Analysis on Clinical Characteristics and Influencing Factors of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

Abstract

Background: To explore the independent prognostic factors for the recurrence/metastasis of patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods: A total of 604 patients initially diagnosed as LANPC by pathohistology in Fujian Provincial Cancer Hospital were selected to analyze the relationship between the clinical pathological patterns, therapeutic protocols and clinical stages with the recurrence/metastasis of LANPC. Results: The 1-, 3-and 5-year locoregionally recurrent rates of LANPC patients were 2.0%, 9.5% and 12.9% respectively, with average recurrent period being 78 months. Univariate analysis results indicated that clinical stages had certain influence on the recurrent period of LANPC patients. However, COX regression models showed that ages, genders and clinical stages were not the independent prognostic factors influencing the recurrence. The 1-, 3-and 5-year metastatic rates of LANPC patients were 6.6%, 17.5% and 18.8% respectively, with average metastatic period of 73 months. Univariate analysis results demonstrated that ages, N stages, clinical stages, locations of lymph node, retropharyngeal lymph node and extracapsular invasion of lymph node had certain influence on the metastatic period of LANPC patients. Additionally, further COX regression analysis results suggested that T stages, reduction protocols and extracapsular invasion of lymph node were the independent prognostic factors influencing the metastasis of patients with LANPC, in which T stages and extracapsular invasion of lymph node were the pestilent factors while reduction protocols the protective factor. Conclusions: Induction chemotherapy is beneficial to LANPC patients with initial treatment, and the metastatic rate decreases greatly after the application of reduction chemotherapy.

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy in Saudi Arabia

“…In the present retrospective review, the distant metastasis was the most common pattern of failure in Saudi patients with NPC treated with IMRT with SIB technique and concurrent chemotherapy that is in agreement with international data 7–9,14. rT4 (especially with intracranial extension via the foramen lacerum and foramen ovale) was the predominant manifestation of locoregional recurrence, which is also in agreement with international data 15.…”

“…Surgery is the feasible option for nodal recurrences in patients treated primarily with IMRT and concurrent chemotherapy 8. Systemic chemotherapy is the treatment of choice in metastatic NPC patients, but it is considered as a palliative option for patients with local or locoregional recurrences 9. Reirradiation in the form of brachytherapy, stereotactic radiosurgery/radiation therapy, and IMRT has been used to treat local or locoregional recurrences with acceptable toxicity and progression-free survival 10–12…”

Patterns of failure and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation therapy in Saudi Arabia.

“…[7][8][9]14 rT4 (especially with intracranial extension via the foramen lacerum and foramen ovale) was the predominant manifestation of locoregional recurrence, which is also in agreement with international data. 15 Recurrence with intracranial extension was found to have poor DFS and OS Note: Bold data indicate significant P-values.…”

“…8 Systemic chemotherapy is the treatment of choice in metastatic NPC patients, but it is considered as a palliative option for patients with local or locoregional recurrences. 9 Reirradiation in the form of brachytherapy, stereotactic radiosurgery/radiation therapy, and IMRT has been used to treat local or locoregional recurrences with acceptable toxicity and progression-free survival. [10][11][12] Previously, we reported our experience of IMRT with simultaneous modulated accelerated boost technique and concurrent chemotherapy in Saudi patients with NPC.…”

Tyrosine Kinase Receptor Landscape in Lung Cancer: Therapeutical Implications

“…In a meta-analysis covering 74 studies with a total of 7631 patients, it was reported that VEGFR1 expression is an indicator of poor prognosis in NSCLC. In this study, it was observed as well that combined high expression of VEGFR2 and VEGFA, or VEGFR3 and VEGFC, featured discrimination power as prognostic biomarkers [ 107 ]. In another study involving surgically resected NSCLC, different patterns of coexpression of HER family receptors have been associated with a shorter disease-free and overall survival [ 108 ].…”