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Zhang C, Zhan Z, Fang Y, Ruan Y, Lin M, Dai Z, Zhang Y, Yang S, Xiao S, Chen B. Prognostic nutritional index and serum lactate dehydrogenase predict the prognosis of nasopharyngeal carcinoma patients who received intensity-modulated radiation therapy. J Cancer Res Clin Oncol 2023; 149:17795-17805. [PMID: 37934254 DOI: 10.1007/s00432-023-05485-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE This research aimed to evaluate the prognostic significance of baseline prognostic nutritional index (PNI) and lactate dehydrogenase (LDH) for the outcome of individuals diagnosed with non-metastatic nasopharyngeal carcinoma (NPC). METHODS A retrospective analysis was conducted on data from 810 patients with non-metastatic NPC who underwent intensity-modulated radiation therapy (IMRT) with or without chemotherapy. The best cut-offs for PNI and LDH were identified by X-tile software to be 48.5 and 150, respectively. To find the independent prognostic factors for survival outcomes, univariate and multivariate regression analyses were conducted, and AUCs were used to compare their prognostic values. RESULTS Multivariate analysis revealed that patients with PNI > 48.5 had better overall survival (OS) (HR: 0.502, P < 0.001), progression-free survival (PFS) (HR: 0.618, P < 0.001), and distant metastasis-free survival (DMFS) (HR: 0.637, P = 0.005). Higher LDH was associated with poorer OS (HR: 1.798, P < 0.001), PFS (HR: 1.671, P < 0.001), and DMFS (HR: 1.756, P < 0.001). The combination of low PNI and high LDH in non-metastatic NPC patients was correlated with poor OS (P < 0.001), PFS (P < 0.001), and DMFS (P < 0.001). The combination of PNI and LDH had the highest AUCs for predicting OS, PFS, and DMFS. CONCLUSIONS PNI and LDH might become valuable predictors of the prognosis of non-metastatic NPC patients undergoing IMRT with or without chemotherapy. Prognostic accuracy can be enhanced by combining PNI and LDH.
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Affiliation(s)
- Chunxia Zhang
- Department of Critical Care Medicine, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350014, China
| | - Zhouwei Zhan
- Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Yunxiang Fang
- Clinical Oncology School, Fujian Medical University, Fujian, China
| | - Yuanyuan Ruan
- Clinical Oncology School, Fujian Medical University, Fujian, China
| | - Mingan Lin
- Clinical Oncology School, Fujian Medical University, Fujian, China
| | - Zhisen Dai
- Department of Anesthesiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Yanping Zhang
- Department of Anesthesiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Shanshan Yang
- Clinical Oncology School, Fujian Medical University, Fujian, China
| | - Shuxiang Xiao
- Clinical Oncology School, Fujian Medical University, Fujian, China
| | - Bijuan Chen
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China.
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Shen DS, Yan C, Chen KH, Li L, Qu S, Zhu XD. A Nomogram Based on Circulating CD4 + T Lymphocytes and Lactate Dehydrogenase to Predict Distant Metastasis in Patients with Nasopharyngeal Carcinoma. J Inflamm Res 2021; 14:6707-6718. [PMID: 34916820 PMCID: PMC8668247 DOI: 10.2147/jir.s341897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Distant metastasis is the main pattern of treatment failure in nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT). We aimed to establish and validate a prognostic nomogram to identify patients with a high risk of distant metastasis. Patients and Methods A total of 503 patients with nonmetastatic NPC were included in this retrospective study. We established a prognostic nomogram for distant metastasis-free survival (DMFS) based on the Cox proportional hazards model. The predictive discriminative ability and accuracy of the nomogram were assessed with the concordance index (C-index), receiver operating characteristic (ROC) curve, and calibration curve. The nomogram’s clinical utility was also evaluated using decision curve analysis (DCA) and Kaplan–Meier method. The predictive ability of the nomogram was validated in an independent cohort. Results The multivariate analysis showed that circulating CD4+ T lymphocytes, lactate dehydrogenase (LDH), serum ferritin (SF), and N stage were independent prognostic factors for DMFS. Then, we constructed the nomogram based on these factors. The C-indexes of the nomogram for distant metastasis were 0.763 (95% CI: 0.685–0.841) and 0.760 (95% CI: 0.643–0.877) in the training cohort and validation cohort, respectively, which was higher than the 8th TNM staging system (0.672 and 0.677). The calibration curve showed that the prediction results of the nomogram were in high agreement with the actual observation. The ROC curve indicated that the nomogram had a better predictive ability than TNM staging. The DCA also demonstrated that the nomogram was clinically beneficial. In addition, the patients were classified into two different risk groups (high-risk, low-risk) by the nomogram. Conclusion As a supplement to TNM staging, our nomogram could provide a more effective and accurate prognostic prediction of distant metastasis in NPC patients. It has the potential to guide the individualized treatment of patients to improve their survival.
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Affiliation(s)
- De-Song Shen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Chang Yan
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Ling Li
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Song Qu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.,Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, 530199, People's Republic of China
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Heidari Beigvand H, Heidari K, Hashemi B, Saberinia A. The Value of Lactate Dehydrogenase in Predicting Rhabdomyolysis-Induced Acute Renal Failure; a Narrative Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e24. [PMID: 34027419 PMCID: PMC8126348 DOI: 10.22037/aaem.v9i1.1096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Introduction Determining the diagnostic value of available biomarkers in predicting rhabdomyolysis-induced acute kidney injury (AKI) is a priority. This study aimed to review the current evidence about the value of lactate dehydrogenase (LDH) in this regard. Methods In this narrative review, the papers in PubMed, Embase, and web of science were studied. The keywords prognosis, prognoses, prognostic, LDH, rhabdomyolysis, emergency patients, and acute kidney failure or AKI had been selected from MeSH medical dictionary. Related papers written in English and published from November 2007 to December 2020 were selected. Results Finally, 14 articles were accepted for analysis. Among the selected articles, four were randomized clinical trials, seven were cross-sectional, and three were case-control studies. The results of the present review showed that abuse of illegal drugs is the most common cause of rhabdomyolysis. AKI is the most serious complication of rhabdomyolysis reported in the studies. These studies have shown a three-fold increase in AKI following drug-induced rhabdomyolysis. The review of the included articles shows that high LDH can predicts AKI, especially in critical and emergency situations such as rhabdomyolysis where there is a risk of death if diagnosed late. These studies show that LDH increases in the presence of renal failure and tissue damage. Conclusion Serum LDH is an appropriate and cost-effective prognostic indicator that can be used for risk classification of patients at risk for rhabdomyolysis-induced AKI.
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Affiliation(s)
- Hazhir Heidari Beigvand
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Heidari
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behrooz Hashemi
- Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Saberinia
- Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Emergency Department, Bahonar Hospital, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Xizhi L, Lifen Z, Xueqin D, Wenwen Z, Shangke H, Minna L, Xinhan Z. Clinicopathological Characteristics and Prognosis of Nasopharyngeal Lymphoepithelial Carcinoma: A Population-Based Retrospective Study. Med Sci Monit 2020; 26:e924492. [PMID: 32865186 PMCID: PMC7482507 DOI: 10.12659/msm.924492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The aim of this study was to establish a predictive model for prognostic factors and overall survival (OS) in nasopharyngeal lymphoepithelial carcinoma (NLEC) patients. Material/Methods The data of 538 NLEC patients diagnosed between 1988 and 2015 were extracted from the Surveillance, Epidemiology, and End Results database. Patients who were diagnosed from 1988 to 1999 were included in the validation cohort, and those diagnosed from 2000 to 2015 in the primary cohort. Least absolute shrinkage and selection operator and multivariate Cox regression analyses were performed. The discrimination and calibration capabilities of the predictive models were evaluated using the receiver operating characteristic (ROC) curve and calibration plot, respectively. Results Radiotherapy (P<0.0001), early-stage cancer based on the American Joint Committee on Cancer (AJCC) staging system (P<0.0001), younger age (P=0.0005) were associated with better OS rates. In the primary cohort, the areas under the ROC curves (AUC) of the nomogram for predicting 1-, 10-, and 15-year OS were 0.749, 0.754, and 0.81, respectively. Meanwhile, in the validation cohort, the AUC of the nomogram for predicting 1-, 10-, and 15-year OS were 0.692, 0.692, and 0.682, respectively. Furthermore, the calibration plot exhibited optimal agreements between the nomogram-predicted and actual 1-, 10-, and 15-year OS in both cohorts. The 1-, 10-, and 15-year OS rates were 93.6%, 62.7%, and 49.9%, respectively. Conclusions Age, early-stage cancer based on the AJCC staging system, radiotherapy, and gender can be used to predict OS in nasopharyngeal lymphoepithelial carcinoma patients.
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Affiliation(s)
- Liu Xizhi
- Department of Oncology, The First Affiliated Hospital of Xian Jiao Tong University, Xian, Shaanxi, China (mainland)
| | - Zhang Lifen
- Department of Oncology, The First Affiliated Hospital of Xian Jiao Tong University, Xian, Shaanxi, China (mainland)
| | - Duan Xueqin
- Department of Oncology, The First Affiliated Hospital of Xian Jiao Tong University, Xian, Shaanxi, China (mainland)
| | - Zhang Wenwen
- Department of Oncology, The First Affiliated Hospital of Xian Jiao Tong University, Xian, Shaanxi, China (mainland)
| | - Huang Shangke
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland)
| | - Luo Minna
- Department of Hematology, The First Affiliated Hospital of Xian Jiao Tong University, Xian, Shaanxi, China (mainland)
| | - Zhao Xinhan
- Department of Oncology, The First Affiliated Hospital of Xian Jiao Tong University, Xian, Shaanxi, China (mainland)
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Long G, Tang W, Fu X, Liu D, Zhang L, Hu G, Hu G, Sun W. Pre-treatment Serum Lactate Dehydrogenase Predicts Distant Metastasis and Poor Survival in Nasopharyngeal Carcinoma. J Cancer 2019; 10:3657-3664. [PMID: 31333783 PMCID: PMC6636291 DOI: 10.7150/jca.32716] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/16/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Pre-treatment serum lactate dehydrogenase (LDH) has emerged as prognostic factor for many cancers. In this study, we evaluated the value of LDH in predicting distant metastasis and poor survival for patients with nasopharyngeal carcinoma (NPC). Methods: Clinical data from 172 non-metastatic NPC patients were retrospectively collected and serum LDH levels were routinely measured before treatment. The independent-samples t test was used to calculate differences between serum LDH levels from the various patient groups. Receiver-operating characteristic (ROC) curve analysis was performed to select the optimal cutoff points. The Kaplan-Meier method and log-rank test were adopted to calculate and compare the distant metastasis free survival (DMFS) and overall survival (OS) rates. The Cox proportional hazards model was used to carry out univariate and multivariate analyses. Results: NPC patients progressed with distant metastasis often have higher pre-treatment serum LDH levels than those did not develop distant metastasis (mean LDH level was 237.1U/L and 108.8U/L, respectively, p=0.001). Elevated LDH level was identified as an independent prognostic factor for poor DMFS (hazard ratio (HR), 8.31; 95% confidence interval (CI), 2.44-28.32; p=0.001) and OS (HR, 4.45; 95% CI, 1.77-11.21; p=0.002). Moreover, subgroup analyses revealed significant associations between serum LDH level and worse survival in advanced stage patients. Conclusions: Pre-treatment serum LDH level can predict distant metastasis and associate with the poor survival in patients with NPC.
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Affiliation(s)
- Guoxian Long
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - Wenhua Tang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - Xiugen Fu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - DongBo Liu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - LinLi Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - Guangyuan Hu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - Guoqing Hu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
| | - Wei Sun
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan 430030, People's Republic of China
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Liu D, Wang D, Wu C, Zhang L, Mei Q, Hu G, Long G, Sun W. Prognostic significance of serum lactate dehydrogenase in patients with breast cancer: a meta-analysis. Cancer Manag Res 2019; 11:3611-3619. [PMID: 31118783 PMCID: PMC6497911 DOI: 10.2147/cmar.s199260] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 03/21/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Multiple studies have assessed the prognostic significance of serum lactate dehydrogenase (LDH) in patients with breast cancer, but their results remain controversial. This study aimed to evaluate the prognostic value of LDH in breast cancer by meta-analysis. Methods: Electronic searches for relevant articles were conducted in PubMed, Embase and Web of Science databases. The HR and their 95% CI were used to assess the prognostic value of serum LDH. Stata Statistical Software 12.0 was applied for statistical analysis. Results: A total of 11 studies involving 6,102 patients were subjected to final analysis. Our results showed that higher serum LDH had significant effect on poor overall survival (HR, 1.88; 95% CI, 1.68–2.11) and progression-free survival (HR, 1.98; 95% CI, 1.46–2.68). Moreover, the results of subgroup analyses were consistent with that of overall outcomes. No significant heterogeneity and publication bias were found in this study. Conclusion: Serum LDH could act as a prognostic factor for patients with breast cancer. Future data are needed to validate and update our results.
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Affiliation(s)
- Dongbo Liu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Dingkun Wang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Cheng Wu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Linli Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Qi Mei
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Guangyuan Hu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Guoxian Long
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
| | - Wei Sun
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, People's Republic of China
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Cao C, Wei Q, Tang X, Jia Y, Sun X, Li W, Hu Q, Chen X. PD-1 and PD-L1 in locoregionally advanced nasopharyngeal carcinoma: Substudy of a randomized phase III trial. Head Neck 2018; 41:1427-1433. [PMID: 30582240 DOI: 10.1002/hed.25601] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 08/30/2018] [Accepted: 12/03/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To evaluate the expression of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) by using immunohistochemistry analysis in locoregionally advanced nasopharyngeal carcinoma (NPC) patients receiving cisplatin, fluorouracil, and docetaxel followed by concurrent chemoradiotherapy. METHODS As part of a previously reported trial, 108 patients were enrolled in this study. RESULTS We observed that Epstein-Barr Virus (EBV) antibody levels were associated with PD-1 positive staining in NPC and PD-1 positive staining was identified as an independent prognostic factor for progression-free survival (hazard ratio 0.363, 95% confidence interval 0.134-0.987, P = .047). By contrast, the correlation between the PD-L1 level and hemoglobin, lactate dehydrogenase and high-sensitivity C-reactive protein was not identified. Moreover, high levels of PD-L1 staining were not significantly associated with clinical outcomes. CONCLUSION NPC patients with negative PD-1 staining had a significantly reduced survival outcome. Furthermore, patients with positive PD-1 staining had significantly higher EBV antibody levels.
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Affiliation(s)
- Caineng Cao
- Department of Radiation Oncology, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Qichun Wei
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiuwen Tang
- Department of Biochemistry and Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yongshi Jia
- Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Xiaonan Sun
- Department of Radiation Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenfeng Li
- Department of Chemoradiation Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiaoying Hu
- Department of Radiation Oncology, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Xiaozhong Chen
- Department of Radiation Oncology, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
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Jia F, Xu D, Yue H, Wu H, Li G. Comparison of Flattening Filter and Flattening Filter-Free Volumetric Modulated Arc Radiotherapy in Patients with Locally Advanced Nasopharyngeal Carcinoma. Med Sci Monit 2018; 24:8500-8505. [PMID: 30472719 PMCID: PMC6276721 DOI: 10.12659/msm.910218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to investigate the therapeutic role of flattening filter-free (FFF) mode in volumetric modulated arc therapy (VMAT) compared with flattening filter (FF) mode in patients with locally advanced nasopharyngeal carcinoma (NPC). MATERIAL AND METHODS Ten previously treated patients with NPC underwent treatment re-planning with FFF and FF VMAT. Radiotherapy dose distribution on planning target volume (PTV), organs at risk (OAR), target conformity index (CI), total monitor units (MUs), and therapeutic time were compared. RESULTS Maximum and mean radiotherapy dose in PTV and PGTV (primary lesions of NPC and cervical lymph node metastases) in FFF VMAT planning were significantly increased compared with FF VMAT planning, but PTV and OAR showed no significant differences. The CI value of PTV in FFF VMAT planning was significantly reduced compared with FF planning (P<0.05). No differences were found for the maximum radiotherapy dose in the spinal cord and left and right optic nerve, and the mean radiotherapy dose in the brainstem, left and right parotid gland (P>0.05). The maximum dose in the brainstem in the FFF planning was significantly higher compared with FF planning (P>0.05). The maximum radiotherapy dose in left and right crystalline lens (P<0.05) in FFF planning was significantly reduced compared with FF planning. The total hop count in FFF planning was significantly increased compared with FF planning (P<0.05). CONCLUSIONS Both 6 MV X-ray FFF mode and FF mode in the treatment of patients with NPC showed that FFF VMAT planning provided improved protection for OAR.
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Affiliation(s)
- Fei Jia
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Dandan Xu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Haizhen Yue
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Hao Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Guowen Li
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
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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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Yang X, Liu H, He M, Liu M, Zhou G, Gong P, Ma J, Wang Q, Xiong W, Ren Z, Li X, Zhang X. Prognostic value of pretreatment C-reactive protein/albumin ratio in nasopharyngeal carcinoma: A meta-analysis of published literature. Medicine (Baltimore) 2018; 97:e11574. [PMID: 30045284 PMCID: PMC6078726 DOI: 10.1097/md.0000000000011574] [Citation(s) in RCA: 11] [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] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND To explore the prognostic value of C-reactive protein/albumin ratio (CAR) in nasopharyngeal carcinoma (NPC), we conducted a comprehensive meta-analysis of relevant literature on the association between CAR and NPC outcome. In recent years, an increasing number of studies has been published analyzing the possible prognostic utility of C-reactive protein/albumin ratio (CAR) in nasopharyngeal carcinoma (NPC), but the results are still controversial. METHODS A relevant literature search was performed by using the PubMed, Embase, Web of Science, Cochrane Library, CBM, Wanfang, VIP, and China National Knowledge Infrastructure databases to evaluate the prognostic value of CAR in patients with NPC. The last date of our primary search was December 5, 2017. This meta-analysis was conducted on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled hazard ratio (HR) with 95% confidence interval (95% CI) was utilized to estimate the association of CAR and overall survival (OS) and distant metastasis-free survival (DMFS). RESULTS Five studies that enrolled 5533 patients with NPC were finally quantified. Our findings revealed that high pretreatment CAR was significantly associated with poor OS (HR = 1.58, 95% CI = 1.36-1.83, P < .001) and DMFS (HR = 1.25, 95% CI = 1.09-1.44, P = .002). The findings from most subgroup meta-analyses were in line with those from the overall meta-analyses. No significant heterogeneity was observed among the included studies for OS and DMFS (P > .05); however, publication bias was found for OS (P < .05). CONCLUSION Our meta-analysis suggests that high pretreatment CAR indicates poor prognosis in NPC. Thus, pretreatment CAR serves as a prognostic marker in NPC and can be used to evaluate prognosis in clinical work.
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Affiliation(s)
- Xiaodi Yang
- Department of Epidemiology and Biostatistics
| | | | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Meitian Liu
- Department of Epidemiology and Biostatistics
| | - Ge Zhou
- Department of Epidemiology and Biostatistics
| | - Ping Gong
- Department of Epidemiology and Biostatistics
| | - Juan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics
| | | | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xuanxuan Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
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Yu BB, Lin GX, Li L, Qu S, Liang ZG, Chen KH, Zhou L, Lu QT, Sun YC, Zhu XD. Cofilin-2 Acts as a Marker for Predicting Radiotherapy Response and Is a Potential Therapeutic Target in Nasopharyngeal Carcinoma. Med Sci Monit 2018; 24:2317-2329. [PMID: 29664897 PMCID: PMC5921956 DOI: 10.12659/msm.909832] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The purpose of this study was to determine whether cofilin-2 could serve as a protein marker for predicting radiotherapy response and as a potential therapeutic target in nasopharyngeal carcinoma (NPC). Material/Methods Cofilin-2 protein levels in serum and tissue samples from patients with NPC were assessed by sandwich ELISA and IHC. In vitro, cofilin-2 levels in CNE-2R cells were significantly higher than those of CNE-2 cells. Meanwhile, CNE-2R cells were silenced for cofilin-2 to obtain a stable cofilin-2-RNAi-LV3 cell line. Then, cell proliferation, radiosensitivity, invasion and migration abilities, cell cycle, and apoptosis were evaluated by Cell Counting Kit 8 assay (CCK-8), flow cytometry (FCM), clone formation assay, and in vitro. Results The secreted levels of the cofilin-2 protein in radioresistant NPC patients were significantly higher than those of radiosensitive cases. After cofilin-2 knockdown in nasopharyngeal carcinoma CNE-2R cells, proliferation was decreased, while apoptosis and radiosensitivity were enhanced; cell cycle distribution was altered, and the transplanted tumors in nude mice grew significantly less. Conclusions Overall, our findings suggest that cofilin-2 acts as a marker for predicting radiotherapy response and is a potential therapeutic target in nasopharyngeal carcinoma.
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Affiliation(s)
- Bin-Bin Yu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Guo-Xiang Lin
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Ling Li
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland).,Key Laboratory of High-Incidence Tumor Prevention and Treatment (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China (mainland)
| | - Song Qu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland).,Key Laboratory of High-Incidence Tumor Prevention and Treatment (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China (mainland)
| | - Zhong-Guo Liang
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Kai-Hua Chen
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Lei Zhou
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Qi-Teng Lu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Yong-Chu Sun
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University and Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Guangxi Medical University, Nanning, Guangxi, China (mainland).,Key Laboratory of High-Incidence Tumor Prevention and Treatment (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China (mainland).,Department of Oncology, Affiliated Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
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12
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Lin Q, Wang H, Lin X, Zhang W, Huang S, Zheng Y. PTPN12 Affects Nasopharyngeal Carcinoma Cell Proliferation and Migration Through Regulating EGFR. Cancer Biother Radiopharm 2018; 33:60-64. [PMID: 29634414 DOI: 10.1089/cbr.2017.2254] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Nasopharyngeal carcinoma (NPC) shows the leading morbidity in otorhinolaryngological malignant tumor. It is a common malignancy in China with obvious reginal distribution. NPC is a polygenic disease that is affected by numerous factors. Protein tyrosine phosphatase nonreceptor type 12 (PTPN12) regulates multiple tumor proliferation and development, including breast cancer and colon cancer. However, the role of PTPN12 in NPC occurrence and development has not been elucidated. PATIENTS AND METHODS NPC cell line CNE2 was cultured in vitro and divided into three groups, including control, empty plasmid, and PTPN12 groups. PTPN12 mRNA and protein expressions were tested by real-time polymerase chain reaction and Western blot. CNE2 cell proliferation was detected by MTT assay. Cell migration was determined by wound healing assay. Cell apoptosis was evaluated by caspase 3 activity detection. Epidermal growth factor receptor (EGFR) expression was assessed by Western blot. RESULTS PTPN12 plasmid transfection increased PTPN12 mRNA and protein expressions, suppressed cell proliferation and migration, reduced EGFR level, and enhanced caspase 3 activity compared with control and empty plasmid groups (p < 0.05). CONCLUSIONS PTPN12 regulates NPC proliferation and migration through negative regulating EGFR. It could be treated as a molecular target for NPC diagnosis and prognosis analysis.
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Affiliation(s)
- Qinghai Lin
- Department of Otolaryngology, First Affiliated Hospital of Shantou University Medical College , Shantou, Guangdong, China
| | - Huige Wang
- Department of Otolaryngology, First Affiliated Hospital of Shantou University Medical College , Shantou, Guangdong, China
| | - Xinqiang Lin
- Department of Otolaryngology, First Affiliated Hospital of Shantou University Medical College , Shantou, Guangdong, China
| | - Wenrui Zhang
- Department of Otolaryngology, First Affiliated Hospital of Shantou University Medical College , Shantou, Guangdong, China
| | - Shuhua Huang
- Department of Otolaryngology, First Affiliated Hospital of Shantou University Medical College , Shantou, Guangdong, China
| | - Yandan Zheng
- Department of Otolaryngology, First Affiliated Hospital of Shantou University Medical College , Shantou, Guangdong, China
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13
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Oei RW, Ye L, Kong F, Du C, Zhai R, Xu T, Shen C, Wang X, He X, Kong L, Hu C, Ying H. Pre-treatment Serum Lactate Dehydrogenase is Predictive of Survival in Patients with Nasopharyngeal Carcinoma Undergoing Intensity-Modulated Radiotherapy. J Cancer 2018; 9:54-63. [PMID: 29290769 PMCID: PMC5743711 DOI: 10.7150/jca.22190] [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: 08/01/2017] [Accepted: 10/24/2017] [Indexed: 12/16/2022] Open
Abstract
Objective:To analyze the prognostic value of pre-treatment serum lactate dehydrogenase (SLDH) level in patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods:From January 2010 to March 2013, 427 eligible patients were reviewed. Pre-treatment SLDH level was measured within 2 weeks prior to treatment. Receiver operating characteristic (ROC) curve analysis was performed to select the optimal cutoff point. The impact of pre-treatment SLDH on overall survival (OS), progression-free survival (PFS) and distant metastasis-free survival (DMFS) were analyzed using Kaplan-Meier method and Cox proportional hazards model. Further propensity score matching was carried out to adjust bias. Results:The optimal cutoff point of 168.5 IU/L was selected based on ROC curve analysis. Multivariate analysis showed that high pre-treatment SLDH level was an independent prognostic factor for OS (P=0.001), PFS (P=0.004) and DMFS (P=0.001). After propensity score matching was performed, it remained to be significantly associated with poor OS (P=0.009), PFS (P=0.015) and DMFS (P=0.008) in the adjusted model. Conclusion:High pre-treatment SLDH level predicts poor survival in patients with NPC treated with IMRT-based therapy. As a routinely performed biomarker, pre-treatment SLDH can be utilized in combination with current Tumor-Node-Metastasis staging to predict survival and to plan a personalized treatment in these patients.
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Affiliation(s)
- Ronald Wihal Oei
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Lulu Ye
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Fangfang Kong
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Chengrun Du
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Ruiping Zhai
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Tingting Xu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Chunying Shen
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Xiaoshen Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Xiayun He
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Lin Kong
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
| | - Hongmei Ying
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China
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14
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Shan GP, Wang BB, Zheng P, Du FL, Yang YW. Efficacy and Safety of Chemotherapy Combined with Stereotactic Radiotherapy in the Treatment of Nasopharyngeal Carcinoma. Med Sci Monit 2017; 23:5630-5636. [PMID: 29176539 PMCID: PMC5716374 DOI: 10.12659/msm.903903] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to investigate the efficacy and safety of chemotherapy (CT) combined with stereotactic radiotherapy (SRT) in the treatment of nasopharyngeal carcinoma (NPC). Material/Methods A total of 329 NPC patients without any previous treatment were included in this study between January 2009 and November 2013. These patients were divided into three groups: CT group (n=114), SRT group (n=109), and CT + SRT group (n=106). Contrast-enhanced nasopharyngeal computed tomography (CT)/magnetic resonance (MR) scan was performed on the third month after treatment. Short-term efficacy was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST). Toxicity was graded according to the Acute Radiation Morbidity Scoring Criteria (RTOG) and the World Health Organization (WHO) toxicity grading scale. Overall survival (OS), progression free survival (PFS), and incidence rate of acute toxicity (grade ≥3) were calculated after a 24 month follow-up. Results Total response rate of all patients was 85.41%. Compared with the CT group and the SRT group, the CT + SRT group showed a substantially improved efficacy in NPC treatment. The incidence rate of the acute toxicity in the CT + SRT group was slightly higher than in the CT group and the SRT group, but the difference was not statistically significant. No treatment-related deaths were observed. The CT + SRT group had the highest two-year OS and PFS, followed by the CT group and the SRT group. Conclusions It was shown that NPC patients treated with CT + SRT had better short- and long-term efficacy than those treated with CT or SRT alone.
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Affiliation(s)
- Guo-Ping Shan
- Department of Radiation Oncology, Zhejiang Cancer Hospital, and Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland)
| | - Bing-Bing Wang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, and Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland)
| | - Peng Zheng
- Department of Radiation Oncology, Zhejiang Cancer Hospital, and Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland)
| | - Feng-Lei Du
- Department of Radiation Oncology, Zhejiang Cancer Hospital, and Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland)
| | - Yi-Wei Yang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, and Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, Zhejiang, China (mainland)
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