability.
6.
MEDIUMreporting
Add a statement that the trial adheres to the CONSORT reporting guideline and include a completed CONSORT checklist as supplementary material.
Explicit reference to a reporting guideline is expected for transparent reporting of randomised trials.
7.
MEDIUMcopyedit
Correct the misspelling of 'pharyngeal constrictors' (currently 'contractors') throughout the manuscript (Abstract, Results, Discussion).
This recurring typo appears in multiple locations and detracts from manuscript quality.
8.
MEDIUMcopyedit
Fix the misplaced closing parenthesis in the Abstract results: change '89.2% (95% confidence interval (CI) 85% to 92)%' to '89.2% (95% CI 85% to 92%)'.
The current formatting is grammatically incorrect and confusing.
9.
MEDIUMcopyedit
Add a period after 'dysphagia' in the Abstract 'Main outcome measures' section and capitalize 'Results' as a new sentence.
Missing punctuation between sentences reduces readability.
10.
LOWcopyedit
Consider rounding the IQR values for EBV DNA load to whole numbers for consistency (e.g., 7852.5 → 7853) in Table 1.
Minor inconsistency: one IQR bound has one decimal while others are whole numbers.
11.
LOWrigor
Provide the manufacturer/model of the radiotherapy equipment used and the prescribed radiation dose (total Gy and fractionation) in the Methods, Procedures section.
Full identification of the investigational product improves reproducibility, though the dose details may be in the appendix.
12.
LOWstatistics
Report the proportional hazards assumption test for the Cox model or cite that it was satisfied based on earlier analysis.
This is a minor omission; many reviewers accept standard methods without explicit assumption testing.

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Medial retropharyngeal nodal region sparing radiotherapy in nasopharyngeal carcinoma: five year analysis of open label, non-inferiority, multicentre, randomised phase 3 trial.

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Journal

DOI

10.1136/bmj-2025-086050

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