1
|
Tang Q, Mei C, Huang B, Huang R, Kang L, Chen A, lei N, Deng P, Ying S, Zhang P, Qin Y. Risk stratification of LA-NPC during chemoradiotherapy based on clinical classification and TVRR. Cancer Med 2024; 13:e7029. [PMID: 38396378 PMCID: PMC10891362 DOI: 10.1002/cam4.7029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
PURPOSE To investigate the correlation between tumor volume reduction rate (TVRR) and prognosis in patients with diverse clinical types of nasopharyngeal carcinoma (NPC) undergoing chemoradiotherapy, thereby aptly categorizing risks and directing the personalized treatment of NPC. MATERIALS AND METHODS A total of 605 NPC patients with varying clinical types were enrolled in this study and subsequently segregated into six subgroups based on their clinical types and TVRR. To accentuate the efficacy of grouping, Groups 1-6 underwent clustered analysis of hazard atio (HR) values pertaining to progression-free survival (PFS), forming three risk clusters denoted as low, intermediate, and high. The log-rank test was employed to discern differences, and R 4.1.1 was utilized for cluster analysis. RESULTS According to survival rates, we classified the first (G2 and G4), second (G1 and G6), and third (G3 and G5) risk clusters as low-, intermediate-, and high-risk, respectively. When comparing risk stratification with the 8th edition of the TNM staging system, our classification exhibited superior predictive prognostic performance. Subgroup analysis of treatments for each risk cluster revealed that the PFS in the neoadjuvant chemotherapy (NACT) + concurrent chemoradiotherapy (CCRT) group surpassed that of the CCRT group significantly (p < 0.05). CONCLUSION The reliance on clinical types and TVRR facilitates risk stratification of NPC during chemoradiotherapy, providing a foundation for physicians to tailor therapeutic strategies. Moreover, the risk cluster delineated for NPC patients during the mid-term of chemoradiotherapy stands as an independent prognostic factor for progression-free survival (PFS), overall survival (OS), distantmetastasis-free survival (DMFS), and local recurrence-free (LRRFS) posttreatment. Additionally, individuals in the high-risk cluster are recommended to undergo adjuvant chemotherapy after CCRT.
Collapse
Affiliation(s)
- Qianlong Tang
- Department of OncologySichuan Mianyang 404 Hospital, First People's Hospital of MianyangMianyangChina
| | - Chaorong Mei
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.)ChengduChina
| | - Bei Huang
- Department of OncologyThird People's Hospital of MianyangMianyangChina
| | - Rui Huang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of MedicineUniversity of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan ProvinceChengduChina
| | - Le Kang
- Department of Hematology and OncologyAnyue County People's HospitalZiyangChina
| | - Ailin Chen
- West China Tianfu Hospital ,Sichuan UniversityChengduChina
| | - Na lei
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.)ChengduChina
| | - Pengcheng Deng
- Department of OncologyChengdu Qingbaijiang District People's HospitalChengduChina
| | - Shouyan Ying
- Department of OncologyYunnan Cancer HospitalKunmingChina
| | - Peng Zhang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of MedicineUniversity of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan ProvinceChengduChina
| | - Yuan Qin
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of MedicineUniversity of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan ProvinceChengduChina
| |
Collapse
|
2
|
Huang Y, Hu W, Huang S, Chu J, Liang Y, Tao Z, Wang G, Zhuang J, Zhang Z, Zhou X, Pan X. Taxonomy and anticancer potential of Streptomyces niphimycinicus sp. nov. against nasopharyngeal carcinoma cells. Appl Microbiol Biotechnol 2023; 107:6325-6338. [PMID: 37566161 DOI: 10.1007/s00253-023-12707-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/16/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
Streptomyces species are ubiquitous, Gram-positive, spore-forming bacteria with the ability to produce various clinically relevant compounds. The strain 4503 T was isolated from mangrove sediments, showing morphological and chemical properties which were consistent with those of members of the genus Streptomyces. Phylogenetic analysis based on 16S rRNA gene sequences revealed that the isolate was primarily identified as members of the genus Streptomyces, sharing more than 99% sequence identity to Streptomyces yatensis DSM 41771 T, S. antimycoticus NBRC 12839 T, and S. melanosporofaciens NBRC 13061 T. Average nucleotide identities (ANI) and digital DNA-DNA hybridization (dDDH) values between strain 4503 T and its close relatives were all below 95-96% and 75% of the novel species threshold, respectively. Results from phylogenetic, genomic, phenotypic, and chemotaxonomic characteristics analyses confirmed that the isolate represented a novel species of the genus Streptomyces, for which the name Streptomyces niphimycinicus sp. nov. 4503 T (= MCCC 1K04557T = JCM 34996 T) is proposed. The bioassay-guided fractionation of the extract of strain 4503 T resulted in the isolation of a known compound niphimycin C, which showed cytotoxic activity against nasopharyngeal carcinoma (NPC) cell lines TW03 and 5-8F with half maximal inhibitory concentration (IC50) values of 12.24 µg/mL and 9.44 µg/mL, respectively. Further experiments revealed that niphimycin C not only exhibited the capacity of anti-proliferation, anti-metastasis, induction of cell cycle arrest, and apoptosis, but was also able to increase the reactive oxygen species (ROS) production and regulate several signaling pathways in NPC cells. KEY POINTS: • Strain 4503 T was classified as a novel species of Streptomyces. • Niphimycin C correlates with the cytotoxic effect of strain 4503 T against NPC cells. • Niphimycin C induces apoptosis, autophagic flux disruption and cell cycle arrest.
Collapse
Affiliation(s)
- Yiying Huang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor, Nanning, China
| | - Wenjin Hu
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Institute of Eco-Environmental Research, Guangxi Academy of Sciences, Nanning, China
- National Engineering Research Center for Non-Food Biorefinery, State Key Laboratory of Non-Food Biomass and Enzyme Technology, Guangxi Key Laboratory of Biorefinery, Guangxi Biomass Engineering Technology Research Center, Guangxi Academy of Sciences, Nanning, China
| | - Shushi Huang
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Institute of Eco-Environmental Research, Guangxi Academy of Sciences, Nanning, China
| | - Jiemei Chu
- Life Science Institute, Guangxi Medical University, Nanning, China
| | - Yushan Liang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhanhua Tao
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Institute of Eco-Environmental Research, Guangxi Academy of Sciences, Nanning, China
| | - Guiwen Wang
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Institute of Eco-Environmental Research, Guangxi Academy of Sciences, Nanning, China
| | - Junlian Zhuang
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Institute of Eco-Environmental Research, Guangxi Academy of Sciences, Nanning, China
| | - Zhe Zhang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China.
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor, Nanning, China.
| | - Xiaoying Zhou
- Life Science Institute, Guangxi Medical University, Nanning, China.
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China.
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor, Nanning, China.
| | - Xinli Pan
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Institute of Eco-Environmental Research, Guangxi Academy of Sciences, Nanning, China.
| |
Collapse
|
3
|
Xu YC, Chen KH, Liang ZG, Zhu XD. Long-term outcomes of chemoradiotherapy versus radiotherapy alone in patients with intermediate-risk nasopharyngeal carcinoma: a population-based analysis. Eur Arch Otorhinolaryngol 2023; 280:1793-1802. [PMID: 36335249 DOI: 10.1007/s00405-022-07726-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To investigate the efficacy of chemotherapy among intermediate-risk (stage II/T3N0) nasopharyngeal carcinoma (NPC) patients receiving radiotherapy (RT). METHODS We identified stage II/T3N0 NPC patients who received radiotherapy with or without chemotherapy from the Surveillance, Epidemiology and End Results database (2004-2019). Overall survival (OS) and cancer-specific survival (CSS) were assessed using the Kaplan-Meier method with log-rank test and Cox proportional hazards models to evaluate the efficacy of chemotherapy. Subgroup analysis was also conducted based on the baseline characteristics. Propensity score matching (PSM) was performed to balance the intergroup covariates. RESULTS A total of 1623 patients were enrolled in the study, 1444 received chemoradiotherapy (CRT) and 179 received RT alone. CRT, compared to RT alone, was independently associated with a better OS (HR 0.57, 95% CI 0.45-0.71) and CSS (HR 0.55, 95% CI 0.39-0.79). After PSM, similar results were obtained, and CRT was superior to RT alone in terms of OS (HR 0.60, 95% CI 0.39-0.92) and CSS (HR 0.60, 95% CI 0.40-0.91). Subgroup analysis revealed that OS benefits from CRT were mainly observed in T0-2N1(HR 0.51, 95% CI 0.38-0.70) and T3N0 (HR 0.64, 95% CI 0.42-0.98) rather than T2N0 (HR 1.00, 95% CI 0.51-1.94). Interestingly, after PSM, OS benefits were still seen in T0-2N1 (HR 0.44, 95% CI 0.24-0.82), while not seen in T2N0 (HR 1.83, 95% CI 0.56-5.97) and T3N0 (HR 0.56, 95% CI 0.28-1.12). CONCLUSION For T0-2N1 NPC patients, CRT was superior to RT alone with better survival, whereas, for T2-3N0 patients, CRT was comparable to RT alone. Prospective large studies should be encouraged to verify the results.
Collapse
Affiliation(s)
- Yao-Can Xu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, 71 He-di Road, Nanning, 530021, People's Republic of China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, 71 He-di Road, Nanning, 530021, People's Republic of China
| | - Zhong-Guo Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, 71 He-di Road, Nanning, 530021, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, 71 He-di Road, Nanning, 530021, People's Republic of China. .,Department of Oncology, Affiliated Wu-Ming Hospital of Guangxi Medical University, Nanning, People's Republic of China.
| |
Collapse
|
4
|
Zeng Z, Xu S, Wang D, Qin G. Prognostic significance of systemic immune-inflammation index in patients with nasopharyngeal carcinoma: a meta-analysis. Syst Rev 2022; 11:247. [PMID: 36403072 PMCID: PMC9675963 DOI: 10.1186/s13643-022-02123-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/05/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous studies have investigated the prognostic value of the systemic immune-inflammation index (SII) in nasopharyngeal carcinoma (NPC). However, the results have been inconsistent. Therefore, this study aims to investigate the prognostic significance of SII in NPC through a meta-analysis. METHODS The PubMed, Web of Science, Embase, and Cochrane Library databases were thoroughly searched. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to evaluate the prognostic value of the SII for survival outcomes. RESULTS A total of six studies comprising 2169 patients were included in the meta-analysis. Pooled analyses indicated that a high SII was significantly associated with worse overall survival (OS) (HR = 1.69, 95% CI = 1.36-2.09, P < 0.001) and progression-free survival (PFS) (HR = 1.60, 95% CI = 1.29-1.98, P < 0.001) in patients with NPC. Subgroup analysis showed that SII was a significant prognostic marker for PFS but not for OS in NPC. CONCLUSION Our meta-analysis demonstrated that a high SII could be an efficient prognostic indicator of OS and PFS in NPC. In our opinion, SII could be used to predict long-term and short-term outcomes in patients with NPC. Furthermore, we suggest that SII be applied to help individual patients with NPC assess the prognostic risk. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022321570.
Collapse
Affiliation(s)
- Zesheng Zeng
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Shengen Xu
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Dingting Wang
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Gang Qin
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
| |
Collapse
|
5
|
Jiromaru R, Nakagawa T, Yasumatsu R. Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options. Cancer Manag Res 2022; 14:2681-2689. [PMID: 36117730 PMCID: PMC9480178 DOI: 10.2147/cmar.s341472] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/07/2022] [Indexed: 12/08/2022] Open
Abstract
Nasopharyngeal carcinoma (NPC) has seen improved treatment outcomes and a decrease in incidence worldwide in recent years due to developments in medicine and improved public health. However, 70% of cases are still diagnosed at advanced stages and these advanced NPC cases show a poor prognosis. Reports on current and future treatment in advanced NPC are summarized. Chemoradiotherapy is the mainstay of treatment for advanced NPC. The administration of platinum agents as a concurrent drug and intensity modulated radiotherapy (IMRT) is the most appropriate irradiation method, and is associated with high local control rates. For induction and adjuvant chemotherapy, platinum-based two- or three-drug combination chemotherapy is recommended. The tumour volume, plasma Epstein-Barr virus (EBV)-DNA levels, and the tumour site are used to determine the indication for adjuvant and neo-adjuvant chemotherapy. The tolerability of induction chemotherapy is controversial, and the indications and timing should be carefully considered in each case. Chemotherapy is used for patients with distant metastasis. Gemcitabine/cisplatin is the first-line regimen. The efficacy of immune checkpoint inhibitor (ICI) treatment has recently been reported for NPC and, as in other areas of the head and neck, it is expected to be effective for patients with recurrent/distant metastasis. Trials are underway for various uses of ICIs, including induction chemotherapy, postoperative treatment, and use in combination with chemoradiotherapy. Immunotherapy for NPC, an EBV-associated cancer, has been reported to have some efficacy with immunotherapy used in other EBV-associated cancers. Immunotherapy may be introduced for NPC in the future, depending on the results of clinical trials. Future changes in the treatment of NPC are expected to include risk classification based on plasma EBV-DNA levels and the development of personalized treatment with individual selection of timing and type of therapy.
Collapse
Affiliation(s)
- Rina Jiromaru
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuji Yasumatsu
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| |
Collapse
|
6
|
Chen K, Jiang Y, Zhao R, Sun Y, Zhu X. Development and validation of prognostic nomograms in patients with ascending type of nasopharyngeal carcinoma: A retrospective study based on
SEER
database. Head Neck 2022; 44:2649-2659. [DOI: 10.1002/hed.27172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/26/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Kai‐Hua Chen
- Department of Radiation Oncology Guangxi Medical University Cancer Hospital Nanning China
| | - Yu‐Ting Jiang
- Department of Radiation Oncology Guangxi Medical University Cancer Hospital Nanning China
| | - Rong Zhao
- Department of Radiation Oncology Guangxi Medical University Cancer Hospital Nanning China
| | - Yong‐Chu Sun
- Department of Radiation Oncology Guangxi Medical University Cancer Hospital Nanning China
| | - Xiao‐Dong Zhu
- Department of Radiation Oncology Guangxi Medical University Cancer Hospital Nanning China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University) Ministry of Education Nanning China
- Department of Oncology Wuming Hospital of Guangxi Medical University Nanning China
| |
Collapse
|