scholarly journals Bone Metastases Pattern in Newly Diagnosed Metastatic Nasopharyngeal Carcinoma: A Real-World Analysis in the SEER Database

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Xiaojing Yang ◽  
Hanru Ren ◽  
Weiwei Yu ◽  
Hongling Li ◽  
Xinmiao Yang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Bone Metastases ◽  
Cox Regression ◽  
Lung Metastases ◽  
Prognostic Indicators ◽  
Logistic Analysis ◽  
Kaplan Meier ◽  
Metastatic Nasopharyngeal Carcinoma ◽  
N Stage ◽  
Male Sex

Objective. To evaluate the prevalence rate and survival situation of bone metastases in initial nasopharyngeal carcinoma (NPC) patients and the hazard and forecast elements of bone metastases NPC patients. Patients and Methods. The data collected from Surveillance, Epidemiology, and End Results (SEER) program between 2010 and 2016 were evaluated. Univariate and multivariable logistic analysis and the Cox regression were carried out to estimate predictors and elements of the being of bone metastases at diagnosis, respectively. The overall survival of different subgroups were appraised by log-rank tests and the Kaplan–Meier analysis. Results. Factors including male sex, higher N stage, presence of liver, and brain or lung metastases were largely related to the occurrence of bone metastases. The median survival time for bone metastasis NPC patients was 14.0 months. A factor of more than one primary sequence number predicted worse survival. Conclusion. The data offer corresponding risks and prognostic indicators of bone metastases for NPC patients.

scholarly journals Optimizing the treatment mode for de novo metastatic nasopharyngeal carcinoma with bone-only metastasis

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Cheng Lin ◽  
Sheng Lin ◽  
Lili Zhu ◽  
Shaojun Lin ◽  
Jianji Pan ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Bone Metastases ◽  
Protective Factor ◽  
Cox Regression ◽  
De Novo ◽  
Progression Free Survival ◽  
Rank Test ◽  
Bone Lesions ◽  
Metastatic Nasopharyngeal Carcinoma ◽  
The Difference

Abstract Background No standard radiotherapy regimens have been established for the treatment of de novo metastatic nasopharyngeal carcinoma (mNPC) with bone-only metastasis. The current study aimed to investigate the efficacy of palliative chemotherapy (PCT) plus locoregional radiotherapy (LRRT) with or without local radiotherapy (RT) for metastatic bone lesions in mNPC. Methods We retrospectively analysed 131 de novo patients with mNPC who had bone-only metastasis and received at least two cycles of PCT with LRRT. The difference in survival was evaluated by the log-rank test. Univariable and multivariable analyses were performed by Cox regression. Results The median overall survival (OS) and progression-free survival (PFS) were 33.0 months and 24.0 months, respectively. Patients with five or fewer metastatic bone lesions had significantly longer OS (72.0 months vs. 23.0 months, Hazard ratios (HR) = 0.45, p <  0.001) and PFS (48.0 months vs. 15.0 months, HR = 0.52, p = 0.004) than those who had more than five metastatic bone lesions. Patients who received four or more cycles of chemotherapy were associated with significantly longer OS (unreached vs. 19.0 months, HR = 0.27, p <  0.001) and PFS (66 months vs. 16.0 months, HR = 0.32, p <  0.001). Multivariate analysis confirmed that fewer bone metastases (≤ 5) and more chemotherapy cycles (≥ 4) were favourable prognostic factors for OS. Subgroup analysis revealed that RT to metastatic bone lesions tended to prolong OS (83.0 months vs. 45.0 months) and PFS (60 months vs. 36.5 months) in patients with five or fewer metastatic bone lesions than in those without RT to metastatic bone lesions (p > 0.05). Patients who received a RT dose > 30 Gy had neither better OS (63.5 months vs. 32.0 months, p = 0.299) nor PFS (48.0 months vs. 28.0 months, p = 0.615) than those who received a RT dose ≤30 Gy. Conclusions Local RT to bone metastases may not significantly improve survival in patients with de novo mNPC with bone-only metastasis who have already received PCT plus LRRT. Receiving four or more cycles of chemotherapy can significantly prolong survival and is a favourable independent protective factor.

scholarly journals Liver Metastases Pattern in Rectal Cancer: A Real-World Analysis in the SEER Database

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Yang X ◽  
◽  
Ren H ◽  
Yang X ◽  
Zhang X ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Cox Regression ◽  
Lung Metastases ◽  
Logistic Analysis ◽  
Kaplan Meier ◽  
N Classification ◽  
New Diagnosis ◽  
Surgical Treatments

Background: The liver is a common metastatic site of colorectal cancer. Rectal cancer patients with organ metastases are more liable to show poor prognosis. The hazard and forecast elements of liver metastases are need to be estimated in rectal cancer patients. Methods: The data of newly diagnosed patients of rectal cancer with liver metastases are evaluated according to Surveillance, Epidemiology, and End Results (SEER) program between 2010 and 2016. The Overall Survival (OS) for dierent subgroups are appraised by Kaplan-Meier analysis and log-rank tests. Univariate and multivariable logistic analysis and Cox regression are performed to evaluate predictors and elements of the presence of liver metastases in new diagnosis, respectively. Results: There are a total of 6,662 (11.1%) rectal cancer patients paired with liver metastases. Factors including age (below), gender (female), marital status (unmarried), race (black), advanced T or N classification, presence of bone or lung metastases, and the absence of surgical treatments are importantly related to the occurrence of liver metastases. The median survival for liver metastases rectal cancer patients was 16.0 months. Indicators referring to elder age, black race, unmarried status, presence of bone, brain or lung metastases, and the absence of surgical treatments all predicted worse survival. Conclusion: The data of our research provide corresponding risks and prognostic elements for liver metastases rectal cancer patients, which offer a way to predict the occurrence of rectal cancer and guide prophylactic treatment in clinical settings.

scholarly journals Oral pH value predicts the incidence of radiotherapy related caries in nasopharyngeal carcinoma patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zheng Li ◽  
Qiuji Wu ◽  
Xiangyu Meng ◽  
Haijun Yu ◽  
Dazhen Jiang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Radiation Dose ◽  
Protective Factors ◽  
Green Tea ◽  
Cox Regression ◽  
Ph Value ◽  
Dynamic Monitoring ◽  
Tea Consumption ◽  
Ph Values ◽  
Kaplan Meier

AbstractRadiotherapy-related caries is a complication of radiotherapy for nasopharyngeal carcinoma; however, factors influencing the occurrence, accurate prediction of onset, and protective factors of radiotherapy-related caries remain unclear. This study analyzed risk factors, disease predictors, and protective factors for radiotherapy-related caries in nasopharyngeal carcinoma. This prospective study included 138 nasopharyngeal carcinoma patients receiving radical radiotherapy at our hospital during June 2012–December 2016 and were followed up for dental caries. Patients’ clinical data on radiotherapy were collected, dynamic monitoring was performed to assess changes in oral pH values, and a questionnaire survey was administered to collect patients’ lifestyle habits. Time-dependent cox regression trees, event-free Kaplan–Meier curve, Mann–Whitely U test were used to analysis the results. The median follow-up time was 30 (12–60) months. Radiotherapy-related caries occurred in 28 cases (20.3%). Univariate analyses showed that radiotherapy-related caries was associated with patient’s age, oral saliva pH value, green tea consumption, and radiation dose to sublingual glands, but not with the radiation dose to the parotid and submandibular glands. Multivariate analysis showed that oral saliva pH value [hazard ratio (HR) = 0.390, 95% confidence interval = 0.204–0.746] was an independent prognostic factor for radiotherapy-related caries. Patients with oral saliva pH values ≤ 5.3 in the 9th month after radiotherapy represented a significantly higher risks for radiotherapy-related caries (p < 0.001). Green tea consumption was associated with the occurrence of radiotherapy-related caries, and oral saliva pH values could predict the occurrence of radiotherapy-related caries. Limiting radiation doses to sublingual glands can reduce the occurrence of radiotherapy-related caries.

Clinical outcomes of intermediate risk metastatic germ cell tumors (IRGCT): Results from a single-institution series.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 380-380
Author(s):  
Daniele Raggi ◽  
Salvatore Lo Vullo ◽  
Patrizia Giannatempo ◽  
Daniele Giardiello ◽  
Nicola Nicolai ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Lung Metastases ◽  
Multivariable Analysis ◽  
Germ Cell Tumors ◽  
Time Frame ◽  
Logrank Test ◽  
First Line Therapy ◽  
Kaplan Meier

380 Background: IRGCT comprises a consistent category of metastatic patients (pts), and information on the recommended management of these pts should be updated. Usually they enter clinical trials for poor prognosis GCT. We aimed to address the heterogeneity of this category and to identify clinical prognostic factors for sub-stratification of pts. Methods: Data on consecutive pts with IRGCT and who received treatment at Fondazione INT Milano in the time-frame 02/1980-03/2014 were collected. Cox regression analyses were done evaluating potential prognostic factors for overall survival (OS, primary endpoint) to first-line therapy. Each factor was evaluated in a multivariable model. An exploratory OS comparison between outlier groups was undertaken with Kaplan Meier curves and logrank test. Results: Data on 181 pts were collected. Median age was 27 yrs (IQR 22-32), 10 pts had a retroperitoneal (RP) primary, 6 had pure seminoma. 72 (39.8%) had lung metastases and 54 (32.3%) bulky (i.e. ≥10cm) RP lymph-nodes (LN). Pts received cisplatin, bleomycin and etoposide (PEB, n=156) or vinblastine (PVB, n=23), 2 other treatments. Median follow up was 173 months (IQR: 87-237). Globally, 5-y PFS and OS were 66.8% (95%CI: 60.1-74.2) and 83.3% (77.8-89.2). However, 5-y OS for pts with AFP 5,000-10,000 IU/ml (N=19) was 61.8% (95%CI: 43.0-88.7) while it was 89.1% (95%CI: 81.2-97.7) for nonseminomas with elevated LDH only (N=57) and similar for elevated HCG only (N=22); overall p<0.001. Multivariable analysis for OS is shown in the table (c-index= 0.63). Distribution of variables over time: bulky RP LN and elevated LDH were more frequent in earlier series (p=0.003 and 0.011). Conclusions: The prognostic heterogeneity of IRGCT category is a matter of fact and should be addressed by clinical trials. Pts with highly elevated AFP have an OS similar to poor prognostic category, while those categorized by elevated HCG or LDH only are close to good risk ones. [Table: see text]

scholarly journals Development and Validation of Prognostic Nomograms for Patients with Parotid Gland Adenocarcinoma Not Otherwise Specified: A SEER Analysis From 2004 To 2016

2021 ◽  
Author(s):  
Zi-Meng Wang ◽  
Zuo-Lin Xiang
Keyword(s):  
Parotid Gland ◽  
Prediction Models ◽  
Cox Regression ◽  
Clinicopathological Characteristics ◽  
Prognostic Indicators ◽  
Regression Analyses ◽  
Cancer Specific Survival ◽  
T Stage ◽  
Not Otherwise Specified ◽  
N Stage

Abstract Background Parotid gland adenocarcinoma not otherwise specified (PANOS) is a rare malignancy, and the characteristics and prognosis of this disease remain unclear. This study aims to characterize PANOS and establish prognostic prediction models for patients with PANOS. Methods Cases from 2004–2016 were retrieved from the Surveillance, Epidemiology, and End Results Program database (SEER database). Univariate and multivariate Cox regression analyses, Gray's test and propensity score matching (PSM) were conducted to analyze demographics, treatments, and survival outcomes . Results The 446 patients ( 289 men) selected for analysis had a median age of 66 (19–95) years, and 307 patients were diagnosed with stage III/IV disease. The median survival of all patients was 66 months, with a 51.8% 5-year overall survival (OS) rate. Surgical treatment clearly improved survival time (p < 0.001). In the subgroup analysis, radiotherapy showed survival benefits in patients with advanced-stage disease (III/IV) (p < 0.001). Multivariate Cox regression analyses revealed that age, T stage, N stage, M stage and surgery were independent prognostic indicators for OS;T stage, N stage, M stage and surgery were independent risk factors for cancer-specific survival(CSS).In addition, age was independently associated with noncancer-related death. Two nomograms were established based on the results of the multivariate analysis, which was validated by the concordance index (C-index) (0.747 and 0.780 for OS and CSS, respectively) and the area under the time-dependent receiver operating characteristic(ROC) curve(0.756, 0.764 and 0.819 regarding for nomograms predicting 3-, 5- and 10- year OS, respectively and 0.794, 0.789 and 0.806 for CSS, respectively). Conclusions Our study clearly presents the clinicopathological characteristics and survival analysis of patients with PANOS. In addition, our constructed nomogram prediction models may assist physicians in evaluating the individualized prognosis and deciding on treatment for patients.

scholarly journals Role of Pretreatment Hemoglobin-to-Platelet Ratio in Predicting Survival Outcome of Locally Advanced Nasopharyngeal Carcinoma Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Cosphiadi Irawan ◽  
Andhika Rachman ◽  
Puji Rahman ◽  
Arif Mansjoer
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cancer Patients ◽  
Cox Regression ◽  
Locally Advanced ◽  
Nasopharyngeal Cancer ◽  
Bivariate Analysis ◽  
Kaplan Meier ◽  
Cell Components ◽  
Negative Predictor

Background. The three-year survival rate of locally advanced nasopharyngeal carcinoma (NPC) patients in Indonesia is lower than in other Asian countries. Calculation of hemoglobin-to-platelet ratio (HPR) may become a more practical predictor than the ratios using leukocyte cell components. Yet, no study has been conducted to investigate the potential of HPR in predicting survival outcomes in locally advanced nasopharyngeal cancer patients. Objective. To determine the role of pretreatment hemoglobin-to-platelet ratio in predicting the three-year overall survival (OS) of locally advanced NPC. Method. A retrospective cohort study followed up on 289 locally advanced NPC patients who had undergone therapy at the Dr. Cipto Mangunkusumo National General Hospital between January 2012 and October 2016. HPR cut-off was determined using ROC. Subjects were classified into two groups according to the HPR value. Kaplan-Meier curve was utilized to illustrate patients’ three-year survival, and Cox regression test analyzed confounding variables to yield an adjusted hazard ratio (HR). Results. The optimal cut-off for HPR was 0.362 (AUC 0.6228, 95% CI: 0.56-0.69, sensitivity 61.27%, specificity 60.34%). Of the subjects, 48.44% had HPR ≤ 0.362 , and they had a higher three-year mortality rate than those with HPR > 0.362 (50% vs. 31.54%). In bivariate analysis, HPR ≤ 0.362 and age ≥ 60 significantly showed a worse three-year OS ( p value = 0.003 and 0.075, respectively). In multivariate analysis, we concluded that a pretreatment HPR ≤ 0.362 was an independent negative predictor of three-year OS in locally advanced NPC patients (adjusted HR 1.82; 95% CI: 1.25–2.65). Conclusion. Pretreatment HPR ≤ 0.362 was a negative predictor of three-year OS in locally advanced nasopharyngeal cancer patients.

A phase II study of sorafenib in combination with cisplatin and 5-fluorouracil in the treatment of recurrent or metastatic nasopharyngeal carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5538-5538 ◽  
Author(s):  
Cong Xue ◽  
Qitao Yu ◽  
Jian-ji Pan ◽  
Yuanlu Sun ◽  
Li Zhang
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Lung Metastases ◽  
Complete Response ◽  
Contrast Enhanced ◽  
Metastatic Nasopharyngeal Carcinoma ◽  
Hand Foot Syndrome ◽  
Efficacy Profile ◽  
Unacceptable Toxicity

5538 Background: Nasopharyngeal carcinoma (NPC) is a disease with distinctive epidemiology and clinical behavior compared with Head and neck cancer (HNC) and more common in South-East Asia. Sorafenib monotherapy has been shown modest anticancer activity in HNC and NPC (C Elser et al; JCO 2007). This study was to evaluate the efficacy and tolerability of sorafenib combined with cisplatin and 5-fluorouracil (5-FU) for patients with recurrent or metastatic NPC. Methods: A phase II, single arm clinical trial was conducted in three centers in China. Chemotherapy-naive histologically confirmed NPC patients with recurrent or metastatic disease were enrolled. Patients received oral sorafenib 400mg bid continuously until disease progression or unacceptable toxicity, cisplatin 80mg/m2 intravenously (iv) on day 1-5, and 5-FU 400mg/m2 iv infusion for 96 hours on day 1. Treatment was repeated every 21 days for a maximum of 6 cycles. Results: 54 patients were enrolled. Most patients were with bone metastases (70.0%), followed by liver (56%) and lung metastases (56%). The median chemotherapy administrated was 4.0 cycles (range, 2 - 6 cycles). The disease control rate (DCR) reached 90.7%, including one complete response (CR), 41 partial responses (PR) and 7 stable diseases (SD). Median PFS was 7.2 months (95% CI 6.8-8.4 months) and median OS was 11.8 months (95% CI 10.6-18.7 months). Tumor cavitation after treatment was observed in 32.1% of patients with lung metastases. Decreased percentage of contrast update in responder patients (PR and CR) with liver metastases was also observed by Contrast-Enhanced Doppler ultrasound. The major toxicities include hand foot syndrome (HFS), myelo-suppression and gastrointestinal reaction.Dose reduction of sorafenib was required in 22 patients (40.7%) and dose interruption in 14 patients (25.9%) because of toxicity. Conclusions: Sorafenib combined with cisplatin and 5-FU has an encouraging efficacy profile with tolerable toxicity. Further randomized studies are needed to confirm the clinical benefit of sorafenib combined with chemotherapy in recurrent or metastatic NPC.

scholarly journals Role of the TGFβ/PDCD4/AP-1 Signaling Pathway in Nasopharyngeal Carcinoma and Its Relationship to Prognosis

2017 ◽  
Vol 43 (4) ◽  
pp. 1392-1401 ◽  
Author(s):  
Jie Ma ◽  
Shu-Hong Xuan ◽  
Yan Li ◽  
Zhi-Ping Zhang ◽  
Xin-Hua Li
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Cox Regression ◽  
Advanced Tumor Stage ◽  
Cox Regression Analysis ◽  
Normal Tissues ◽  
Kaplan Meier ◽  
Low Expression

Background: The objective of the present study was to evaluate the role of the TGFβ/PDCD4/AP-1 pathway in nasopharyngeal carcinoma (NPC) and its relationship to NPC prognosis. Methods: NPC tissues collected from 66 NPC patients were compared to 17 nasopharyngeal mucosa biopsy specimens collected as normal tissues. Immunohistochemical staining was performed to assess expression of transforming growth factor-β receptor I (TGFβRI), programmed cell death 4 (PDCD4) and activator protein-1 (AP-1). The Kaplan-Meier method was applied to evaluate NPC patient overall survival (OS) and progression-free-survival (PFS). Cox regression analysis was used to estimate independent prognostic factors for NPC. The human NPC cell line CNE2 was selected and treated with SB431542, an inhibitor of TGFβRI; expression of TGFβRI and PDCD4 in CNE2 cells was determined by western blotting. NPC tissues showed higher expression of TGFβRI and AP-1 but lower expression of PDCD4 than normal tissues (all P < 0.05). Results: The results of Kaplan-Meier analysis showed that TGFβRI-positive patients and AP-1-positive patients had shorter OS and PFS than TGFβRI-negative patients and AP-1-negative patients; additionally, PDCD4-positive patients had higher OS and PFS than PDCD4-negative patients. Cox regression analysis revealed that advanced tumor stage, overexpression of TGFβRI and AP-1, and low expression of PDCD4 were unfavorable factors influencing OS and PFS in NPC patients. Compared with the control group, expression of TGFβRI decreased and that of PDCD4 increased significantly in CNE2 cells treated with the inhibitor (all P < 0.05). These findings indicate that the TGFβ/PDCD4/AP-1 pathway may be associated with NPC development and progression. Conclusion: High expression of TGFβRI and AP-1 and low expression of PDCD4 may be unfavorable prognostic factors for NPC.

scholarly journals Oral pH Value Predicts the Incidence of Radiotherapy Related Caries in Nasopharyngeal Carcinoma Patients

2020 ◽  
Author(s):  
Zheng LI ◽  
Qiuji WU ◽  
Xiangyu MENG ◽  
Haijun YU ◽  
Dazhen JIANG ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Radiation Dose ◽  
Protective Factors ◽  
Green Tea ◽  
Cox Regression ◽  
Ph Value ◽  
Dynamic Monitoring ◽  
Tea Consumption ◽  
Ph Values ◽  
Kaplan Meier

Abstract Purpose: Radiotherapy-related caries is a complication of radiotherapy for nasopharyngeal carcinoma; however, factors influencing the occurrence, accurate prediction of onset, and protective factors of radiotherapy-related caries remain unclear. This study analyzed risk factors, disease predictors, and protective factors for radiotherapy-related caries in nasopharyngeal carcinoma. Methods and Materials: This prospective study included 138 nasopharyngeal carcinoma patients receiving radical radiotherapy at our hospital during June 2012-December 2016 and were followed up for dental caries. Patients’ clinical data on radiotherapy were collected, dynamic monitoring was performed to assess changes in oral pH values, and a questionnaire survey was administered to collect patients’ lifestyle habits. Time-dependent cox regression tress, event-free Kaplan-Meier curve, Mann-Whitely U test were used to analysis the results.Results: The median follow-up time was 30 (12-60) months. Radiotherapy-related caries occurred in 28 cases (20.3%). Univariate analyses showed that radiotherapy-related caries was associated with patient’s age, oral saliva pH value, green tea consumption, and radiation dose to sublingual glands, but not with the radiation dose to the parotid and submandibular glands. Multivariate analysis showed that oral saliva pH value (hazard ratio [HR]=0.390, 95% confidence interval=0.204-0.746) was an independent prognostic factor for radiotherapy-related caries. Patients with oral saliva pH values ≤5.3 in the 9th month after radiotherapy a significantly higher risks for radiotherapy-related caries (HR=33.68, p<0.001). Conclusions: Green tea consumption was associated with the occurrence of radiotherapy-related caries, and oral saliva pH values could predict the occurrence of radiotherapy-related caries. Limiting radiation doses to sublingual glands can reduce the occurrence of radiotherapy-related caries.

scholarly journals Optimizing the Treatment Mode for de Novo Metastatic Nasopharyngeal Carcinoma with Bone-Only Metastasis

2021 ◽  
Author(s):  
Cheng Lin ◽  
Sheng Lin ◽  
li Li Zhu ◽  
jun Shao Lin ◽  
ji Jian Pan ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Nasopharyngeal Carcinoma ◽  
Cox Regression ◽  
De Novo ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Rank Test ◽  
Bone Lesions ◽  
Metastatic Lesions ◽  
Metastatic Nasopharyngeal Carcinoma

Abstract Purpose: No standard radiotherapy regimens was established in the treatment of de novo metastatic nasopharyngeal carcinoma (mNPC) with bone-only metastasis. The current study aimed to investigate the efficacy of palliative chemotherapy (PCT) plus locoregional radiotherapy (LLRT) with or without local radiotherapy (RT) to bone metastatic lesions in mNPC, and identify the optimal candidates.Methods: We retrospectively analyzed 141 de novo mNPC patients with bone-only metastasis who received at least two cycles of PCT with or without LLRT and RT to bone metastasis. The difference in survival was evaluated by the log-rank test. Univariable and multivariable analysis was made by Cox regression. Results: Patients who received PCT plus LLRT had significantly longer overall survival (OS) (45.0 months vs 13.5 months, HR = 0.30 , p = 0.001) and progression-free survival (PFS) (29.0 months vs 11.0 months, HR = 0.34, p = 0.014), especially in patients who had less than 3 metastatic bone lesions. Multivariate analysis confirmed that LRRT, more chemotherapy cycles (≥ 4) and limited number of bone metastasis (≤ 3) were favorable prognostic factors for OS. Subgroup analysis revealed that RT to metastatic bones had a tendency to prolong the survival time in the unselected population who received PCT plus LLRT (p > 0.05), while further data suggested that RT to metastatic bones dramatically improve OS (72.0 months vs 26.0 months, p = 0.002) and PFS (60.0 months vs 20.0 months, p = 0.006) for mNPC with less than 3 metastatic bone lesions.Conclusions: LLRT and RT to bone metastatic lesions followed by PCT in de novo mNPC with bone-only metastasis significantly prolonged survival in patients with less than 3 metastatic bone lesions.

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