1
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Jiang YT, Chen KH, Liang ZG, Yang J, Qu S, Li L, Zhu XD. Individualized number of induction chemotherapy cycles for locoregionally advanced nasopharyngeal carcinoma patients based on early tumor response. Cancer Med 2023; 12:4010-4022. [PMID: 36127746 PMCID: PMC9972137 DOI: 10.1002/cam4.5256] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND The optimal number of cycles of induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LANPC) is unclear. We aimed to combine the tumor response during IC and tumor stage to individualize the number of IC cycles. METHODS Totally, 498 LANPC patients who received IC plus CCRT between 2014 and 2018 were reviewed. Tumor response during IC was used to stratify patients with different risks. All patients were classified into those who received two cycles of IC and those who were treated with three cycles. Propensity score matching methods were performed to compare the treatment efficiency. RESULTS After two cycles of IC, 340/498 (68.3%) cases showed complete tumor response (CR)/partial response (PR) and 158 (31.7%) achieved stable disease (SD)/disease progression (PD). Unfavorable responders (SD/PD) exhibited poor survival outcomes. The three-cycle IC regimen was correlated with better OS and PFS than the two-cycle regimen for N2-3 patients in the CR/PR group. However, the use of different IC cycle strategies achieved similar survival outcomes for SD/PD or N0-1 patients. The incidences of acute toxicities were higher in the IC = 3 group. CONCLUSIONS Tumor response during IC could be a powerful predictor of LANPC and could be used to guide the individualized number of IC cycles. A three-cycle IC regimen seemed to be preferable for N2-3 patients who received CR/PR during IC. However, an additional cycle of IC could not benefit N0-1 or SD/PD patients, and the optimal treatment strategies for these patients require further consideration.
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Affiliation(s)
- Yu-Ting Jiang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Zhong-Guo Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Jie Yang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Song Qu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China.,Key Laboratory of Early Prevention and Treatment for Regional High-Incidence- Tumor, Guangxi Medical University, Ministry of Education, Nanning, China
| | - Ling Li
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China.,Key Laboratory of Early Prevention and Treatment for Regional High-Incidence- Tumor, Guangxi Medical University, Ministry of Education, 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-Incidence- Tumor, Guangxi Medical University, Ministry of Education, Nanning, China.,Department of Oncology, Affiliated Wuming Hospital of Guangxi Medical University, Nanning, China
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2
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Wang Q, Hu X, Du M, Lu Z, Yan K, Zhao D, Jiang N, Peng Y, He X, Yin L. ZNRD1-AS1 Promotes Nasopharyngeal Carcinoma Cell Invasion and Metastasis by Regulating the miR-335-ROCK1 Axis. Onco Targets Ther 2020; 13:4779-4790. [PMID: 32547105 PMCID: PMC7263878 DOI: 10.2147/ott.s250028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 05/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Long noncoding RNAs (lncRNAs) are known as key regulators in many cancer types, but their biological functions in nasopharyngeal carcinoma (NPC) remain largely unknown. In the present study, we aim to explore the role of the lncRNA ZNRD1-AS1 in NPC tumor development. Methods The role of ZNRD1-AS1 in NPC tissues and cells was explored by using quantitative real-time PCR assay. Cellular behavioral experiments were used in testing NPC cell proliferation, invasion, and migration. Luciferase reporter assay, RNA-binding protein immunoprecipitation, and Western blot analysis were used in estimating the associations among ZNRD1-AS1, miR-335, and ROCK1. Results ZNRD1-AS1 expression was elevated in the NPC tissues and cells, and ZNRD1-AS1 overexpression was positively correlated with advanced TNM stage and the presence of lymph node metastasis. Our biological experiments indicated that ZNRD1-AS1 knockdown reduces NPC cell invasion and metastasis. Further analyses revealed that ZNRD1-AS1 as a ceRNA promotes the migration and invasion of NPC cells by sponging miR-335. We provided evidence that ZNRD1-AS1 facilitates the invasion and metastasis of NPC cells via the miR-335–ROCK1 axis. Conclusion Our data shed light on the oncogenic role of ZNRD1-AS1 in NPC tumor development, and a promising therapeutic target for NPC was identified.
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Affiliation(s)
- Qiang Wang
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China.,Department of Radiation Oncology, Xuzhou Cancer Hospital, Xuzhou, Jiangsu, People's Republic of China
| | - Xinyu Hu
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China
| | - Mingyu Du
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China
| | - Zhiwei Lu
- Department of Radiation Oncology, Xuzhou Cancer Hospital, Xuzhou, Jiangsu, People's Republic of China
| | - Keshi Yan
- Department of Anesthesiology, Clinical Medical School of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou, People's Republic of China
| | - Dingliang Zhao
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Ning Jiang
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China
| | - Yi Peng
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China
| | - Xia He
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China
| | - Li Yin
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, People's Republic of China
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3
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Hu W, Li H, Wang S. LncRNA SNHG7 promotes the proliferation of nasopharyngeal carcinoma by miR-514a-5p/ELAVL1 axis. BMC Cancer 2020; 20:376. [PMID: 32370736 PMCID: PMC7202000 DOI: 10.1186/s12885-020-06775-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 03/23/2020] [Indexed: 12/19/2022] Open
Abstract
Background Nasopharyngeal carcinoma (NPC), with distinct geographical distribution, has gathered public attention. Despite that radiotherapy and chemotherapy are applied to treat NPC, cell metastasis still cannot be avoided. Numerous works have elucidated that lncRNAs are essential players in the development of multiple cancers. LncRNA SNHG7 has been reported as a contributing factor in the occurrence of certain cancers, but its mechanism in NPC deserves further investigation. The purpose of the study is to figure out the role and molecular regulation mechanism of SNHG7 in NPC. Methods The role of SNHG7 in NPC was verified by CCK-8, colony formation, EdU staining, western blot and capase-3 assays. The interactions between SNHG7/ELAVL1 and miR-514a-5p were confirmed by RNA pull down, RT-qPCR, RIP and luciferase reporter assays. Results SNHG7 was upregulated in NPC cells, and absence of SNHG7 suppressed cell proliferation as well as promoted cell apoptosis in NPC. Furthermore, SNHG7 was confirmed to bind with miR-514a-5p and negatively modulate miR-514a-5p expression. Besides, miR-514a-5p was found to be able to bind with ELAVL1 and negatively regulate ELAVL1 mRNA and protein expressions. In the end, rescue assays demonstrated that the miR-514a-5p deficiency restored the NPC progression inhibited by SNHG7 silence, and ELAVL1 partly counteracted the restoration caused by miR-514a-5p inhibitor in HNE1 cells. Conclusions LncRNA SNHG7 promotes the proliferation and migration of nasopharyngeal carcinoma by miR-514a-5p/ ELAVL1 axis.
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Affiliation(s)
- Weiqun Hu
- Department of Otolaryngology, Putian University Affiliated Hospital, Putian, 351100, Fujian, China
| | - Haolin Li
- Department of Otolaryngology, Xinxiang First People's Hospital, Xinxiang, 453000, Henan, China
| | - Shaozhong Wang
- Otolaryngngology of Qinghai Provincial People's Hospital, Gonghe Road No.2, Xining, 810007, Qinghai Province, China.
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4
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Liu SL, Sun XS, Xie HJ, Chen QY, Lin HX, Liang H, Liang YJ, Li XY, Yan JJ, Lin C, Yang ZC, Guo SS, Liu LT, Tang QN, Du YY, Tang LQ, Guo L, Mai HQ. Comparing three induction chemotherapy regimens for patients with locoregionally advanced nasopharyngeal carcinoma based on TNM stage and plasma Epstein-Barr virus DNA level. BMC Cancer 2020; 20:89. [PMID: 32013967 PMCID: PMC6998839 DOI: 10.1186/s12885-020-6555-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 01/20/2020] [Indexed: 12/28/2022] Open
Abstract
Background We compared the efficacy and toxicity of three IC regimens (TPF: taxanes, cisplatin, and 5-fluorouracil; TP: taxanes and cisplatin; and PF: cisplatin and 5-fluorouracil) followed by CCRT in locoregionally advanced NPC. Methods The retrospective study involved 1354 patients with newly diagnosed stage III-IVA NPC treated with IC and CCRT. The median follow-up time in our cohort was 50 months. Based on EBV DNA level, all the patients with stage IV were divided into low- (pre-EBV DNA < 1500 copies) and high-risk group (pre-EBV DNA ≥ 1500 copies). Progression free survival (PFS), overall survival (OS), locoregional relapse free survival (LRFS), distant metastasis free survival (DMFS) and grade 3–4 toxicities were compared among different IC regimens. The survival rates were compared using log-rank test and a Cox proportional hazards model was used to perform multivariate analyses. Results A multivariate analysis revealed TPF to be more effective than TP. Among stage III patients, no significant difference in clinical outcome between the different IC regimens was showed, while TPF was associated with significantly better survival conditions in the stage IV patients. A further subgroup analysis revealed that only patients with pre-EBV DNA ≥ 1500 copies could benefit from the application of TPF among stage IV NPC. In terms of acute toxicities, PF was associated with fewer grade 3/4 acute toxicities. Conclusions In low-risk NPC patients, PF-based IC showed similar efficacy as TPF and TP but was associated with fewer grade 3/4 acute toxicities. In high-risk patients, however, the TPF regimen was superior to PF and TP, although grade 3/4 toxicities were more common with the TPF regimen.
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Affiliation(s)
- Sai-Lan Liu
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Xue-Song Sun
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Hao-Jun Xie
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Qiu-Yan Chen
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Huan-Xin Lin
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Hu Liang
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Yu-Jing Liang
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Xiao-Yun Li
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Jin-Jie Yan
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Chao Lin
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Zhen-Chong Yang
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Shan-Shan Guo
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Li-Ting Liu
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Qing-Nan Tang
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Yu-Yun Du
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Lin-Quan Tang
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
| | - Ling Guo
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
| | - Hai-Qiang Mai
- Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
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5
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Wang YW, Ho SY, Lee SW, Chen CC, Litsu S, Huang WT, Yang CC, Lin CH, Chen HY, Lin LC. Induction Chemotherapy Improved Long Term Outcomes in Stage IV Locoregional Advanced Nasopharyngeal Carcinoma. Int J Med Sci 2020; 17:568-576. [PMID: 32210706 PMCID: PMC7085214 DOI: 10.7150/ijms.42005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/24/2020] [Indexed: 12/08/2022] Open
Abstract
Purpose: We aimed to determine whether adding induction chemotherapy (IC) to concurrent chemoradiation (CCRT) improved outcomes in each stage of locally advanced nasopharyngeal carcinoma (LANPC). Methods: From 2007 to 2013, we retrospectively collected 259 histopathologically identified adult LANPC patients from two campuses in south Taiwan. Among the 238 eligibly treated cases, 156 patients received CCRT (CCRT group) upfront and 82 received IC followed by CCRT (IC group). Of these patients, 130 were stage III (92 patients that received CCRT and 38 that received IC adding CCRT) and 108 were stage IV (76 CCRT and 32 IC adding CCRT). Most chemotherapy regimens for IC are composed of cisplatin (P), 5-fluorouracil (F), and ifosfamide (I), while concurrent chemotherapy (CC) was essentially cisplatin-based. For CCRT as the upfront treatment, a P or PF regimen was usually used in CC. Survival outcomes were accessed with a Kaplan-Meier estimate and a p-value by log-rank test to compare the survival distributions of IC added to CCRT or CCRT as the upfront treatment in all LANPC stage III and LANPC IV patients. The failure free survival (FFS), overall survival (OS), local relapse free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), first failure site, and other prognostic factors were analyzed. Results: The median follow-up time of all treated LANPC patients was 59 months. For all LANPC patients, there was a significant difference only in the DMFS favoring IC group (91.5% vs 79.4%, p=0.013). In the subgroup study, for the stage III group, there was no significant difference between the groups for overall OS (IC group 71.3% vs CCRT group 78.7%), FFS (71.5% vs 62.4%) and RRFS (91.9% vs 90.9%). However, inferior LRLS (71.7% vs 91.5%; p = 0.03) was noted for the IC group. In contrast, for stage IV, there were significantly longer OS (75.8% vs 52.6%), FFS (66.8% vs 46.8%), and DMFS (86.0% vs 69.6%; p = 0.02, p = 0.04, and p = 0.03, respectively) rates in the IC group. Conclusion: Adding PIF-based IC to CCRT for the LANPC patients resulted in better outcomes for stage IV patients, but not for stage III patients. A future properly designed study should stratify enough LANPC cases under the structure of the AJCC stage grouping system to determine which subgroups truly benefit from adding IC to CCRT.
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Affiliation(s)
- Yu-Wen Wang
- Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Sheng-Yow Ho
- Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Sung-Wei Lee
- Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chia-Chun Chen
- Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Shieh Litsu
- Department of Radiation Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Wen-Tsung Huang
- Division of Hematology-Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Ching-Chieh Yang
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hui Lin
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan
| | - Hsuan-Yu Chen
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Li-Ching Lin
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan
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6
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Liu Y, Chen S, Dong A, Ai F, Quan T, Cui C, Zhou J, Liang S, Wang J, Wang S, Hua L, Xu S, Chen M, Sun Y, Li H, Liu L. Nodal grouping in nasopharyngeal carcinoma: prognostic significance, N classification, and a marker for the identification of candidates for induction chemotherapy. Eur Radiol 2019; 30:2115-2124. [PMID: 31811429 DOI: 10.1007/s00330-019-06537-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/06/2019] [Accepted: 10/22/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES This study aimed to evaluate the value of nodal grouping (NG), defined as the presence of at least three contiguous lymph nodes (LNs) within one LN region, in staging and management of patients with non-metastatic nasopharyngeal carcinoma (NPC). METHODS MR images were reviewed to evaluate LN variables, including NG. The Kaplan-Meier method and multivariate Cox regression models evaluated the association between the variables and survival. Harrell's concordance index (C-index) was used to measure the performance of prognostic models. The outcome of induction chemotherapy (IC) in patients with and without NG was compared using matched-pair analysis. RESULTS In 1224 patients enrolled, NG was found to be an independent prognostic factor for overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and regional recurrence-free survival. The hazard ratio and 95% confidence interval (CI) of NG for OS (3.86, 2.09-7.12) were higher than those of stage N2 (3.54, 1.89-6.70). On upgrading patients with NG from stages N1 to N2, the revised N staging yielded a higher C-index compared to the American Joint Committee on Cancer system in predicting PFS (0.664 vs. 0.658, p = 0.022) and DMFS (0.699 vs. 0.690, p = 0.005). Results of the matched-pair analysis revealed that for patients with NG in stages N1 and N2, IC was correlated with improved OS (p = 0.022), PFS (p = 0.007), and DMFS (p = 0.021). CONCLUSIONS NG is a significant prognostic factor for patients with NPC. Patients with NG may be upgraded from stages N1 to N2. NG was also a marker for identifying patients who would benefit from IC. KEY POINTS • Nodal grouping, defined as the presence of at least three contiguous LNs within one LN region on MRI, was identified as a significant prognostic factor. • In patients with nasopharyngeal carcinoma, nodal grouping may influence lymph node staging. • Nodal grouping was a marker for identifying patients who may benefit from induction chemotherapy.
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Affiliation(s)
- Yifei Liu
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Shenghuan Chen
- Department of Radiology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, People's Republic of China
| | - Annan Dong
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Fei Ai
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Tingting Quan
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Chunyan Cui
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Jian Zhou
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Shaobo Liang
- Department of Radiation Oncology, First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Jiamin Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shunxin Wang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ling Hua
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shuoyu Xu
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Mingyuan Chen
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Haojiang Li
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
| | - Lizhi Liu
- Department of Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
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7
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Liu SL, Sun XS, Yan JJ, Chen QY, Lin HX, Wen YF, Guo SS, Liu LT, Xie HJ, Tang QN, Liang YJ, Li XY, Lin C, Du YY, Yang ZC, Xiao BB, Yang JH, Tang LQ, Guo L, Mai HQ. Optimal cumulative cisplatin dose in nasopharyngeal carcinoma patients based on induction chemotherapy response. Radiother Oncol 2019; 137:83-94. [DOI: 10.1016/j.radonc.2019.04.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/20/2019] [Accepted: 04/17/2019] [Indexed: 01/04/2023]
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8
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Chen Y, Chen W, Yang Y, Zhao Y, Yang X. Characteristics of symptom distress in Chinese nasopharyngeal carcinoma patients and its relation to mood disturbance: A cross‐sectional study. Eur J Cancer Care (Engl) 2019; 28:e13032. [DOI: 10.1111/ecc.13032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/13/2018] [Accepted: 01/17/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yu Chen
- School of Nursing Southern Medical University Guangzhou Guangdong Province China
| | - Weichen Chen
- School of Nursing Southern Medical University Guangzhou Guangdong Province China
| | - Yuan Yang
- Department of Psychiatry and Psychology, Nanfang Hospital Southern Medical University Guangzhou Guangdong Province China
| | - Yang Zhao
- School of Nursing Southern Medical University Guangzhou Guangdong Province China
| | - Xueling Yang
- Department of Psychology, School of Public Health Southern Medical University Guangzhou Guangdong Province China
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9
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Huang CJ, Huang MY, Shih MCP, Cheng KY, Lee KW, Lu TY, Yuan SS, Fang PT. Post-radiation sinusitis is associated with recurrence in nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy. Radiat Oncol 2019; 14:61. [PMID: 30971260 PMCID: PMC6458621 DOI: 10.1186/s13014-019-1261-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/27/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This study investigated the impact of post-radiation sinusitis on the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT). METHODS Two hundred and thirty patients with non-metastatic NPC were analyzed in terms of freedom from local failure (FFLF), freedom from distant failure (FFDF), overall survival (OS), and disease-free survival (DFS). For each patient, the status of the sinus mucosa was flexibly assessed by documenting mucosal changes as indicated by differences between images obtained before radiotherapy and more than 6 months post-radiation. RESULTS With a median follow-up of 39.7 months (8 to 81 months), 19 (8.26%) patients relapsed locally, 13 (5.65%) patients failed in the neck, and 26 (11.3%) patients developed distant metastases. The presence of sinusitis noted in images post-radiation was a significant predictor for DFS (p = 0.001), FFLF (p = 0.004), and FFDF (p = 0.015), in addition to having high negative predictive value for local relapse (97.5%). CONCLUSIONS This is the first study to investigate the prognostic value of post-radiation sinusitis in NPC patients treated with IMRT. Post-radiation sinusitis was found to be a significant predictor for DFS, FFLF, and FFDF, and was also found to have high negative predictive value for local recurrence (97.5%). It may thus be used as an additional tool for clinicians to determine the possibility of recurrence.
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Affiliation(s)
- Chih-Jen Huang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807 Taiwan
- Department of Radiation Oncology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yii Huang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807 Taiwan
- Department of Radiation Oncology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Chen Paul Shih
- Department of Medical imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Radiology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-yuan Cheng
- Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ka-Wo Lee
- Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tzu-Ying Lu
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807 Taiwan
- Department of Radiation Oncology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shyng-Shiou Yuan
- Translational Research Center, Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pen-Tzu Fang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807 Taiwan
- Department of Radiation Oncology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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10
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Liu SL, Sun XS, Li XY, Chen QY, Lin HX, Wen YF, Guo SS, Liu LT, Xie HJ, Tang QN, Liang YJ, Yan JJ, Lin C, Yang ZC, Tang LQ, Guo L, Mai HQ. Liposomal paclitaxel versus docetaxel in induction chemotherapy using Taxanes, cisplatin and 5-fluorouracil for locally advanced nasopharyngeal carcinoma. BMC Cancer 2018; 18:1279. [PMID: 30572856 PMCID: PMC6302514 DOI: 10.1186/s12885-018-5192-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 12/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background We wished to evaluate the efficacy and safety of liposomal paclitaxel and docetaxel for induction chemotherapy (IC) for nasopharyngeal carcinoma (NPC). Methods A total of 1498 patients with newly-diagnosed NPC between 2009 and 2017 treated with IC plus concurrent chemotherapy were included in our observational study. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS) and grade-3–4 toxicities were compared between groups using propensity score matching (PSM). Results In total, 767 patients were eligible for this study, with 104 (13.6%) and 663 (86.4%) receiving a liposomal paclitaxel-based and docetaxel-based taxanes, cisplatin and 5-fluorouracil (TPF) regimen, respectively. PSM identified 103 patients in the liposomal-paclitaxel group and 287 patients in the docetaxel group. There was no significant difference at 3 years for OS (92.2% vs. 93.9%, P = 0.942), PFS (82.6% vs. 81.7%, P = 0.394), LRFS (94.7% vs. 93.3%, P = 0.981) or DMFS (84.6% vs. 87.4%, P = 0.371) between the two groups after PSM. Significant interactions were not observed between the effect of chemotherapy regimen and sex, age, T stage, N stage, overall stage, or Epstein–Barr virus DNA level in the subgroup multivariate analysis. The prevalence of grade-3–4 leukopenia and neutropenia in the liposomal-paclitaxel group was significantly lower than that of the docetaxel group (P < 0.05 for all). Conclusions Compared with docetaxel, liposomal paclitaxel has identical anti-tumor efficacy, but causes fewer and milder adverse reactions in IC for NPC.
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Affiliation(s)
- Sai-Lan Liu
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Xue-Song Sun
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Xiao-Yun Li
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Qiu-Yan Chen
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Huan-Xin Lin
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center
- , Guangzhou, Guangdong Province, People's Republic of China
| | - Yue-Feng Wen
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Shan-Shan Guo
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Li-Ting Liu
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Hao-Jun Xie
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Qing-Nan Tang
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Yu-Jing Liang
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Jin-Jie Yan
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Chao Lin
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhen-Chong Yang
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Lin-Quan Tang
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Ling Guo
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China
| | - Hai-Qiang Mai
- State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.
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11
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Zhang J, Peng H, Li WF, Zhang Y, Liu LZ, Tian L, Lin AH, Sun Y, Ma J. Individualized induction chemotherapy by pre-treatment plasma Epstein-Barr viral DNA in advanced nasopharyngeal carcinoma. BMC Cancer 2018; 18:1276. [PMID: 30567511 PMCID: PMC6299978 DOI: 10.1186/s12885-018-5177-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 12/04/2018] [Indexed: 04/27/2023] Open
Abstract
Background The role of pretreatment Epstein-Barr virus DNA (pre-DNA) for individualized induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) still remains unknown. We aimed to address this clinical issue. Methods In total, data on 6218 patient with newly diagnosed LA-NPC receiving concurrent chemoradiotherapy (CCRT) with or without IC were retrospectively reviewed. Receiver operating characteristics (ROC) curve was adopted to calculate the cut-off value of pre-DNA based on disease-free survival (DFS). Propensity score matching (PSM) method was adopted to balance prognostic factors and match patients. Survival outcomes between IC + CCRT and CCRT groups were compared. Results Among the original cohort, no survival difference between IC + CCRT and CCRT groups was found. The cut-off value of pre-DNA was 4650 copies/ml (area under curve [AUC], 0.620; sensitivity, 0.6224; specificity, 0.5673). For patients with Pre-DNA ≤ 4650 copies/ml, the IC + CCRT and CCRT groups also achieved comparable survival outcomes (P > 0.05 for all rates). However, IC + CCRT was associated with significantly improved 3-year DFS (78.6% vs. 74.8%, P = 0.03), overall survival (OS; 91.4% vs. 87.5%, P = 0.002) and distant metastasis-free survival (DMFS; 86.0% vs. 82.2%, P = 0.036) for patient with pre-DNA > 4650 copies/ml. Multivariate analysis also confirm that IC + CCRT was an independent prognostic factor for DFS (HR, 0.817; 95% CI, 0.683–0.977; P = 0.027), OS (HR, 0.675; 95% CI, 0.537–0.848; P = 0.001) and DMFS (HR, 0.782; 95% CI, 0.626–0.976; P = 0.03). Conclusions Pre-DNA may be a feasible and powerful consideration for individualized IC apart from other baseline clinical characteristics in LA-NPC. Electronic supplementary material The online version of this article (10.1186/s12885-018-5177-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jian Zhang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, People's Republic of China
| | - Hao Peng
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, People's Republic of China
| | - Wen-Fei Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, People's Republic of China
| | - Yuan Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, People's Republic of China
| | - Li-Zhi Liu
- Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Li Tian
- Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ai-Hua Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, People's Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, People's Republic of China. .,State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
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12
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Koukourakis MI, Giatromanolaki A. Warburg effect, lactate dehydrogenase, and radio/chemo-therapy efficacy. Int J Radiat Biol 2018; 95:408-426. [PMID: 29913092 DOI: 10.1080/09553002.2018.1490041] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The anaerobic metabolism of glucose by cancer cells, even under well-oxygenated conditions, has been documented by Otto Warburg as early as 1927. Micro-environmental hypoxia and intracellular pathways activating the hypoxia-related gene response, shift cancer cell metabolism to anaerobic pathways. In the current review, we focus on a major enzyme involved in anaerobic transformation of pyruvate to lactate, namely lactate dehydrogenase 5 (LDH5). The value of LDH5 as a marker of prognosis of cancer patients, as a predictor of response to radiotherapy (RT) and chemotherapy and, finally, as a major target for cancer treatment and radio-sensitization is reported and discussed. Clinical, translational and experimental data supporting the uniqueness of the LDHA gene and its product LDH5 isoenzyme are summarized and future directions for a metabolic treatment of cancer are highlighted.
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Affiliation(s)
- Michael I Koukourakis
- a Department of Radiotherapy and Oncology, Medical School, Democritus University of Thrace , Alexandroupolis , Greece
| | - Alexandra Giatromanolaki
- b Department of Pathology , Medical School, Democritus University of Thrace , Alexandroupolis , Greece
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13
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Hong R, Hsiao C, Ting L, Ko J, Wang C, Chang J, Lou P, Wang H, Tsai M, Lai S, Liu T. Final results of a randomized phase III trial of induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in patients with stage IVA and IVB nasopharyngeal carcinoma-Taiwan Cooperative Oncology Group (TCOG) 1303 Study. Ann Oncol 2018; 29:1972-1979. [DOI: 10.1093/annonc/mdy249] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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14
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Lan M, Chen C, Huang Y, Mao M, Han F, Liao J, Deng M, Duan Z, Zheng L, Wu S, Lu T, Jian Y. Elevated plasma fibrinogen level shows superior prognostic value than Epstein-Barr virus DNA load for stage IVA/B nasopharyngeal carcinoma patients in the intensity-modulated radiotherapy era. Oncotarget 2018; 7:46242-46252. [PMID: 27323828 PMCID: PMC5216794 DOI: 10.18632/oncotarget.10083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/29/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose Effective prognostic factors for patients with stage IVA/B nasopharyngeal carcinoma (NPC) who are susceptible to distant metastases are limited. We aim to investigate the prognostic value of pretreatment plasma fibrinogen (FIB) level and Epstein–Barr virus DNA (EBV-DNA) load in these patients in the era of intensity-modulated radiotherapy (IMRT). Results The 5-year DSS, DFS and DMFS rates of the entire cohort were 72.7%, 66.8%, 80.0%, respectively. High FIB level was identified as a negative prognostic factor for survival: the 5-year DSS, DFS and DMFS rates for patients with high FIB (> 4.0 g/L) and normal FIB (≤ 4.0 g/L) were 60.3% vs. 76.0%, 56.0% vs. 69.9%, and 59.4% vs. 85.5%, respectively (all P < 0.001). Subgroup analysis demonstrated that DSS, DFS and DMFS decreased as FIB gradually increased, even within the normal range. The risk of distant metastasis in patients with high FIB was over 3-fold than patients with normal FIB. EBV-DNA was not an independent prognostic factor for any survival outcomes in multivariate analysis. Conclusion High pretreatment FIB level shows superior prognostic value than EBV-DNA load for stage IVA/B NPC patients in the era of IMRT. Materials and Methods A total of 755 patients with newly-diagnosed stage IVA/B NPC treated with definitive IMRT between January 2007 and December 2011 were enrolled. Plasma FIB and EBV-DNA were measured before treatment. Disease-specific survival (DSS), disease-free survival (DFS) and distant metastasis-free survival (DMFS) were calculated using the Kaplan-Meier method; differences were compared using the log-rank test.
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Affiliation(s)
- Mei Lan
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Chunyan Chen
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Huang
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Minjie Mao
- Department of Clinical Laboratory, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Fei Han
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Junfang Liao
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Meiling Deng
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhijun Duan
- Department of Radiation Diagnosis and Interventional Center, Chengdu Military General Hospital, Chengdu, China
| | - Lie Zheng
- Department of Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Shaoxiong Wu
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Taixiang Lu
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yutao Jian
- Institute of Stomatological Research, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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15
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Wang J, Li L, Dong BQ, Xu YJ, Zheng YD, Sun ZW, Yang Y, Chen YY, Chen XZ, Chen M. Post-treatment serum lactic dehydrogenase as a predictive indicator for distant metastasis and survival of patients with nasopharyngeal carcinoma. Oncotarget 2018; 7:27458-67. [PMID: 27050275 PMCID: PMC5053663 DOI: 10.18632/oncotarget.8480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/18/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine the function of serum lactic dehydrogenase (SLDH) level after intensity-modulated radiotherapy (IMRT) as a predictive factor for and loco-regional relapse free survival (LRFS), distant metastasis-free survival (DMFS), disease free survival (DFS), and overall survival(OS) among patients with in-situ nasopharyngeal carcinoma (NPC). Results Compared with the normal pt-SLDH group, elevated pt-SLDH demonstrated significant lower DMFS (46 versus 66 months, hazard ratio (HR) 4.07, 95% CI 2.43–6.80, p < 0.001), DFS (46 versus 63 months, HR 2.78, 95% CI 1.70–4.53, p < 0.001), and OS (54 versus 66 months, HR 2.93, 95% CI 1.65–5.23, p < 0.001). Distant metastasis were observed in 32.8% (20/61) patients with elevated pt-SLDH, and 8% (54/678) in normal SLDH (odds ratio (OR) 6.13, 95% CI 3.35–11.18, p < 0.001). COX regression showed that pt-SLDH was an independent prognostic factors for OS (HR 2.91, 95% CI 1.57–5.41, p < 0.001), DMFS (HR 4.21, 95% CI 2.51–7.07, p < 0.001), LRFS (HR 2.53, 95% CI 1.22–5.24, p < 0.001), and DFS (HR 2.81, 95% CI 1.72–4.59, p < 0.001). Materials and Methods The records of 739 in-situ NPC patients admitted to Zhejiang Cancer Hospital between January 2007 and May 2012 were retrospectively reviewed. The relationships between post-treatment SLDH (pt-SLDH) and LRFS, DMFS, DFS, and OS were analyzed. Conclusions Our finding indicated that elevated pt-SLDH could be a simple available prognostic indicator for distant metastasis and survival for in-situ NPC patients.
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Affiliation(s)
- Jin Wang
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Li Li
- Department of Ultrasonography, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Bai-Qiang Dong
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Yu-Jin Xu
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Yuan-da Zheng
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Zhong-Wen Sun
- Department of Oncology, Jining First People's Hospital, Jining, People's Republic of China
| | - Yang Yang
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Yuan-Yuan Chen
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xiao-Zhong Chen
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Ming Chen
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
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16
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Long non-coding RNA n326322 promotes the proliferation and invasion in nasopharyngeal carcinoma. Oncotarget 2017; 9:1843-1851. [PMID: 29416735 PMCID: PMC5788603 DOI: 10.18632/oncotarget.22828] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/05/2017] [Indexed: 12/16/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) have been reported to perform significant roles in cancer development and progression. Our research has found that a novel lncRNA n326322 was higher in nasopharyngeal carcinoma (NPC) cells. Moreover, the gain and loss of functional approaches revealed that the overexpression of lncRNA-n326322 promoted NPC cell proliferation and invasion, whereas the downregulation of lncRNA-n326322 suppressed cell proliferation and invasion. Further experiments demonstrated that potential mechanism may be associated with the activation of PI3K/AKT and ERK/MAPK pathways. Taken together, these results indicate that lncRNA-n326322 is associated with tumorigenesis of NPC.
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Chen JLY, Huang YS, Kuo SH, Hong RL, Ko JY, Lou PJ, Wang CW. Intensity-modulated radiation therapy achieves better local control compared to three-dimensional conformal radiation therapy for T4-stage nasopharyngeal carcinoma. Oncotarget 2017; 8:14068-14077. [PMID: 27764778 PMCID: PMC5355163 DOI: 10.18632/oncotarget.12736] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 10/12/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine the survival outcomes and late toxicity profiles of three-dimensional conformal radiation therapy (3DCRT) vs. intensity-modulated radiation therapy (IMRT) for patients with nasopharyngeal carcinoma (NPC). Methods Three hundred and seventy-four patients with newly diagnosed, non-metastatic, NPC who were curatively treated with 3DCRT between 2004 and 2006 and 481 patients treated with IMRT between 2007 and 2009 were analyzed. Patients were categorized as having advanced-stage disease (stage III, IVA, and IVB disease; n = 709) or early-stage disease (stage I and II; n = 146). The median follow-up time was 90.3 months for patients treated with 3DCRT and 86.3 months for patients treated with IMRT. Results For early-stage patients, the outcomes of IMRT vs. 3DCRT were similar considering locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS). For advanced-stage patients, IMRT was associated with better LRC compared with 3DCRT (5-year LRC rate: 85.6% vs. 76.6%, respectively; p = 0.035) and OS (5-year OS rate: 82.3% vs. 71.8%, respectively; p = 0.002), whereas DMFS was similar for both treatments (5-year DMFS rate: 80.9% vs. 79.0%, respectively; p = 0.324). Furthermore, the IMRT technique was more beneficial for patients with T4 disease. Late toxicities occurred more frequently in patients treated with 3DCRT than in those treated with IMRT (grade ≥3 neck fibrosis: 6.7% vs. 3.7%, respectively, p = 0.036; radiographic temporal lobe necrosis: 10.2% vs. 4.4%, respectively, p < 0.001). Conclusions Compared with 3DCRT, IMRT offered better LRC in patients with advanced-stage non-metastatic NPC, which corresponded with better OS.
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Affiliation(s)
- Jenny Ling-Yu Chen
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Radiation Oncology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Yu-Sen Huang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Sung-Hsin Kuo
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan
| | - Ruey-Long Hong
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jenq-Yuh Ko
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chun-Wei Wang
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Zhang LL, Zhou GQ, Li YC, Lin AH, Ma J, Qi ZY, Sun Y. Induction Chemotherapy Has No Prognostic Value in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma and Chronic Hepatitis B Infection in the IMRT Era. Transl Oncol 2017; 10:800-805. [PMID: 28844018 PMCID: PMC5576973 DOI: 10.1016/j.tranon.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/13/2017] [Accepted: 07/13/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND: The effectiveness of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) over CCRT alone in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and chronic hepatitis B infection in the intensity-modulated radiotherapy (IMRT) era is unknown. PATIENTS AND METHODS: A total of 249 patients with stage T1-2 N2-3 or T3-4 N1-3 NPC and chronic hepatitis B infection treated with IMRT were retrospectively reviewed. Propensity score matching (PSM) was employed to balance covariates; 140 patients were propensity-matched (1:1 basis). Survival outcomes in the IC + CCRT and CCRT groups were compared using the Kaplan–Meier method, log-rank test and Cox proportional hazards model. RESULTS: No significant survival differences were observed between IC + CCRT and CCRT (5-year overall survival, 88.3% vs. 82.2%; P = .484; disease-free survival, 73.9% vs. 75.2%; P = .643; distant metastasis-free survival, 84.1% vs. 85.1%; P = .781; and locoregional failure-free survival, 87.9% vs. 85.1%; P = .834). After adjusting for known prognostic factors in multivariate analysis, IC was not an independent prognostic factor for any outcome (all P > .05); subgroup analysis based on T category (T1-2/T3-4), N category (N0-1/N2-3), and overall stage (III/IV) confirmed these results. The incidence of hepatic function damage in the IC + CCRT and CCRT groups was not significantly different. CONCLUSION: IC + CCRT leads to comparable survival outcomes and hepatic function damage compared to CCRT alone in patients with locoregionally advanced NPC with chronic hepatitis B infection in the IMRT era. Further investigations are warranted.
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Affiliation(s)
- Lu-Lu Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
| | - Guan-Qun Zhou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
| | - Yang-Chan Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
| | - Ai-Hua Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
| | - Zhen-Yu Qi
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China.
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Wu LR, Jiang XS, Song X, Yu HL, Fan YX, Wang FJ, Huang SF, Guo WJ, He X, Liu JY. Comparing the efficacy of induction-concurrent with concurrent-adjuvant chemotherapy in locoregionally advanced nasopharyngeal carcinoma: a propensity score matching analysis. Oncotarget 2017; 8:79953-79963. [PMID: 29108377 PMCID: PMC5668110 DOI: 10.18632/oncotarget.20389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/06/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose This study aimed to compare the efficacy of induction-concurrent (IC-CCRT) with concurrent-adjuvant (CCRT-AC) chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated by intensity-modulated radiotherapy (IMRT). Materials and Methods Data on 834 patients with newly diagnosed, non-metastatic stage III-IVA (except T3N0) NPC receiving either IC-CCRT or CCRT-AC between July, 2004 and December, 2014 were retrospectively reviewed. Propensity score matching (PSM) method was adopted to balance prognostic factors and match patients. Survival outcomes of matched patients between IC-CCRT and CCRT-AC were compared. Results The median follow-up duration is 45.2 months (range, 1.07–145.4 months). Overall, 309 pairs were selected by PSM. Univariate analysis revealed the CCRT-AC group achieved significantly higher 3-year DFS (83.9% vs. 78.7 %; P = 0.014) and OS (87.6% vs. 87.0%; P = 0.031). Multivariate analysis also identified treatment group (IC-CCRT vs. CCRT-AC) as an independent prognostic factor for 3-year DFS (HR, 1.546; 95% CI, 1.113–2.149; P = 0.009) and OS (HR, 1.487; 95% CI, 1.035–2.136; P = 0.032). Subgroup analysis revealed IC-CCRT was a protective factor for DMFS (HR, 0.145; 95% CI, 0.043–0.488; P = 0.002) in stage III disease; however, it could adversely affected DFS (HR, 2.009; 95% CI, 1.316–3.065; P = 0.001), OS (HR, 1.671; 95% CI, 1.060–2.636; P = 0.027) and DMFS (HR, 1.986; 95% CI, 1.155–3.416; P = 0.013) in stage IVA disease. Conclusions CCRT-AC may be a more effective treatment modality in patients with stage IVA NPC disease, while IC-CCRT was superior in stage III disease.
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Affiliation(s)
- Li-Rong Wu
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Xue-Song Jiang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Xue Song
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Hong-Liang Yu
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Yan-Xin Fan
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Fei-Jiang Wang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Sheng-Fu Huang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Wen-Jie Guo
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Xia He
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Ju-Ying Liu
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
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20
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Wu LR, Yu HL, Jiang N, Jiang XS, Zong D, Wen J, Huang L, Xie P, Chen W, Wang TT, Gu DY, Yan PW, Yin L, He X. Prognostic value of chemotherapy in addition to concurrent chemoradiotherapy in T3-4N0-1 nasopharyngeal carcinoma: a propensity score matching study. Oncotarget 2017; 8:76807-76815. [PMID: 29100350 PMCID: PMC5652744 DOI: 10.18632/oncotarget.20014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/30/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose The objective of this study is to evaluate the contribution of induction (IC) or adjuvant (AC) chemotherapy additional to concurrent chemoradiotherapy (CCRT) for patients with T3-4N0-1 nasopharyngeal carcinoma (NPC) in the era of intensity-modulate radiotherapy (IMRT). Method and Materials We retrospectively reviewed the data on 685 patients with newly diagnosed T3-4N0-1 NPC. Propensity score matching (PSM) method was used to match patients. Survival outcomes between different groups were calculated by Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model was adopted to establish independent prognostic factors. Results In total, 236 pairs were selected from the primary cohort. Univariate analysis revealed 3-year overall survival (OS) (90.8% vs. 90.3%, P = 0.820), distant failure-free survival (DFFS) (87.3% vs. 89.4%, P = 0.896) and locoregional failure-free survival (LRFFS) (95.4% vs. 93.0%, P = 0.311) rates were comparable between CCRT plus IC/AC and CCRT alone groups. Multivariate analysis found that treatment group was not an independent prognostic factors for OS (HR, 0.964; 95% CI, 0.620-1.499; P = 0.869), DFFS (HR, 1.036; 95% CI, 0.626-1.714; P = 0.890) and LRFFS (HR, 0.670; 95% CI, 0.338-1.327; P = 0.250). Further subgroup analysis according to overall stage also obtained similar results. Conclusion Patients with T3-4N0-1 NPC receiving CCRT could not benefit from additional induction or adjuvant chemotherapy in the era of IMRT.
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Affiliation(s)
- Li-Rong Wu
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Hong-Liang Yu
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Ning Jiang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Xue-Song Jiang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Dan Zong
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Jing Wen
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Lei Huang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Peng Xie
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Wei Chen
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Ting-Ting Wang
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Da-Yong Gu
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Peng-Wei Yan
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Li Yin
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
| | - Xia He
- Department of Radiation Oncology, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing 210009, China
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Ke LR, Xia WX, Qiu WZ, Huang XJ, Yu YH, Liang H, Liu GY, Xiang YQ, Guo X, Lv X. A phase II trial of induction NAB-paclitaxel and cisplatin followed by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma. Oral Oncol 2017. [DOI: 10.1016/j.oraloncology.2017.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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DEPDC1 is required for cell cycle progression and motility in nasopharyngeal carcinoma. Oncotarget 2017; 8:63605-63619. [PMID: 28969015 PMCID: PMC5609947 DOI: 10.18632/oncotarget.18868] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/02/2017] [Indexed: 01/02/2023] Open
Abstract
DEP domain containing 1 (DEPDC1) is a newly identified cancer-related and cell cycle related gene and has been demonstrated as a novel therapeutic target for bladder cancer. However, the functional involvement and therapeutic potential of DEPDC1 in nasopharyngeal carcinoma (NPC) remains unclear. Our results showed that DEPDC1 was overexpressed at both mRNA and protein levels in NPC tissues compared with normal or non-tumor tissues. The siRNA-mediated DEPDC1 depletion resulted in significant inhibition of proliferation and delay in cell cycle progression in both NPC cell lines, CNE-1 and HNE-1. Detailed analysis with indirect immunofluorescence assays revealed that DEPDC1 depletion caused significant mitotic arrest accompanied with mitotic defects such as multipolar spindles and multiple nuclei followed by apoptotic cell death. Notably, DEPDC1 depletion also reduces migration and invasion ability in both cell lines. Consistent with its regulatory role in NF-κB pathway, knockdown of DEPDC1 caused significant upregulation of A20 and downregulation of mutiple NF-κB downstream target genes implicated in proliferation and tumorigenesis (c-Myc, BCL2, CCND1, CCNB1 and CCNB2), and metastasis (MMP2, MMP9, ICAM1, vimentin, Twist1). Moreover, in vivo study demonstrated that DEPDC1 knockdown also caused significant inhibition of tumor growth in the NPC xenograft nude mouse model. Taken together, our present study demonstrated that DEPDC1 is essentially required for the accelerated cell cycle progression and motility in NPC cells, and strongly suggested that DEPDC1 may serve as a novel therapeutic target in NPC.
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Wang Y, Chen G. Identifying pretreatment baseline factors predictive of distant metastasis in patients with nasopharyngeal carcinoma after radiotherapy. Medicine (Baltimore) 2017; 96:e6692. [PMID: 28445271 PMCID: PMC5413236 DOI: 10.1097/md.0000000000006692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This retrospective study was performed to identify pretreatment baseline factors that could predict the development of distant metastasis (DM) in patients with nasopharyngeal carcinoma (NPC).A cohort of 119 NPC patients undergoing radiotherapy (RT) or chemoradiotherapy (CRT) were recruited into the study. Among them, 51 developed DM (DM group) within 3 years after treatment and 68 did not (DM-free group). Various clinicopathological factors were measured before the treatment and analyzed by univariate as well as multivariate analyses for the potential correlation with DM development.Univariate analysis revealed that increased peripheral lactate dehydrogenase (LDH) level, lower lymphocyte-monocyte ratio (LMR), higher neutrophil-lymphocyte ratio (NLR), advanced American Joint Committee on Cancer (AJCC) stage, advanced T stage, and advanced N stage were significantly correlated with the presence of DM. Multivariate analysis identified advanced AJCC stage and high LDH level were independent predictive factors for DM.Routinely measured pretreatment clinical factors, including AJCC state and serum LDH level, could independently predict DM. These factors will benefit the selection of appropriate treatment options and improve the overall survival of NPC patients.
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Ke LR, Xia WX, Qiu WZ, Huang XJ, Yang J, Yu YH, Liang H, Liu GY, Ye YF, Xiang YQ, Guo X, Lv X. Safety and efficacy of lobaplatin combined with 5-fluorouracil as first-line induction chemotherapy followed by lobaplatin-radiotherapy in locally advanced nasopharyngeal carcinoma: preliminary results of a prospective phase II trial. BMC Cancer 2017; 17:134. [PMID: 28202000 PMCID: PMC5311839 DOI: 10.1186/s12885-017-3080-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/23/2017] [Indexed: 12/27/2022] Open
Abstract
Background Due to improvements in imaging and radiological techniques as well as the use of chemotherapy, distant metastasis has become the predominant mode of treatment failure in patients with locally advanced nasopharyngeal carcinoma (LA-NPC). Platinum-based systemic chemotherapy has shown survival benefits and is now the standard strategy for systemic therapy in patients with LA-NPC. Notably, the third-generation platinum reagent lobaplatin has shown anti-tumor effects in several solid tumors with lower incidences of gastrointestinal, hepatic and renal toxicity relative to other platinum drugs. However, the safety and efficacy of lobaplatin as a first-line regimen in patients with LA-NPC are undetermined. Methods Patients with stage III–IVa-b NPC received lobaplatin at a dose of 30 mg/m2 on days 1 and 22 combined with a continuous 120-h intravenous injection of 5-fluorouracil at a dose of 4 g/m2 followed by lobaplatin at a dose of 50 mg/m2 on days 43 and 64 concomitant with intensity-modulated radiation therapy. Objective response rates and acute toxicity were assessed based on RECIST (1.1) and CTCAE v.3.0, respectively. Kaplan-Meier analysis was used to calculate survival rates. Results Fifty-nine patients were enrolled, and 44 patients (74.6%) received allocated cycles of chemotherapy. The objective response rates were 88.1% (95% confidence interval [CI], 0.77 to 0.95) and 100% after induction chemotherapy (ICT) and concurrent chemoradiotherapy (CRT), respectively. With a median follow-up period of 44 months, the 3-year estimated progression-free survival and overall survival were 86.4% (95% CI, 69.8 to 98.8) and 94.9% (95% CI, 89.5 to 100), respectively. The most common grade 3–4 toxicities were neutropenia (8.5%) and thrombocytopenia (40.7%) after ICT and CRT, respectively. Conclusion Lobaplatin combined with 5-fluorouracil followed by lobaplatin-RT treatment showed encouraging anti-tumor effects with tolerable toxicities in patients with LA-NPC. Randomized controlled trials of lobaplatin in patients with LA-NPC are warranted. Trial registration This trial was registered with the Chinese Clinical Trials Registry and approved on March 31st, 2012, number ChiCTR-ONC-12002060.
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Affiliation(s)
- Liang-Ru Ke
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Wei-Xiong Xia
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Wen-Ze Qiu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Xin-Jun Huang
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Jing Yang
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Ya-Hui Yu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Hu Liang
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Guo-Ying Liu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Yan-Fang Ye
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Yan-Qun Xiang
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China. .,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China.
| | - Xiang Guo
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China. .,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China.
| | - Xing Lv
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China. .,State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China.
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25
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Peng H, Chen L, Zhang J, Li WF, Mao YP, Zhang Y, Liu LZ, Tian L, Lin AH, Sun Y, Ma J. Induction Chemotherapy Improved Long-term Outcomes of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma: A Propensity Matched Analysis of 5-year Survival Outcomes in the Era of Intensity-modulated Radiotherapy. J Cancer 2017; 8:371-377. [PMID: 28261337 PMCID: PMC5332887 DOI: 10.7150/jca.16732] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/13/2016] [Indexed: 12/21/2022] Open
Abstract
Background: The aim of this study is to evaluate the long-term therapeutic gain of induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT). Methods: Data on 957 patients with stage T1-2N2-3 or T3-4N1-3 NPC treated with IMRT were retrospectively reviewed. Propensity score matching (PSM) method was adopted to balance influence of various covariates. Patient survival between IC and non-IC groups were compared. Results: For the 318 pairs selected from the original 957 patients by PSM, the median follow-up duration was 57.13 months (range, 1.27-78.1 months). The 5-year overall survival (OS), distant metastasis-free survival (DMFS), disease-free survival (DFS) and locoregional relapse-free survival (LRRFS) rates for IC group vs. non-IC group were 87.2% vs. 80.8% (P = 0.023), 88.1% vs. 83.2% (P = 0.071), 80.7% vs. 71.4% (P = 0.011) and 92.1% vs. 86.7% (P = 0.081), respectively. Multivariate analysis identify IC as an independent prognostic factor for OS (HR, 0.595; 95% CI, 0.397-0.891; P = 0.012) and DFS (HR, 0.627; 95% CI, 0.451-0.872; P = 0.006). After excluding the patients not receiving concurrent chemotherapy, IC was found to be an independent prognostic factor for OS (HR, 0.566; 95% CI, 0.368-0.872; P = 0.01), DMFS (HR, 0.580; 95% CI, 0.367-0.916; P = 0.02) and DFS (HR, 0.633; 95% CI, 0.444-0.903; P = 0.012). Conclusions: IC is an effective treatment modality for patients with stage T1-2N2-3 and T3-4N1-3 NPC, and the incorporation of IC with standard CCRT could achieve the best therapeutic gain.
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Affiliation(s)
- Hao Peng
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Lei Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Jian Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Wen-Fei Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Yuan Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Li-Zhi Liu
- Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Li Tian
- Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Ai-Hua Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, People's Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
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26
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Chen Z, Guo Q, Lu T, Lin S, Zong J, Zhan S, Xu L, Pan J. Pretreatment Serum Lactate Dehydrogenase Level as an Independent Prognostic Factor of Nasopharyngeal Carcinoma in the Intensity-Modulated Radiation Therapy Era. Med Sci Monit 2017; 23:437-445. [PMID: 28120819 PMCID: PMC5289097 DOI: 10.12659/msm.899531] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aims of this study were to analyze the prognostic value of baseline lactate dehydrogenase (LDH) among nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT), and to evaluate the potential application of LDH in monitoring treatment efficacy dynamically. Material/Methods From June 2005 to December 2010, 1188 patients with non-metastatic NPC who underwent IMRT with or without chemotherapy were reviewed. Univariate and multivariate analyses were performed to evaluate the predictive value of baseline LDH. Wilcoxon signed-rank test was used to analyze the difference between baseline and post-radiotherapy LDH, and to compare post-radiotherapy LDH with the LDH in cases of distant failure. Results Patients with elevated LDH had significant inferior survival rates, in terms of overall survival (70.0% vs. 83.2%, p=0.010), disease-specific survival (71.1% vs. 85.7%, p=0.002), and distant metastasis-free survival (71.1% vs. 83.4%, p=0.009), but not correlated with locoregional relapse-free survival (p=0.275) or progression-free survival (p=0.104). Subgroup analysis demonstrated that this predictive effect was more significant with advanced stage. Sixty-five post-radiotherapy LDH levels were available from the 90 patients with high LDH at initial diagnosis, and these levels fell in 65 patients, with 62 cases (95.4%) falling within the normal range. Of the 208 patients who experienced distant metastasis, 87 had an available LDH level at that time. Among them, 69 cases (79.3%) had an increased level compared with the post-radiotherapy LDH level. Conclusions Pretreatment LDH is a simple, cost-effective biomarker that could predict survival rates and might be used in individualized treatment. It is also a potential biomarker that might reflect tumor burden and be used to monitor therapy efficacy.
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Affiliation(s)
- Zhuhong Chen
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Qiaojuan Guo
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Tianzhu Lu
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Shaojun Lin
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Jingfeng Zong
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Shenghua Zhan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Luying Xu
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
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27
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Türkölmez Ş, Aksoy SY, Özdemir E, Kandemir Z, Yıldırım N, Özsavran AY, Çetindağ MF, Köse K. Prognostic Significance of Standardized Uptake Value on 18Fluorine-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients with Nasopharyngeal Carcinoma. World J Nucl Med 2017; 16:33-38. [PMID: 28217017 PMCID: PMC5314661 DOI: 10.4103/1450-1147.181151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of this study was to investigate the prognostic significance of standardized uptake value (SUV) on 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma (NPC). Thirty-four patients who have histologically proven NPC and underwent 18F-FDG PET/CT were included in this study. After 18F-FDG PET/CT, all the patients received radiation therapy and 32 of them received concomitant weekly chemotherapy. The maximum SUV (SUVmax) at the primary tumor and the SUVmaxof the highest neck nodes were determined. The SUVmax-T ranged from 5.00 to 30.80 (mean: 15.37 ± 6.10) and there was no difference between SUVmax-T values for early and late stages (P = 0.99). The SUVmax-N ranged from 3.10 to 23.80 (mean: 13.23 ± 5.76). There was no correlation between SUVmax-T and SUVmax-N (r = 0.111, P = 0.532). There was no difference between the SUVmax-T and the positivity of neck lymph nodes (P = 0.169). The ability of SUVmaks-N to predict stage was obtained by a receiver operating characteristic (ROC) analysis. The area under the curve is 0.856 and the best cut-off value is 7.88. There was a good correlation between SUVmax-N and stage. While the mean SUVmax-T for the alive patients was slightly lower than that for the dead (14.65 ± 5.58 vs. 20.30 ± 7.92, P = 0.061), the difference between the groups was not statistically significant. Furthermore, there was no statistically significant difference for SUVmax-N between these two groups (P: 0.494). Cox-regression analysis showed that an increase in SUVmax-T and SUVmax-N was associated with death risk (relative risk [RR]: 1.13, P = 0.078 and RR: 1.052, P = 0.456, respectively). SUVmax-T and SUVmax-N were independent prognostic factors for survival in NPC patients. This will help the clinicians in choosing suitable candidates for more aggressive treatment modalities.
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Affiliation(s)
- Şeyda Türkölmez
- Department of Nuclear Medicine, Ankara Ataturk Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Sabire Yılmaz Aksoy
- Department of Nuclear Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Elif Özdemir
- Department of Nuclear Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Zuhal Kandemir
- Department of Nuclear Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Nilüfer Yıldırım
- Department of Nuclear Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Atiye Yılmaz Özsavran
- Department of Radiation Oncology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Mehmet Faik Çetindağ
- Department of Radiation Oncology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Kenan Köse
- Department of Biostatistics, Ankara University Medical School, Ankara, Turkey
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28
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Peng H, Chen L, Li WF, Guo R, Mao YP, Zhang Y, Guo Y, Sun Y, Ma J. Tumor response to neoadjuvant chemotherapy predicts long-term survival outcomes in patients with locoregionally advanced nasopharyngeal carcinoma: A secondary analysis of a randomized phase 3 clinical trial. Cancer 2016; 123:1643-1652. [PMID: 28001301 DOI: 10.1002/cncr.30520] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Tumor response to neoadjuvant chemotherapy using the regimen of cisplatin and 5-fluorouracil could define high-risk patients with locoregionally advanced nasopharyngeal carcinoma (NPC). However, the regimen of docetaxel, cisplatin, and 5-fluorouracil (TPF) appears to be more effective than the regimen of cisplatin and 5-fluorouracil. Therefore, one needs to redefine the high-risk subpopulation of patients receiving neoadjuvant chemotherapy with TPF. METHODS A total of 231 patients from a randomized phase 3 trial with American Joint Committee on Cancer/International Union Against Cancer stage III to stage IVB NPC (except T3-T4N0 disease) who were receiving treatment with the TPF regimen were enrolled. Patient survival rates between different groups were compared. RESULTS Of the 231 patients, the overall response to neoadjuvant chemotherapy was a complete response (CR) for 26 (11.3%), a partial response (PR) for 184 patients (79.6%), and stable disease (SD) for 21 patients (9.1%). Univariate analysis revealed the 3-year failure-free survival (FFS) rates in the CR (88.5% vs 61.9%; P =.017) and PR (81.2% vs 61.9%; P = .01) groups, and the 3-year overall survival rates for the CR (96.2% vs 76.2%; P =.048) and PR (93.4% vs 76.2%; P =.025) groups were obviously higher compared with that of the SD group. In multivariate analysis, CR was established as a favorable prognostic factor for FFS (hazard ratio [HR], 0.210; 95% confidence interval [95% CI], 0.057-0.779 [P =.02]), and PR for FFS (HR, 0.447; 95% CI, 0.213-0.936 [P =.033]) and OS (HR, 0.361; 95% CI, 0.132-0.986 [P =.047]) when compared with SD. No survival difference was observed between the CR and PR groups. CONCLUSIONS Tumor response to TPF may be a properly powerful prognosis predictor and help to develop individualized treatment strategies for patients with locoregionally advanced NPC. Cancer 2017;123:1643-1652. © 2017 American Cancer Society.
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Affiliation(s)
- Hao Peng
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lei Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wen-Fei Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Rui Guo
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yuan Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Guo
- Department of Clinical Trials Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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29
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Optimize the cycle of neoadjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy: A propensity score matching analysis. Oral Oncol 2016; 62:78-84. [DOI: 10.1016/j.oraloncology.2016.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/28/2016] [Accepted: 10/16/2016] [Indexed: 11/18/2022]
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30
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Wu X, Huang J, Liu L, Li H, Li P, Zhang J, Xie L. Cetuximab concurrent with IMRT versus cisplatin concurrent with IMRT in locally advanced nasopharyngeal carcinoma: A retrospective matched case-control study. Medicine (Baltimore) 2016; 95:e4926. [PMID: 27684830 PMCID: PMC5265923 DOI: 10.1097/md.0000000000004926] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 08/10/2016] [Accepted: 08/23/2016] [Indexed: 02/05/2023] Open
Abstract
To evaluate the treatment efficacies and toxicities of concurrent cetuximab-based bioradiotherapy (BRT) or cisplatin-based chemoradiotherapy (CRT) in locally advanced nasopharyngeal carcinoma. :Patients with previously untreated locally advanced nasopharyngeal carcinoma were matched into pairs, and enrolled into the study. All patients were given either BRT or CRT. Survival outcomes, toxicities, and prognostic factors were evaluated. :A total of 112 patients were enrolled. The 5-year overall survival was 79.3% and 79.5% in CRT and BRT arm, respectively (P = 0.797) and the 5-year DFS was 73.5% and 74.6%, respectively (P = 0.953). In toxicity analysis, CRT arm had more significant decrease in white blood cell, platelet, hemoglobin, and severe vomiting, while more severe skin reactions and mucositis were shown in BRT arm. :BRT was not less efficacious than traditional CRT. They lead to different aspects of toxicities. If patients cannot stand more severe toxicities caused by CRT, BRT could be an ideal alternative.
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Affiliation(s)
| | | | - Lei Liu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University
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31
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RBM24 suppresses cancer progression by upregulating miR-25 to target MALAT1 in nasopharyngeal carcinoma. Cell Death Dis 2016; 7:e2352. [PMID: 27584791 PMCID: PMC5059856 DOI: 10.1038/cddis.2016.252] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 07/01/2016] [Accepted: 07/19/2016] [Indexed: 12/28/2022]
Abstract
Abnormal interaction between non-coding RNAs has been demonstrated to be a common molecular event in various human cancers, but its significance and underlying mechanisms have not been well documented. RNA-binding proteins (RBPs) are key regulators of RNA transcription and post-transcriptional processing. In this study, we found that RNA-binding protein 24 (RBM24) was frequently downregulated in nasopharyngeal carcinoma (NPC). The restoration of RBM24 expression suppressed NPC cellular proliferation, migration and invasion and impeded metastatic colonization in mouse models. Microarray analyses revealed that miR-25 expression was upregulated by RBM24 expression in NPC cells. Similarly, ectopic miR-25 expression suppressed NPC cellular growth and motility by targeting the pro-oncogenic lncRNA MALAT1, and the knockdown of MALAT1 expression exhibited similar effects as RBM24 restoration in NPC cells. Overall, these findings suggest a novel role of RBM24 as a tumor suppressor. Mechanistically, RBM24 acts at least in part through upregulating the expression of miR-25, which in turn targets MALAT1 for degradation.
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32
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Liu LT, Chen QY, Tang LQ, Zhang L, Guo SS, Xie CM, Liu XW, Guo L, Mo HY, Chen MY, Zhao C, Guo X, Cao KJ, Qian CN, Zeng MS, Bei JX, Hong MH, Shao JY, Sun Y, Ma J, Mai HQ. Advanced-Stage Nasopharyngeal Carcinoma: Restaging System after Neoadjuvant Chemotherapy on the Basis of MR Imaging Determines Survival. Radiology 2016; 282:171-181. [PMID: 27479804 DOI: 10.1148/radiol.2016152540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the prognostic value of the restaging system after neoadjuvant chemotherapy (NACT) in patients with advanced-stage nasopharyngeal carcinoma (NPC). Materials and Methods This study was approved by the clinical research committee and a written informed consent was required before enrolling in the study. Prospectively enrolled were 412 consecutive patients with stage III-IVb NPC treated with NACT followed by concurrent chemotherapy and radiation therapy. Patients were staged before NACT and restaged after NACT. The progression-free survival (PFS) and distant metastasis-free survival (DMFS) were calculated with the Kaplan-Meier method, and differences were compared by using the log-rank test. Results Post-NACT T classification (PFS, P = .001) and N classification (PFS, P < .001; DMFS, P = .001) resulted in better survival curve separations than pre-NACT T classification and N classification. Patients downstaged from N2-N3 to N0-N1 disease had a better prognosis than did patients who continued to have N2-N3 diseases (3-year PFS, 83.8% vs 66.6%, P = .001; 3-year DMFS, 88.0% vs 78.4%, P = .026). Multivariate analysis revealed that post-NACT T classification (hazard ratio [HR] = 1.67; 95% confidence interval [CI]: 1.18, 2.36; P = .003) and post-NACT N classification (HR = 1.54; 95% CI: 1.17, 2.03; P = .002) were independent prognostic factors for PFS; also, post-NACT N classification (HR = 1.48; 95% CI: 1.05, 2.07; P = .025) was an independent prognostic factor for DMFS. Multivariate analysis in patients with N2-N3 disease demonstrated that the N downstaging effects of NACT was the only independent prognostic factor for PFS (HR = 0.48; 95% CI: 0.29, 0.81; P = .006) and DMFS (HR = 0.52; 95% CI: 0.28, 0.97; P = .039). Conclusion The post-NACT stage is more representative of prognosis than the pre-NACT stage in advanced-stage NPC patients, which suggests that major clinical decisions should be based on the post-NACT stage. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Li-Ting Liu
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Qiu-Yan Chen
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Lin-Quan Tang
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Lu Zhang
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Shan-Shan Guo
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Chuan-Miao Xie
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Xue-Wen Liu
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Ling Guo
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Hao-Yuan Mo
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Ming-Yuan Chen
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Chong Zhao
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Xiang Guo
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Ka-Jia Cao
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Chao-Nan Qian
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Mu-Sheng Zeng
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Jin-Xin Bei
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Ming-Huang Hong
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Jian-Yong Shao
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Ying Sun
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Jun Ma
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
| | - Hai-Qiang Mai
- From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., C.M.X., X.W.L., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., M.S.Z., J.X.B., M.H.H., J.Y.S., Y.S., J.M., H.Q.M.), Department of Nasopharyngeal Carcinoma (L.T.L., Q.Y.C., L.Q.T., L.Z., S.S.G., L.G., H.Y.M., M.Y.C., C.Z., X.G., K.J.C., C.N.Q., H.Q.M.), Imaging Diagnosis and Interventional Center (C.M.X., X.W.L.), Good Clinical Practice Center (M.H.H.), Department of Molecular Diagnostics (J.Y.S.), and Department of Radiation Oncology (Y.S., J.M.), Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, P.R. China (H.Q.M.)
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Peng H, Chen L, Li WF, Guo R, Zhang Y, Zhang F, Liu LZ, Tian L, Lin AH, Sun Y, Ma J. Prognostic Value of Neoadjuvant Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma with Low Pre-treatment Epstein-Barr Virus DNA: a Propensity-matched Analysis. J Cancer 2016; 7:1465-71. [PMID: 27471562 PMCID: PMC4964130 DOI: 10.7150/jca.15736] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/24/2016] [Indexed: 11/17/2022] Open
Abstract
Background: The aim of this study is to investigate the prognostic value of neoadjuvant chemotherapy (NCT) in locoregionally advanced nasopharyngeal carcinoma (NPC) with low pre-treatment Epstein-Barr virus (EBV) DNA in the era of intensity-modulated radiotherapy (IMRT). Methods: Data on 1099 locoregionally advanced NPC patients treated with IMRT were retrospectively reviewed. Propensity score matching (PSM) method was adopted to balance influence of covariates. Patient survival between NCT and non-NCT groups were compared. Results: The cut-off value of pre-treatment Epstein-Barr virus DNA (pre-DNA) was 1550 copies/ml for DMFS (area under curve [AUC], 0.655; sensitivity, 0.819; specificity, 0.445). For the 145 pairs selected by PSM, the 3-year distant metastasis-free survival (DMFS), overall survival (OS), disease-free survival (DFS) and locoregional relapse-free survival (LRRFS) rates were 98.6% vs. 93.7% (P = 0.101), 95.8% vs. 94.4% (P = 0.881), 91.7% vs. 87.5% (P = 0.309) and 94.4% vs. 95.0% (P = 0.667), respectively. Multivariate analysis did not identify NCT as an independent prognostic factor (P > 0.05 for all rates), and stratified analysis based on overall stage (III and IV) and N category (N0-1 and N2-3) also got the same results. Conclusion: NCT was not established as an independent prognostic factor, and it should not be used in locoregionally advanced NPC with low pre-DNA.
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Affiliation(s)
- Hao Peng
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Lei Chen
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Wen-Fei Li
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Rui Guo
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Yuan Zhang
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Fan Zhang
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Li-Zhi Liu
- 2. Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Li Tian
- 2. Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Ai-Hua Lin
- 3. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, People's Republic of China
| | - Ying Sun
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
| | - Jun Ma
- 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China
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Liu LT, Tang LQ, Chen QY, Zhang L, Guo SS, Guo L, Mo HY, Zhao C, Guo X, Cao KJ, Qian CN, Zeng MS, Bei JX, Hong MH, Shao JY, Sun Y, Ma J, Mai HQ. The Prognostic Value of Plasma Epstein-Barr Viral DNA and Tumor Response to Neoadjuvant Chemotherapy in Advanced-Stage Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2015; 93:862-9. [DOI: 10.1016/j.ijrobp.2015.08.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/30/2015] [Accepted: 08/03/2015] [Indexed: 01/18/2023]
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Tan T, Lim WT, Fong KW, Cheah SL, Soong YL, Ang MK, Ng QS, Tan D, Ong WS, Tan SH, Yip C, Quah D, Soo KC, Wee J. Concurrent chemo-radiation with or without induction gemcitabine, Carboplatin, and Paclitaxel: a randomized, phase 2/3 trial in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2015; 91:952-60. [PMID: 25832687 DOI: 10.1016/j.ijrobp.2015.01.002] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/29/2014] [Accepted: 01/02/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE To compare survival, tumor control, toxicities, and quality of life of patients with locally advanced nasopharyngeal carcinoma (NPC) treated with induction chemotherapy and concurrent chemo-radiation (CCRT), against CCRT alone. PATIENTS AND METHODS Patients were stratified by N stage and randomized to induction GCP (3 cycles of gemcitabine 1000 mg/m(2), carboplatin area under the concentration-time-curve 2.5, and paclitaxel 70 mg/m(2) given days 1 and 8 every 21 days) followed by CCRT (radiation therapy 69.96 Gy with weekly cisplatin 40 mg/m(2)), or CCRT alone. The accrual of 172 was planned to detect a 15% difference in 5-year overall survival (OS) with a 5% significance level and 80% power. RESULTS Between September 2004 and August 2012, 180 patients were accrued, and 172 (GCP 86, control 86) were analyzed by intention to treat. There was no significant difference in OS (3-year OS 94.3% [GCP] vs 92.3% [control]; hazard ratio 1.05; 1-sided P=.494]), disease-free survival (hazard ratio 0.77, 95% confidence interval 0.44-1.35, P=.362), and distant metastases-free survival (hazard ratio 0.80, 95% confidence interval 0.38-1.67, P=.547) between the 2 arms. Treatment compliance in the induction phase was good, but the relative dose intensity for concurrent cisplatin was significantly lower in the GCP arm. Overall, the GCP arm had higher rates of grades 3 and 4 leukopenia (52% vs 37%) and neutropenia (24% vs 12%), but grade 3 and 4 acute radiation toxicities were not statistically different between the 2 arms. The global quality of life scores were comparable in both arms. CONCLUSION Induction chemotherapy with GCP before concurrent chemo-irradiation did not improve survival in locally advanced NPC.
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Affiliation(s)
- Terence Tan
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore.
| | - Wan-Teck Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Kam-Weng Fong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Shie-Lee Cheah
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Yoke-Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Mei-Kim Ang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Quan-Sing Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Daniel Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Whee-Sze Ong
- Division of Clinical Trial and Epidemiological Sciences, National Cancer Centre Singapore, Singapore
| | - Sze-Huey Tan
- Division of Clinical Trial and Epidemiological Sciences, National Cancer Centre Singapore, Singapore
| | - Connie Yip
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Daniel Quah
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Khee-Chee Soo
- Division of Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - Joseph Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
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Wen L, You C, Lu X, Zhang L. Phase II trial of concurrent chemoradiotherapy with S-1 versus weekly cisplatin for locoregionally advanced nasopharyngeal carcinoma. Mol Clin Oncol 2015; 3:687-691. [PMID: 26137288 DOI: 10.3892/mco.2015.529] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/20/2015] [Indexed: 11/05/2022] Open
Abstract
This is a prospective randomized trial performed to compare the efficacy of concurrent chemoradiotherapy (CCRT) + S-1 (oral fluoropyrimidine) with that of CCRT + cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma. A total of 105 eligible patients were randomly assigned to receive CCRT with S-1 (S-1 arm, n=50) or cisplatin weekly (control arm, n=55). Patients in the S-1 arm received CCRT plus S-1 (40-60 mg, twice daily for 4 consecutive weeks. Patients in the control arm received standard CCRT with weekly cisplatin. All the patients were included in an intention-to-treat survival analysis. Our results demonstrated that the S-1 and control arms did not differ significantly in terms of complete response, partial response, progression-free survival or overall survival (all P-values >0.05). However, the two arms varied significantly regarding certain grade 3-4 toxicities, including leukopenia, 5.5 vs. 22.0% (P=0.013); mucositis, 20.0 vs. 46.0% (P=0.004); dermatitis, 15.5 vs. 32.7% (P=0.011); and nausea, 9.1 vs. 41.6% (P<0.001) for the S-1 and control arms, respectively. In conclusion, CCRT with S-1 was found to be similar in efficacy but superior in terms of toxicity compared to the standard CCRT with weekly cisplatin.
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Affiliation(s)
- Linchun Wen
- Department of Oncology, Suqian People's Hospital of Nanjing, Gulou Hospital Group, Suqian, Jiangsu, P.R. China
| | - Chuanwen You
- Department of Oncology, Suqian People's Hospital of Nanjing, Gulou Hospital Group, Suqian, Jiangsu, P.R. China
| | - Xiyan Lu
- Department of Oncology, Suqian People's Hospital of Nanjing, Gulou Hospital Group, Suqian, Jiangsu, P.R. China
| | - Longzhen Zhang
- Department of Radiotherapy, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, P.R. China
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Wu SY, Wu YH, Yang MW, Hsueh WT, Hsiao JR, Tsai ST, Chang KY, Chang JS, Yen CJ. Comparison of concurrent chemoradiotherapy versus neoadjuvant chemotherapy followed by radiation in patients with advanced nasopharyngeal carcinoma in endemic area: experience of 128 consecutive cases with 5 year follow-up. BMC Cancer 2014; 14:787. [PMID: 25351202 PMCID: PMC4228264 DOI: 10.1186/1471-2407-14-787] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 10/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background Combined radiotherapy and chemotherapy is considered the standard of care for locally advanced nasopharyngeal carcinoma (LA-NPC) in Epstein-Barr virus infection endemic area. This study compared the long-term outcomes between LA-NPC patients treated with neoadjuvant chemotherapy followed by radiotherapy (NACT) and those treated with concurrent chemoradiotherapy (CCRT). Methods From 2003 to 2007, a total of 128 histopathologically proven LA-NPC patients receiving either NACT or CCRT were consecutively enrolled at the National Cheng Kung University Hospital in Taiwan. NACT consisted of 3-week cycles of mitomycin, epirubicin, and cisplatin on day 1 and fluorouracil and leucovorin on day 8 (MEPFL) or weekly alternated cisplatin on day 1 and fluorouracil and leucovorin on day 8 (P-FL). CCRT comprised 3-week cycles of cisplatin (Cis 100) or 4-week cycles of cisplatin and fluorouracil (PF4). The first failure site, disease free survival (DFS), overall survival (OS), and other prognostic factors were analyzed. Results Thirty-eight patients (30%) received NACT. Median follow-up duration was 53 months. More patients with advanced nodal disease (N2-N3) (86.8% vs 67.8%, p =0.029) and advanced clinical stage (stage IVA-IVB) enrolled in the NACT group (55.2% vs 26.7%, p =0.002). For NACT, both MEPFL and P-FL had similar 5-year DFS and OS (52.9% vs 50%, p =0.860 and 73.5% vs 62.5%, p =0.342, respectively). For CCRT, both PF4 and Cis 100 had similar 5-year DFS and OS (62.8% vs 69.6%, p =0.49 and 72.9% vs 73.9%, p =0.72, respectively). Compared to CCRT, NACT had similar 5-year DFS and OS (51.5% vs 65.1%, p =0.28 and 71.7% vs 74.3%, p =0.91, respectively). Among patients who were recurrence-free in the first 2 years after treatment, those treated with NACT experienced poorer locoregional control compared to those treated with CCRT (Hazard ratio =2.57, 95% confidence interval: 1.02 to 6.47, p =0.046). Conclusions For LA-NPC, both CCRT and NACT were similarly efficacious treatment strategies in terms of long-term disease control and survival probability. Close locoregional follow-up is recommended for patients receiving NACT, because these patients are more prone to develop locoregional failure than patients receiving CCRT.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Chia-Jui Yen
- Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
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Zeng L, Tian YM, Sun XM, Huang Y, Chen CY, Han F, Liu S, Lan M, Guan Y, Deng XW, Lu TX. Intensity-modulated radiotherapy for stage IVA/IVB nasopharyngeal carcinoma: clinical outcomes and patterns of failure in an endemic area in China. Strahlenther Onkol 2014; 190:993-1000. [PMID: 24838409 DOI: 10.1007/s00066-014-0680-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to analyze the mode of relapse patterns and survival of 209 patients with stage IVA and IVB nasopharyngeal carcinoma (NPC). PATIENTS AND MATERIALS A total of 209 patients who underwent magnetic resonance imaging (MRI) and were subsequently histologically diagnosed with nondisseminated stage IV NPC received intensity-modulated radiotherapy (IMRT) as their primary treatment and were included in this retrospective study. RESULTS Median follow-up time was 65 months (range, 3-108 months). The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates for patients with stage IVA and stage IVB NPC were 72.7 vs. 60.0 % (p = 0.319), 62.9 vs. 51.3 % (p = 0.070), 82.9 vs. 93.1 % (p = 0.070), 82.9 vs. 82.9 % (p = 0.897), 76.4 vs. 58.5 % (p = 0.003), respectively. Age older than 44 years was found to be a statistically significant adverse independent prognostic factor for OS. Patients with advanced N status had worse OS, DFS, and DMFS rates. Patients with a primary gross tumor volume (GTV-P) ≥ 55.11 ml had worse OS, DFS, and LRRFS rates. CONCLUSION The results of treating stage IVA NPC with IMRT were excellent. Distant metastasis remains the most difficult treatment challenge for patients with stage IVA and IVB NPC, and more effective systemic chemotherapy should be explored.
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Affiliation(s)
- Lei Zeng
- State Key Laboratory Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
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Chen JLY, Huang YS, Kuo SH, Chen YF, Hong RL, Ko JY, Lou PJ, Tsai CL, Chen WY, Wang CW. Intensity-modulated radiation therapy for T4 nasopharyngeal carcinoma. Treatment results and locoregional recurrence. Strahlenther Onkol 2013; 189:1001-8. [PMID: 24158634 DOI: 10.1007/s00066-013-0429-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 07/18/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this work was to examine outcomes in patients with T4 nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). METHODS AND MATERIALS Between 2007 and 2010, 154 patients with nonmetastatic T4 NPC were treated with IMRT to a total dose of 70 Gy in 33-35 fractions. In addition, 97% of patients received concurrent platinum-based chemotherapy. The median follow-up time was 52.8 months. RESULTS The rates of 5-year actuarial locoregional control, distant metastasis-free survival, progression free-survival, and overall survival (OS) were 81.2, 72.2, 61.9, and 78.1%, respectively. A total of 27 patients had locoregional recurrence: 85.2% in-field failures, 11.1% marginal failures, and 3.7% out-of-field failures. Fourteen patients with locoregional recurrence received aggressive treatments, including nasopharyngectomy, neck dissection, or re-irradiation, and the 5-year OS rate tended to be better (61.9%) compared to those receiving conservative treatment (32.0%, p=0.051). In patients treated with 1 course of radiotherapy, grade ≥3 toxicities of ototoxicity, neck fibrosis, xerostomia, epistaxis, and radiographic temporal lobe necrosis occurred in 18.2, 9.8, 6.3, 2.1, and 5.6% of patients, respectively. Increased ototoxicity, osteonecrosis, severe nasal bleeding, and temporal necrosis were observed in patients treated by re-irradiation. CONCLUSION IMRT offers good locoregional control in patients with T4 NPC. For patients with locoregional recurrence after definitive radiotherapy, aggressive local treatment may be considered for a better outcome.
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Affiliation(s)
- J L-Y Chen
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, 100, Taipei, Taiwan
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Fan TY, Xing J, Lu J, Liu TH, Xu M, Zhang YJ, Shao Q, Li JB, Yu JM. Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncol Lett 2013; 5:889-895. [PMID: 23426016 PMCID: PMC3576218 DOI: 10.3892/ol.2013.1137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 01/07/2013] [Indexed: 01/09/2023] Open
Abstract
This study aimed to evaluate the efficacy, toxicity and tolerability of simultaneous modulated accelerated radiation therapy (SMART)-intensity modulated radiotherapy (IMRT) plus cisplatin and 5-fluorouracil (5-FU) chemotherapy for patients with advanced nasopharyngeal cancer (NPC). Forty-five patients with stage II–IV NPC, determined by the American Joint Committee on Cancer system, were treated with prescribed doses of 72 Gy total to the gross tumor volume, 60 Gy to the clinical target volume and metastatic nodal station, and 54 Gy to the clinically-negative neck region. Before radiotherapy, two cycles of cisplatin (30 mg/m2/day on days 1–3) plus 5-FU (400 mg/m2/day on days 1–5) were delivered every three weeks for two cycles. Patients received two cycles of cisplatin (30 mg/m2 day on days 1–3) every three weeks during radiotherapy. In addition, two cycles of cisplatin and 5-FU were given after radiation. All patients completed the prescribed radiotherapy and all scheduled cycles of chemotherapy. Thirty of the 45 patients (66.6%) had a complete response at the end of treatment. Grade 3 mucositis occurred in 4/45 patients (8.8%) and grade 3 dermatitis occurred in 5/45 (11.1%) during radiotherapy. Grade 3 neutropenia occurred in 6/45 (13.3%) during concurrent chemotherapy. There was no treatment-related mortality. After a median follow-up time of 51 months, only three patients’ treatments had failed. Local and distant failure rates were 1.5 and 3.0%, respectively. SMART-IMRT plus cisplatin and 5-FU chemotherapy showed promising activity with manageable toxicity. It is a feasible regimen and improves locoregional disease control.
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Affiliation(s)
- Ting-Yong Fan
- School of Medicine, Shandong University, Jinan, Shandong 250012; ; Shandong Cancer Hospital and Institute, Jinan, Shandong 240117, P.R. China
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Adjuvant chemotherapy in advanced nasopharyngeal carcinoma based on plasma EBV load. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s13566-012-0036-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Chien CR, Lin HW, Yang CH, Yang SN, Wang YC, Kuo YC, Chen SW, Liang JA. High case volume of radiation oncologists is associated with better survival of nasopharyngeal carcinoma patients treated with radiotherapy: a multifactorial cohort analysis. Clin Otolaryngol 2011; 36:558-65. [DOI: 10.1111/j.1749-4486.2011.02405.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chan SC, Chang JT, Lin CY, Ng SH, Wang HM, Liao CT, Chang CJ, Lin SY, Yen TC. Clinical utility of 18F-FDG PET parameters in patients with advanced nasopharyngeal carcinoma. Nucl Med Commun 2011; 32:989-96. [DOI: 10.1097/mnm.0b013e3283495662] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chang YC, Chen SY, Ting LL, Peng SSF, Wang TC, Wang TG. A 2-year follow-up of swallowing function after radiation therapy in patients with nasopharyngeal carcinoma. Arch Phys Med Rehabil 2011; 92:1814-9. [PMID: 21840500 DOI: 10.1016/j.apmr.2011.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 06/10/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate over a 2-year period the serial swallowing function of patients with nasopharyngeal carcinoma (NPC) after completing radiotherapy (RT). DESIGN Prospective longitudinal follow-up. SETTING University hospital. PARTICIPANTS Patients with NPC (N=76) referred for RT: 53 of them at 1 year after RT, and 23 at 2 years after RT. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants completed a questionnaire and had a video-recorded fluoroscopic swallowing study before RT and 1 month, 1 year, and 2 years after RT. RESULTS The highest incidence of dysphagia symptoms and retropharyngeal soft tissue swelling occurred in the first month after RT and decreased over time. Pharyngeal transit time was prolonged continuously up to 1 year after RT. Epiglottic vallecular stasis and pharyngeal mucosal coating were worst in the first month after RT and stable afterwards. Aspiration was uncommon during the first 2 years after RT. CONCLUSIONS At a 2-year follow-up after RT, patients with NPC had a progressively increasing pharyngeal transit time, although the subjectively identified symptoms of dysphagia decreased after the first month after RT.
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Affiliation(s)
- Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Hu YC, Chang CH, Chen CH, Ger LP, Liu WS, Lin LC, Leung CM, Chang KC. Impact of intracranial extension on survival in stage IV nasopharyngeal carcinoma: identification of a subset of patients with better prognosis. Jpn J Clin Oncol 2010; 41:95-102. [PMID: 20852300 DOI: 10.1093/jjco/hyq171] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE T-stage is an imperfect prognostic indicator for patients with nasopharyngeal carcinoma. We evaluated the effect of extent of intracranial involvement on survival after conventional radiotherapy in patients with Stage T4 nasopharyngeal carcinoma. METHODS We conducted a retrospective analysis of the results of computed tomography, magnetic resonance imaging and treatment outcomes in 84 consecutive patients with Stage T4 nasopharyngeal carcinoma during the period September 1993 to December 2002 in Taiwan. The patients were subcategorized into those who had limited intracranial involvement (primary nasopharyngeal tumors with involvement of the unilateral cavernous sinus or the parasellar region only) or extensive involvement (extension of the tumors to the bilateral cavernous sinus or the parasellar region, into the orbit and the ethmoid sinus anteriorly, or to the prepontine region and the posterior cranial fossa). RESULTS Extensive intracranial involvement was found in 51.2% of the patients. Among these patients, the 5-year rate of overall survival after conventional radiotherapy was only 3.4%. In contrast, the 5-year survival among patients with limited intracranial involvement was 42.9%. This difference was significant (P < 0.001). In the multivariate analysis, extensive intracranial involvement, advanced age and a nodal status of N3 correlated with poor overall survival (all P < 0.05). CONCLUSIONS Among patients with T4 nasopharyngeal carcinoma, better treatment outcomes were associated with limited intracranial involvement. We conclude that a subdivision of Stage T4 nasopharyngeal carcinoma disease based on the extent of intracranial involvement would provide better prognostic information.
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Affiliation(s)
- Yu-Chang Hu
- Department of Radiation Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Zheng J, Wang G, Yang GY, Wang D, Luo X, Chen C, Zhang Z, Li Q, Xu W, Li Z, Wang D. Induction Chemotherapy with Nedaplatin with 5-FU Followed by Intensity-modulated Radiotherapy Concurrent with Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma. Jpn J Clin Oncol 2010; 40:425-31. [DOI: 10.1093/jjco/hyp183] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shih C, Ko JY, Wang CP, Ting LL, Hsiao JK. Recurrent Nasopharyngeal Carcinoma Presenting as a Positron Emission Tomography False-negative Scan. Tzu Chi Med J 2009. [DOI: 10.1016/s1016-3190(09)60064-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Yen RF, Ting LL, Cheng MF, Wu YW, Tzen KY, Hong RL. Usefulness of201TL SPECT/CT relative to18F-FDG PET/CT in detecting recurrent skull base nasopharyngeal carcinoma. Head Neck 2009; 31:717-24. [DOI: 10.1002/hed.21026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wee J. 4th FY Khoo Memorial Lecture 2008: Nasopharyngeal Cancer Workgroup – The Past, The Present and The Future. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2008. [DOI: 10.47102/annals-acadmedsg.v37n7p606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Ma BBY, Hui EP, Chan ATC. Systemic approach to improving treatment outcome in nasopharyngeal carcinoma: current and future directions. Cancer Sci 2008; 99:1311-8. [PMID: 18498420 PMCID: PMC11158701 DOI: 10.1111/j.1349-7006.2008.00836.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Revised: 03/22/2008] [Accepted: 03/27/2008] [Indexed: 12/13/2022] Open
Abstract
Systemic therapy is an integral part of the management of non-keratinizing nasopharyngeal carcinoma (NPC). The purposes of this review are to provide the latest results and future directions of clinical and translational research for this disease, and to illustrate how some of these new therapies have improved the treatment outcome for patients with NPC. Particular attention will be paid to the clinical application of chemotherapy in the adjunctive treatment of locoregionally advanced NPC, novel targeted drugs, Epstein-Barr virus-targeted vaccine therapies, and the use of plasma Epstein-Barr virus DNA as a biomarker for selecting patients for adjunctive therapies.
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Affiliation(s)
- Brigette B Y Ma
- Department of Clinical Oncology at the Sir Y. K. Pao Center for Cancer, Prince of Wales Hospital, Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, China
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