Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis

作     者：Ming-Yuan Chen Rou Jiang Ling Guo Xiong Zou Qing Liu Rui Sun Fang Qiu Zhong-Jun Xia Hui-Qiang Huang Li Zhang Ming-Huang Hong Hai-Qiang Mai Chao-Nan Qian 

作者机构：Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center of Cancer Medicine Department of Nasopharyngeal CarcinomaSun Yat-sen University Cancer Center Department of EpidemiologySun Yat-sen University Cancer Center Department of Medical OncologySun Yat-sen University Cancer Center 

出 版 物：《Chinese Journal of Cancer》 (Chinese Journal of Cancer)

年 卷 期：2013年第32卷第11期

页      面：604-613页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by grants from the National Natural Science Foundation of China (No. 81071890 and No. 81030043) Training Programme Foundation for the Talents by Sun Yat-sen University Cancer Center Program for New Century Excellent Talents in University in China Program for New Century Excellent Talents in University (NCET-12-0562) Sun Yat-sen University Clinical Research 5010 Program (201310) Guangdong Provincial Natural Science Foundation of China (S2013020012726) 

主　　题：鼻咽癌 放疗 患者 放射治疗 诊断 多因素分析 转移性 化疗 

摘      要：Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma(NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival(OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio(HR)=0.9, P=0.529]; this risk was 60% lower than that of the group undergoing supportive treatment(HR=0.4, P=0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy(HR=2.3, P0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.