Induction Chemotherapy Combined With Intensity-Modulated Radiotherapy for 129 Nasopharyngeal Carcinoma Patients With Synchronous Metastases: A Retrospective Study

Mengshan Ni; Mengshan Ni; Mengshan Ni; Lijun Geng; Lijun Geng; Lijun Geng; Fangfang Kong; Fangfang Kong; Fangfang Kong; Chengrun Du; Chengrun Du; Chengrun Du; Ruiping Zhai; Ruiping Zhai; Ruiping Zhai; Yingchen Lyu; Yingchen Lyu; Yingchen Lyu; Chaosu Hu; Chaosu Hu; Chaosu Hu; Hongmei Ying; Hongmei Ying; Hongmei Ying

doi:10.3389/fonc.2021.654871

Frontiers in Oncology (May 2021)

Induction Chemotherapy Combined With Intensity-Modulated Radiotherapy for 129 Nasopharyngeal Carcinoma Patients With Synchronous Metastases: A Retrospective Study

Mengshan Ni,
Mengshan Ni,
Mengshan Ni,
Lijun Geng,
Lijun Geng,
Lijun Geng,
Fangfang Kong,
Fangfang Kong,
Fangfang Kong,
Chengrun Du,
Chengrun Du,
Chengrun Du,
Ruiping Zhai,
Ruiping Zhai,
Ruiping Zhai,
Yingchen Lyu,
Yingchen Lyu,
Yingchen Lyu,
Chaosu Hu,
Chaosu Hu,
Chaosu Hu,
Hongmei Ying,
Hongmei Ying,
Hongmei Ying

Affiliations

Mengshan Ni: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Mengshan Ni: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Mengshan Ni: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Lijun Geng: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Lijun Geng: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Lijun Geng: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Fangfang Kong: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Fangfang Kong: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Fangfang Kong: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Chengrun Du: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Chengrun Du: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Chengrun Du: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Ruiping Zhai: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Ruiping Zhai: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Ruiping Zhai: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Yingchen Lyu: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Yingchen Lyu: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Yingchen Lyu: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Chaosu Hu: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Chaosu Hu: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Chaosu Hu: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
Hongmei Ying: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Hongmei Ying: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Hongmei Ying: Shanghai Key Laboratory of Radiation Oncology, Shanghai, China

DOI: https://doi.org/10.3389/fonc.2021.654871
Journal volume & issue: Vol. 11

Abstract

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ObjectiveTo analyze the therapeutic effect and prognostic factors of nasopharyngeal carcinoma (NPC) patients with distant metastases at initial diagnosis receiving induction chemotherapy with intensity-modulated radiotherapy (IMRT).MethodsA total of 129 patients who underwent platinum-based induction chemotherapy followed by definitive IMRT with or without concurrent or adjuvant chemotherapy for newly diagnosed distant metastatic NPC in our center between March 2008 and November 2018 were retrospectively analyzed. 41 patients underwent local therapy for metastatic sites. Kaplan-Meier method was used to estimate survival rates, Log-rank test and Cox proportional hazards model were used to figure out independent prognostic factors of overall survival (OS).ResultsA total of 66 patients had been dead (median follow-up time, 51.5 months). The median overall survival (OS) time was 54.2 months (range, 7-136 months), and the 1-year, 2-year, 3-year, 5-year overall survival rates were 88.0%,71.0%,58.0%, and 47.0%. Multivariate analysis found that the factors correlated with poor overall survival were pre-treatment serum lactate dehydrogenase (SLDH) >180U/L, chemotherapy cycles<4, and M1 stage subdivision (M1b, single hepatic metastasis and/or multiple metastases excluding the liver; and M1c, multiple hepatic metastases). The 5-year OS rates for M1a, M1b and M1c were 62.6%,40.4% and 0%, respectively.ConclusionPlatinum-containing induction chemotherapy combined with IMRT seemed to be advantageous to prolong survival for some NPC patients with synchronous metastases at initial diagnosis. The independent factors to prognosticate OS were pre-treatment SLDH, number of chemotherapy cycles, and M1 subcategories. Prospective clinical trials are needed to confirm the result.

Published in Frontiers in Oncology

ISSN: 2234-943X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.frontiersin.org/journals/oncology/

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