Prognostic factors in metastatic nasopharyngeal carcinoma

Toumi, Nozha; Ennouri, Sana; Charfeddine, Ilhem; Daoud, J.; Khanfir, Afef

doi:10.1016/j.bjorl.2020.05.022

Cited by 15 publications

(11 citation statements)

References 29 publications

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“…We observed that multiple metastases and bone metastases were associated with poorer survival, which was in accordance with previous studies 18,22,25,26 . One of these studies reported that the HR was 2.26 (95%CI 1.69–3.03) and 1.39 (95%CI 1.18–1.65) for multiple metastases and bone metastases, respectively 26 .…”

Section: Discussionsupporting

confidence: 91%

“…Toumi et al found that the 1‐year OS of the patients with synchronous metastatic NPC was 57.1% in the radiotherapy group, while 47.7% in nonradiotherapy group ( p = 0.046), (HR 0.15, 95%CI 0.01–0.32). For all metastatic NPC, the 1‐year OS was 70% in radiotherapy group and 22.6% in nonradiotherapy group ( p = 0.03) (HR 0.61, 95%CI 0.24–1.59) 22 . In another study, patients with mNPC who received local treatment in metastatic sites (including radiotherapy and surgery) had longer median OS than those who did not receive any local treatment (32.43 months vs. 28.66 months) ( p = 0.086) 23 .…”

Section: Discussionmentioning

confidence: 99%

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Local radiotherapy versus nonradiotherapy to distant lesions for metastatic nasopharyngeal carcinoma: Retrospective cohort study

et al. 2021

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Background To evaluate the efficiency of local radiotherapy to metastatic lesions in patients with metastatic nasopharyngeal carcinoma (mNPC). Methods The overall survival was observed and compared for mNPC patients who received local radiotherapy versus nonradiotherapy to metastatic lesions by using the Kaplan–Meier method and Cox analysis. Results One hundred and nine patients with NPC were involved in this study, with 61 (56.0%) received radiotherapy to metastatic sites and 48 (44.0%) did not receive radiotherapy to metastatic sites. The 2‐ and 5‐year OS for patients who received local radiotherapy to metastatic lesions were 65.8% and 35.7%, and for patients who did not receive radiotherapy to metastatic lesions were 45.3% and 26.2%. The multivariable adjusted hazard radios for local radiotherapy versus nonradiotherapy to metastatic lesions were 0.482 (95% confidence interval is 0.278–0.834, p = 0.009). Conclusions Local radiotherapy to metastatic lesions might be a protective factor for patients with mNPC.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Local radiotherapy versus nonradiotherapy to distant lesions for metastatic nasopharyngeal carcinoma: Retrospective cohort study

et al. 2021

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“…The multivariable analysis indicated that TTP of <1 year, multiple organ involvement, liver metastasis, and grouping were independently associated with the prognosis of patients with metastatic nasopharyngeal carcinoma, as supported by Li et al [ 8 ] and Toumi et al [ 26 ]…”

Section: Discussionsupporting

confidence: 55%

Gemcitabine plus platinum versus docetaxel plus platinum as first line therapy for metastatic nasopharyngeal carcinoma: A randomized clinical study

Yang

Zhao

et al. 2021

Saudi J Med Med Sci

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Background: A well-established first-line chemotherapy standard for metastatic nasopharyngeal carcinoma is yet lacking. Objectives: To compare the efficacy and safety of gemcitabine plus platinum versus docetaxel plus platinum regimen as first-line therapies for distal metastatic nasopharyngeal carcinoma. Study Design and Participants: A single center, randomized, open-label, parallel-arm study. The study included 120 patients with metastatic nasopharyngeal carcinoma who met the study requirements. Interventions: Participants were randomized in a 1:1 ratio through a sealed envelope selection. Gemcitabine 1000 mg/m 2 /d intravenously (IV) for >30 min (days 1 and 8) or docetaxel 75 mg/m 2 /d IV for 1 h (day 1) were administered to the respective group participants. Nedaplatin 75 mg/m 2 /d, IV (day 1), cisplatin 75 mg/m 2 /d IV (day 1) or carboplatin (area under the curve set as 5) IV (day 1) were used in both groups. One cycle duration was 21 days, with 4–6 cycles for all participants. Outcomes: The primary assessed outcomes were progression-free survival (PFS) and overall survival (OS), and the secondary outcomes were short-term efficacy [i.e., response rate (RR) and disease control rate (DCR)] and safety. Results: Seven patients withdrew from the study, and efficacy and adverse reactions were obtained for 113 patients (gemcitabine: 56; docetaxel: 57). Compared with the docetaxel plus platinum group, the gemcitabine plus platinum group had significantly higher RR (71.4% vs. 52.6%, P < 0.05); mPFS (9.7 vs. 7.8 months, P < 0.05), and mOS (20.6 vs. 16.8 months, P < 0.01). The significance was not associated with increased adverse reactions, as both groups showed similar Grades 3 and 4 adverse reactions ( P > 0.05). DCR was non-significantly higher in the gemcitabine group (85.7% vs. 75.4%, P > 0.05). Multivariable analysis revealed that time to disease progression, number of involved organs, liver metastasis, and grouping were associated with mPFS and mOS (all P < 0.05). Conclusion: The combination of gemcitabine with platinum is likely superior to that of docetaxel with platinum as first-line treatment for metastatic nasopharyngeal carcinoma.

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“…However, HRs were close to 1.00 among patients with de novo metastasis, who have distinct disease features and clinical outcomes compared those with recurrent disease. 22 , 23 Recently, a phase III study demonstrated that FP chemotherapy plus radiotherapy significantly improved OS compared with FP alone in patients with de novo metastatic NPC (HR, 0.36). 11 However, future work is needed to address the optimal treatment modality for this patient group in whom the standard of care has become GP.…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine Plus Cisplatin Versus Fluorouracil Plus Cisplatin as First-Line Therapy for Recurrent or Metastatic Nasopharyngeal Carcinoma: Final Overall Survival Analysis of GEM20110714 Phase III Study

Hong

Zhang

et al. 2021

JCO

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PURPOSE GEM20110714 (ClinicalTrials.gov identifier: NCT01528618 ), the first randomized, phase III study of systemic chemotherapy in recurrent or metastatic nasopharyngeal carcinoma (NPC), reported significant progression-free survival improvement with gemcitabine plus cisplatin (GP) versus fluorouracil plus cisplatin (FP; hazard ratio, 0.55; 95% CI, 0.44 to 0.68; P < .001). Data from the final analysis of overall survival (OS) are presented here. METHODS From February 2012 to October 2015, 362 patients were randomly assigned to receive either GP (gemcitabine 1 g/m2 once daily on days 1 and 8 and cisplatin 80 mg/m2 once daily on day 1; n = 181) or FP (fluorouracil 4 g/m2 in continuous intravenous infusion over 96 hours and cisplatin 80 mg/m2 once daily on day 1; n = 181) once every 21 days. The primary end point was progression-free survival, which has been previously reported; OS was a secondary end point. RESULTS After a median follow-up time of 69.5 months with GP and 69.7 months with FP, 148 (81.8%) and 166 (91.7%) deaths occurred in the GP and FP arms, respectively. The estimated hazard ratio for OS was 0.72 (95% CI, 0.58 to 0.90; two-sided P = .004). The median OS was 22.1 months (95% CI, 19.2 to 25.0 months) with GP versus 18.6 months (95% CI, 15.4 to 21.7 months) with FP. The OS probabilities at 1, 3, and 5 years were 79.9% versus 71.8%, 31.0% versus 20.4%, and 19.2% versus 7.8%, respectively. Poststudy therapy was administered in 51.9% and 55.2% of patients in the GP and FP arms, respectively. CONCLUSION Among patients with previously untreated advanced nasopharyngeal carcinoma, those who receive GP have longer OS than those receive FP. Gemcitabine plus cisplatin should be considered a preferred front-line option for these patients.

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Prognostic factors in metastatic nasopharyngeal carcinoma

Cited by 15 publications

References 29 publications

Local radiotherapy versus nonradiotherapy to distant lesions for metastatic nasopharyngeal carcinoma: Retrospective cohort study

Local radiotherapy versus nonradiotherapy to distant lesions for metastatic nasopharyngeal carcinoma: Retrospective cohort study

Gemcitabine plus platinum versus docetaxel plus platinum as first line therapy for metastatic nasopharyngeal carcinoma: A randomized clinical study

Gemcitabine Plus Cisplatin Versus Fluorouracil Plus Cisplatin as First-Line Therapy for Recurrent or Metastatic Nasopharyngeal Carcinoma: Final Overall Survival Analysis of GEM20110714 Phase III Study

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