Heterogeneity revealed through meta-analysis might link geographical differences with nasopharyngeal carcinoma incidence in Han Chinese populations

Epidemiological Characteristics and Survival Analysis of Patients With Nasopharyngeal Cancer in Western Greece

Purpose The purpose of this study is to assess the overall survival (OS) of patients with nasopharyngeal cancer and the factors affecting the survival rates. Methods A retrospective cohort study was performed, including 77 patients with nasopharyngeal cancer diagnosed and treated in the Otorhinolaryngology Clinic of the University Hospital of Patras during 1990-2017. The prognostic impact of age, gender, occupation, smoking/alcohol, and TNM staging were evaluated using Kaplan-Meier analysis. Results During the last 28 years, nasopharyngeal cancer (NPC) was higher in men (80.5% of patients) than women (19.5%) (mean age 56-years). Most patients were smokers (64.9%, mean 70 pack-years) and 35 (45.5%) of them were alcohol users. Postoperative staging indicated 39% stage-III, 26% stage-IV, and 26% stage-I. Histologically, 70.1% of the volumes were WHO-III, 20.8% WHO-II, and 5.2% WHO-I. Also, 98.7% of patients received radiotherapy, 85.7% chemotherapy, and 20.8% surgery. More than half were farmers (26%), self-employed (16.9%), and workers (14.3). During the follow-up (mean 66 months), 38 (49.5%) patients died, 88.9% from disease-related causes. The 5-year survival was 58.8%, 74.5% for non-smokers, and 49.1% for smokers, and 10-year survival was 43.6%, 63.4%, and 31.6%, respectively (p=0.016). Moreover, significant statistical differences were observed in age (p=0.054), time period of diagnosis and treatment (p=0.002), cause of death (p=0.033), and metastatic disease (p=0.023). Conclusions Age, stage in disease detection, tumor characteristics, treatment, and tobacco abuse are important factors that affect the OS of patients with NPC during the three last decades.

Echo-Tracking Technique in Ultrasonography Can Monitor Changes in Carotid Artery Elastic Function at Early Stage of Intensity-Modulated Radiation Therapy for Nasopharyngeal Carcinoma

Background

We used echo-tracking (ET) technique to observe short-term dynamic changes of the carotid artery in nasopharyngeal carcinoma (NPC) patients after intensity-modulated radiation therapy (IMRT).

Material/Methods

Sixty-one NPC patients received IMRT. In the irradiation group, the carotid artery was examined by ultrasonography before radiotherapy, at 2, 4, and 6 weeks after the start of radiotherapy, and at 3 and 6 months after the end of radiotherapy. In the control group, the carotid artery was examined by ultrasonography before radiotherapy of patients in the irradiation group, and at 3 and 6 months after the end of radiotherapy of patients in the irradiation group.

Results

During radiotherapy for the 61 patients, the maximum dose on the carotid artery was 65.14±4.35 Gy, the average dose was 57.46±4.12 Gy, and the 50% volume dose was 51.80±5.32 Gy. At the end of irradiation, Ep (kPa) and β values were significantly different from those before treatment.

Conclusions

The present study demonstrates that the elastic function of the carotid artery can be significantly affected when the irradiation dose exceeds 45 Gy.

Radiomic Nomogram: Pretreatment Evaluation of Local Recurrence in Nasopharyngeal Carcinoma based on MR Imaging

Background: To develop and validate a radiomic nomogram incorporating radiomic features with clinical variables for individual local recurrence risk assessment in nasopharyngeal carcinoma (NPC) patients before initial treatment. Methods: One hundred and forty patients were randomly divided into a training cohort (n = 80) and a validation cohort (n = 60). A total of 970 radiomic features were extracted from pretreatment magnetic resonance (MR) images of NPC patients from May 2007 to December 2013. Univariate and multivariate analyses were used for selecting radiomic features associated with local recurrence, and multivariate analyses was used for building radiomic nomogram. Results: Eight contrast-enhanced T1-weighted (CET1-w) image features and seven T2-weighted (T2-w) image features were selected to build a Cox proportional hazard model in the training cohort, respectively. The radiomic nomogram, which combined radiomic features and multiple clinical variables, had a good evaluation ability (C-index: 0.74 [95% CI: 0.58, 0.85]) in the validation cohort. The radiomic nomogram successfully categorized those patients into low- and high-risk groups with significant differences in the rate of local recurrence-free survival (P <0.05). Conclusions: This study demonstrates that MR imaging-based radiomics can be used as an aid tool for the evaluation of local recurrence, in order to develop tailored treatment targeting specific characteristics of individual patients.

HMG-box transcription factor 1: a positive regulator of the G1/S transition through the Cyclin-CDK-CDKI molecular network in nasopharyngeal carcinoma

HMG-box transcription factor 1 (HBP1) has been reported to be a tumor suppressor in diverse malignant carcinomas. However, our findings provide a conclusion that HBP1 plays a novel role in facilitating nasopharyngeal carcinoma (NPC) growth. The Kaplan-Meier analysis indicates that high expression HBP1 and low miR-29c expression both are negatively correlated with the overall survival rates of NPC patients. HBP1 knockdown inhibits cellular proliferation and growth, and arrested cells in G1 phase rather than affected cell apoptosis via flow cytometry (FCM) analysis. Mechanistically, HBP1 induces the expression of CCND1 and CCND3 levels by binding to their promoters, and binds to CDK4, CDK6 and p16^INK4A promoters while not affects their expression levels. CCND1 and CCND3 promote CCND1-CDK4, CCND3-CDK6, and CDK2-CCNE1 complex formation, thus, E2F-1 and DP-1 are activated to accelerate the G1/S transition in the cell cycle. MiR-29c is down-regulated and correlated with NPC tumorigenesis and progression. Luciferase assays confirms that miR-29c binds to the 3' untranslated region (3'-UTR) of HBP1. Introduction of pre-miR-29c decreased HBP1 mRNA and protein levels. Therefore, the high endogenous HBP1 expression might be attributed to the low levels of endogenous miR-29c in NPC. In addition, HBP1 knockdown and miR-29c agomir administration both decrease xenograft growth in nude mice in vivo. It is firstly reported that HBP1 knockdown inhibited the proliferation and metastasis of NPC, which indicates that HBP1 functions as a non-tumor suppressor gene in NPC. This study provides a novel potential target for the prevention of and therapies for NPC.

Cigarette smoking complements the prognostic value of baseline plasma Epstein-Barr virus deoxyribonucleic acid in patients with nasopharyngeal carcinoma undergoing intensity-modulated radiation therapy: a large-scale retrospective cohort study

We evaluated the combined prognostic value of cigarette smoking and baseline plasma Epstein-Barr virus deoxyribonucleic acid (EBV DNA) in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Of consecutive patients, 1501 with complete data were eligible for retrospective analysis. Smoking index (SI; cigarette packs per day times smoking duration [years]), was used to evaluate the cumulative effect of smoking. Primary endpoint was overall survival (OS); progression-free survival (PFS), distant metastasisfree survival (DMFS) and locoregional relapse-free survival (LRFS) were secondary end-points. Both cigarette smoking and baseline plasma EBV DNA load were associated with poorer survival (P<0.001). Patients were divided into four groups: low EBV DNA and light smoker (LL), low EBV DNA and heavy smoker (LH), high EBV DNA and light smoker (HL), and high EBV DNA and heavy smoker (HH). The respective 5-year survival rates were: OS (93.1%, 87.2%, 82.9%, and 76.3%, P<0.001), PFS (87.0%, 84.0%, 73.9%, and 64.6%, P<0.001), DMFS (94.1%, 92.1%, 82.4%, and72.5%, P<0.001), and LRFS (92.8%, 92.4%, 88.7%, and 84.0%, P=0.012).OS and PFS were significantly different between the LH and HL groups and HL and HH groups, but not LL and LH groups (pairwise comparisons). The combined risk stratification remained an independent prognostic factor for all endpoints (all P_trend<0.001; multivariate analysis). Both cigarette smoking and baseline plasma EBV DNA were independent prognostic factors for survival outcomes. Combined interpretation of EBV DNA with smoking led to the refinement of the risks stratification for patient subsets, especially with improved risk discrimination in patients with high baseline plasma EBV DNA.

The incidence and prognosis of nasopharyngeal carcinoma patients with family history

Purpose

Epidemiological data showed that nasopharyngeal carcinoma (NPC) was a regional malignancy. It suggested that genetic factor may play an important role in tumorigenesis of NPC. The aim was to investigate the incidence and the prognosis of NPC patients with family history.

Methods

The clinical data of patients with NPC treated in Fudan University Shanghai Cancer Center from January 2008 to December 2012 were reviewed, and the patients with family history were selected. The prognosis of patients with family history was follow-up. The 5-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed by Kaplan-Meier and log-rank test. Cox proportional hazard model was used for multivariate analysis.

Results

There were 3.64% (135/3706) NPC patients with family history of NPC. Eighty-three percent (112/135) patients had only one family member suffering from NPC previously, and 74.1% (100/135) patients who had family history only in first-degree family members. Excluding five patients lost to follow-up, 130 patients were eventually used to analyze the prognosis. The 5-year OS, LRFS, and DMFS rates of all patients with family history were 84.1%, 83.4%, and 83.8%, respectively. There were no significant differences of OS, LRFS and DMFS between one relative group and at least two relatives group. In addition, the degree of NPC had no association with OS, LRFS and DMFS, respectively.

Conclusion

Our results showed that there was an incidence rate of 3.64% NPC patients with family history. These patients had a satisfied prognosis, and the prognosis of NPC patients with family history in different degree or numbers of relatives had no significant differences.