DOI QR코드

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Prognostic Factors on Overall Survival of Newly Diagnosed Metastatic Nasopharyngeal Carcinoma

  • Li, Jia-Xin (Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, and State Key Laboratory of Oncology) ;
  • Huang, Shao-Min (Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, and State Key Laboratory of Oncology) ;
  • Wen, Bi-Xiu (Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University) ;
  • Lu, Tai-Xiang (Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, and State Key Laboratory of Oncology)
  • 발행 : 2014.04.01

초록

Background: To investigate factors associated with overall survival in patients with newly diagnosed metastatic nasopharyngeal carcinoma. Materials and Methods: Two hundred and two consecutive patients with pathologically confirmed nasopharyngeal carcinoma with distant metastasis at diagnosis seen between December 2007 and May 2011 were reviewed. Patient, tumor and treatment factors were analyzed for their significance regarding overall survival. Results: The median follow-up time was 22 months. At the time of this report, 116 patients had died. For 112 patients, cause of death was nasopharyngeal carcinoma. The 1, 2, 3, and 4-year overall survival rates were 75.6%, 50.2%, 39.2%, and 28.2%, respectively. Cox regression multivariate analysis showed that T-stage (p=0.045), N-stage (p=0.014), metastasis number (p<0.001) and radiotherapy for nasopharynx and neck (p<0.001) were significant factors for overall survival. Conclusions: Early T-stage and N-stage, solitary metastasis in a single organ were good prognostic factors for patients with newly diagnosed metastatic nasopharyngeal carcinoma. Radiotherapy should be strongly recommended in systemic treatment.

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참고문헌

  1. Cao X, He LR, Xie FY, et al (2011). Factors determining the survival of nasopharyngeal carcinoma with lung metastasis alone: does combined modality treatment benefit? BMC Cancer, 11, 370. https://doi.org/10.1186/1471-2407-11-370
  2. Chan AT, Hsu MM, Goh BC, et al (2005). Multicenter, phase II study of cetuximab in combination with carboplatin in patients with recurrent or metastatic nasopharyngeal carcinoma. J Clin Oncol, 23, 3568-76. https://doi.org/10.1200/JCO.2005.02.147
  3. Chen C, Wang FH, An X, et al (2013). Triplet combination with paclitaxel, cisplatin and 5-FU is effective in metastatic and/or recurrent nasopharyngeal carcinoma. Cancer Chemother Pharmacol, 71, 371-8. https://doi.org/10.1007/s00280-012-2020-x
  4. Chen C, Fei Z, Pan J, et al (2011). Significance of primary tumor volume and T-stage on prognosis in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy. Jpn J Clin Oncol, 41, 537-42. https://doi.org/10.1093/jjco/hyq242
  5. Chen MK, Chen TH, Liu JP, et al (2004). Better prediction of prognosis for patients with nasopharyngeal carcinoma using primary tumor volume. Cancer, 100, 2160-6. https://doi.org/10.1002/cncr.20210
  6. Fandi A, Bachouchi M, Azli N, et al (2000). Long-term disease-free survivors in metastatic undifferentiated carcinoma of nasopharyngeal type. J Clin Oncol, 18, 1324-30. https://doi.org/10.1200/JCO.2000.18.6.1324
  7. Johnson CR, Thames HD, Huang DT, Schmidt-Ullrich RK (1995). The tumor volume and clonogen number relationship: tumor control predictions based upon tumor volume estimates derived from computed tomography. Int J Radiat Oncol Biol Phys, 33, 281-7. https://doi.org/10.1016/0360-3016(95)00119-J
  8. Khanfir A, Frikha M, Ghorbel A, et al (2006). Metastatic nasopharyngeal carcinoma: clinical study and therapeutic results of 95 cases. Cancer Radiother, 10, 545-9. https://doi.org/10.1016/j.canrad.2006.05.004
  9. Lee AW, Poon YF, Foo W, et al (1992). Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976-1985: overall survival and patterns of failure. Int J Radiat Oncol Biol Phys, 23, 261-70. https://doi.org/10.1016/0360-3016(92)90740-9
  10. Lee CC, Chu ST, Ho HC, et al (2008). Primary tumor volume calculation as a predictive factor of prognosis in nasopharyngeal carcinoma. Acta Otolaryngol, 128, 93-7. https://doi.org/10.1080/00016480701361921
  11. Leong SS, Wee J, Rajan S, et al (2008). Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal carcinoma. Cancer, 113, 1332-7. https://doi.org/10.1002/cncr.23687
  12. Lin S, Tham IW, Pan J, et al (2012). Combined high-dose radiation therapy and systemic chemotherapy improves survival in patients with newly diagnosed metastatic nasopharyngeal cancer. Am J Clin Oncol, 35, 474-9. https://doi.org/10.1097/COC.0b013e31821a9452
  13. Ngan RK, Yiu HH, Lau WH, et al (2002). Combination gemcitabine and cisplatin chemotherapy for metastatic or recurrent nasopharyngeal carcinoma: report of a phase II study. Ann Oncol, 13, 1252-8. https://doi.org/10.1093/annonc/mdf200
  14. Pan CC, Lu J, Yu JR, et al (2012). Challenges in the modification of the M1 stage of the TNM staging system for nasopharyngeal carcinoma: A study of 1027 cases and review of the literature. Exp Ther Med, 4, 334-8. https://doi.org/10.3892/etm.2012.584
  15. Parkin DM, Whelan SL, Ferlay J, et al (1997). Cancer incidence in five continents, vol. VII. Lyon, France: IRAC Scientific Publications Number, 143, 334-7.
  16. Peng G, Wang T, Yang KY, et al (2012). A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol, 104, 286-93. https://doi.org/10.1016/j.radonc.2012.08.013
  17. Phua Chee Ee V1, Tan BS, Tan AL, et al (2013). Dose planning study of target volume coverage with intensity- modulated radiotherapy for nasopharyngeal carcinoma: Penang General Hospital experience. Asian Pac J Cancer Prev, 14, 2243-8. https://doi.org/10.7314/APJCP.2013.14.4.2243
  18. Siu LL, Czaykowshi PM, Tannock IF (1998). Phase I/II study of the CAPABLE regimen for patients with poorly differentiated carcinoma of the nasopharynx. J Clin Oncol, 16, 2514-21. https://doi.org/10.1200/JCO.1998.16.7.2514
  19. Sobin LH, Gospodaroeics MK, Wittekind Ch (2009). TNM Classification of Malignant Tumours, 7th edition. New York, US: Wiley Press.
  20. Teo PM, Kwan WH, Lee WY, et al (1996). Prognosticators determining survival subsequent to distant metastasis from nasopharyngeal carcinoma. Cancer, 77, 2423-31. https://doi.org/10.1002/(SICI)1097-0142(19960615)77:12<2423::AID-CNCR2>3.0.CO;2-N
  21. Toh CK, Heng D, Ong YK, et al (2005). Validation of a new prognostic index score for disseminated nasopharyngeal carcinoma. Br J Cancer, 92, 1382-7. https://doi.org/10.1038/sj.bjc.6602525
  22. Wei K, Xu Y, Liu J, Zhang W, Liang Z (2010). No incidence trends and no change in pathological proportions of nasopharyngeal carcinoma in Zhongshan in 1970-2007. Asian Pac J Cancer Prev, 11, 1595-9.

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  6. microRNA-125b reverses the multidrug resistance of nasopharyngeal carcinoma cells via targeting of Bcl-2 vol.15, pp.4, 2017, https://doi.org/10.3892/mmr.2017.6233
  7. The Ratio of C-Reactive Protein/Albumin is a Novel Inflammatory Predictor of Overall Survival in Cisplatin-Based Treated Patients with Metastatic Nasopharyngeal Carcinoma vol.2017, pp.1875-8630, 2017, https://doi.org/10.1155/2017/6570808