Our data demonstrated that the prognosis was poor for patients with aneuploid cancers or increased SPF. Therefore, DNA quantification by flow cytometry may provide important information for predicting the prognosis of the disease.
N1 disease (91.2% vs 72.3%, P<.001), had larger LN size on physical examination (P<.001), and had more patients with T2N1 disease (P<.001) than those patients treated with IMRT alone. For the chemotherapy regimen, 57 patients were treated with concurrent weekly cisplatin 40 mg/m 2 and 59 patients were treated with 3 weekly cisplatin 100 mg/m 2 . Eight patients were treated with concurrent carboplatin. There was no difference between the use of RT dosage, mostly 70 Gy over 33 fractions. There is no statistical difference in 5-year cancer-specific survival (88.5% vs 90.8%, PZ0.89) and 5 year progression-free survival (87% vs 85.6%, PZ.75) between the CRT and IMRT alone groups. Overall local recurrence (5.6% vs 7.0%), regional recurrence (6.5% vs 1.2%), and distant metastasis rates (11.3% vs 9.3%) were not statistically different in the CRT and IMRT alone groups. A distant metastasis rate of T2N0 and T1N1 with LN2 cm is low (6.1% and 7.8%) with or without concurrent chemotherapy. For patients with T1N1 with LN >2cm, 10.5% had distant metastasis (3 of 33 patients in the CRT group and 1 of 5 in the IMRT group). For patients with T2N1 with LN <2cm, there was a low distant metastasis rate in both the CRT and IMRT groups (11.1% and 6.7%). However, for T2N1 with LN >2cm, 5 of 28 and 2 of 5 patients had distant metastasis in the CRT and IMRT alone groups, respectively. Conclusion: Concurrent chemoradiation seems to have no role in T2N0 and T1N1 NPC patients with small LN size. Concurrent chemotherapy may have a role in decreasing the distant metastasis rate in patients with T1N1 and T2N1 disease with large LN size. Further investigation is warranted.
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