Higher N stage and serum ferritin, but lower serum albumin levels are associated with distant metastasis and poor survival in patients with nasopharyngeal carcinoma following intensity-modulated radiotherapy

Objective. To analyze the clinical outcomes and prognostic factors of intensity-modulated radiotherapy (IMRT) for T4 stage nasopharyngeal carcinoma (NPC).Methods. Between March 2005 and March 2010, 110 patients with T4 stage NPC without distant metastases were treated. All patients received IMRT. Induction and/or concurrent chemotherapy were given. 47 (42.7%) patients received IMRT replanning.Results. The 5-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 90.1%, 97.0%, 67.5%, 63.9%, and 64.5%, respectively. Eleven patients experienced local-regional failure and total distant metastasis occurred in 34 patients. 45 patients died and 26 patients died of distant metastasis alone. The 5-year LRFS rates were 97.7% and 83.8% for the patients that received and did not receive IMRT replanning, respectively (P=0.023). Metastasis to the retropharyngeal lymph nodes (RLN) was associated with inferior 5-year OS rate (61.0% versus 91.7%,P=0.034). The gross tumor volume of the right/left lymph nodes (GTVln) was an independent prognostic factor for DMFS (P=0.006) and PFS (P=0.018). GTVln was with marginal significance as the prognostic factor for OS (P=0.050).Conclusion. IMRT provides excellent local-regional control for T4 stage NPC. Benefit of IMRT replanning may be associated with improvement in local control. Incorporating GTVln into the N staging system may provide better prognostic information.

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Intensity-modulated radiotherapy controls nasopharyngeal carcinoma distant metastasis and improves survival of patients

SpringerPlus ◽

10.1186/s40064-016-3117-1 ◽

2016 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Xiaoqian Chen ◽

Hao Lei ◽

Zhongguo Liang ◽

Ling Li ◽

Song Qu ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Distant Metastasis ◽

Intensity Modulated Radiotherapy ◽

Intensity Modulated

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The Value of Cervical Node Features in Predicting Long-Term Survival of Nasopharyngeal Carcinoma in Intensity-Modulated Radiotherapy Era

10.21203/rs.3.rs-109566/v1 ◽

2020 ◽

Author(s):

Yunming Tian ◽

Lei Zeng ◽

Runda Huang ◽

Yuhong Lan ◽

Xia Yuan ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Prognostic Value ◽

Intensity Modulated Radiotherapy ◽

Distant Metastases ◽

Term Survival ◽

Intensity Modulated ◽

Cervical Node ◽

Extranodal Extension ◽

N Stage ◽

Multivariate Proportional Hazard

Abstract The prognostic value of cervical node features in nasopharyngeal carcinoma(NPC) patients treated with intensity-modulated radiotherapy (IMRT) was controversial. In this study, about 1752 patients after IMRT from 2008 to 2011 were recruited. The nodal features including the nodal number, maximize dimension diameter, extranodal extension(ENE)and cervical node necrosis(CNN) were retrospective analyzed. Univariate Cox and multivariate proportional hazard regression models were used to test the prognostic value of nodal features. Prognostic nomograms were built to predict the survival. The 10-year distant metastases free survival (DMFS) and disease-specific survival(DSS) rates were 86.5% and 80.8%. By multivariate analysis, the independent factors for the DSS were gender, age, lactate dehydrogenase (LDH), CNN, ENE, T stage and N stage. Nomogram A (without nodal features ) and nomogram B (with nodal features) were built. The calibration curve for the probability of DSS showed good agreement between prediction by nomogram and actual observation.The C-index of nomogram B was higher than for nomogram A in predicting DSS ( 0.708 vs 0.676,P <.01). These results demonstrated the nodal features including the ENE and CNN were negative prognostic factors in patients with NPC, and the prognostic nomogram incorporating the nodal features was more accurate.

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Tumor Regression and Patterns of Distant Metastasis of T1-T2 Nasopharyngeal Carcinoma with Intensity-Modulated Radiotherapy

PLoS ONE ◽

10.1371/journal.pone.0154501 ◽

2016 ◽

Vol 11 (4) ◽

pp. e0154501 ◽

Cited By ~ 6

Author(s):

Ming-Yao Wu ◽

Xia-Yun He ◽

Chao-Su Hu

Keyword(s):

Nasopharyngeal Carcinoma ◽

Distant Metastasis ◽

Tumor Regression ◽

Intensity Modulated Radiotherapy ◽

Intensity Modulated

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Risk factors and prediction-score model for distant metastasis in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Tumor Biology ◽

10.1007/s13277-015-3574-0 ◽

2015 ◽

Vol 36 (11) ◽

pp. 8349-8357 ◽

Cited By ~ 17

Author(s):

An-Chuan Li ◽

Wei-Wei Xiao ◽

Lin Wang ◽

Guan-Zhu Shen ◽

An-An Xu ◽

...

Keyword(s):

Risk Factors ◽

Nasopharyngeal Carcinoma ◽

Distant Metastasis ◽

Intensity Modulated Radiotherapy ◽

Prediction Score ◽

Intensity Modulated ◽

Score Model

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Clinical Outcomes and Prognostic Factors of 695 Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiotherapy

BioMed Research International ◽

10.1155/2014/814948 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 8

Author(s):

Weidong Wang ◽

Mei Feng ◽

Zixuan Fan ◽

Jie Li ◽

Jinyi Lang

Keyword(s):

Prognostic Factors ◽

Nasopharyngeal Carcinoma ◽

Clinical Outcomes ◽

Distant Metastasis ◽

Clinical Target Volume ◽

Intensity Modulated Radiotherapy ◽

Disease Free Survival ◽

Target Volume ◽

Free Survival ◽

Intensity Modulated

Objective. The 5-year clinical outcomes and prognostic factors of nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiotherapy (IMRT) were evaluated.Methods. Six hundred ninety five NPC patients primarily treated with IMRT in Sichuan Cancer Hospital from January, 2003 to December, 2006 were analyzed retrospectively, including 540 males and 155 females. The prescription dose was delivered as follows: gross target volume (GTVnx) 67–76 Gy in 30–33 fractions, positive neck lymph nodes (GTVln-R/L) 60–70 Gy in 30–33 fractions, high-risk clinical target volume (CTV1) 60–66 Gy, low-risk clinical target volume (CTV2) 54–60 Gy, and clinical target volume of cervical lymph node regions (CTVln) 50–55 Gy.Results. The 5-year local control (LC), regional control, distant metastasis-free survival (DMFS), disease free survival, disease specific survival, and overall survival (OS) rates were 89.8%, 95.2%, 74.1%, 69.6%, 83.2%, and 77.1%. The 5-year DMFS of IMRT and IMRT combined with chemotherapy was 62.1% and 70.9%, the OS of them was 72.9% and 79.1%. The incidence of grade 3 acute and late toxicity was 38.3% and 4.2%, respectively.Conclusion. The 5-year LC and OS rate of NPC treated with IMRT was 89.8% and 77.1%. The clinical stage, N stage, volume of GTVnx, and chemotherapy were the main prognostic factor for the OS. Distant metastasis was the main pattern of failure.

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