Primary tumor inflammation in gross tumor volume as a prognostic factor for nasopharyngeal carcinoma patients

Abstract

PurposeThe objective of this study is to investigate the prognostic value of primary tumor inflammation (PTI) in nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiation therapy (IMRT).ResultsPTI was observed in 376/1708 (22.0%) patients, and was present in the sphenoid sinus in 289/376 (76.9%), in the nasal cavity in 27 (7.2%), and in both places in 60 (15.9%). The estimated 4-year local relapse-free survival (LRFS), disease-free survival (DFS), overall survival (OS) and distant metastasis-free survival (DMFS) rates for PTI vs. non-PTI group were 89.2% vs. 96.1% (P < 0.001), 73.4% vs. 85.1% (P < 0.001), 85.0% vs. 92.1% (P < 0.001) and 83.6% vs. 91.4% (P < 0.001), respectively. After adjustment for these known prognostic factors, PTI was confirmed as an independent prognostic factor for LRFS (HR 2.152, 95% CI 1.318–3.516, P = 0.002), DFS (HR 1.581, 95% CI 1.204–2.077, P = 0.001) and DMFS (HR 1.682, 95% CI 1.177–2.402, P = 0.004).ConclusionsPrimary tumor inflammation was identified as a strong prognostic factor for patients with NPC in the era of IMRT and should be considered when devising future treatment strategies aimed at improving survival in NPC patients.Materials and MethodsData on 1708 patients with nonmetastatic, histologically-confirmed NPC treated with IMRT between November 2009 and February 2012 at Sun Yat-Sen University Cancer Center were retrospectively reviewed. Patient survival between PTI and non-PTI groups were compared.

Novel prognostic scoring system for diffuse large B-cell lymphoma

“…As early as 1863, Rudolf Virchow, who suggested that lymphoreticular infiltration reflected the origin of cancer at sites of chronic inflammation, identified a connection between inflammation and cancer (16). Subsequently, numerous studies have provided evidence that the host inflammatory responses serve a critical function in various aspects of cancer, including cancer initiation, promotion, progression and metastasis (7,(17)(18)(19) Previously, a number of inflammatory markers have been proposed to have potential for use as predictors of OS and PFS for solid tumors (8,12,(20)(21)(22)(23). The present study identified that NLR, LMR and PLR may be able to predict the prognosis of patients with DLBCL.…”

“…These cell types are able to differentiate into tumor-associated macrophages in tumor tissue, which undergo tumor-promotion and M2-like macrophage polarization and secrete angiogenic factors, including interleukin-8, vascular endothelial growth factor (VGEF) and fibroblast growth factor, then induce further tumor angiogenesis and progression (24,25). Furthermore, monocyte-derived cells may provide nutritional factors that directly promote the growth and survival of malignant tumors (17)(18)(19).…”

Evaluation of the Effect of Cumulative Cisplatin Dose in Locoregionally Advanced Nasopharyngeal Carcinoma Patients Receiving Intensity-Modulated Radiotherapy

“…Previous studies of CCD cut-off values associated with better survival outcomes have reported inconsistent results. [5,[11][12][13][14][15][16] Some studies have noted superior survival with a CCD > 200 mg/m 2 , but these investigations used heterogeneous modalities of RT, including two-dimensional RT (2D-RT), three-dimensional RT (3D-RT), and IMRT. [5,11,12,14] Lee et al [5] applied NPC-9901 and NPC-9902 trials and found that the locoregional failure-free rate plateaued (88%) after a CCD of 200 mg/m 2 .…”

“…Ou et al [15] reported significantly higher distant metastasis-free survival (DMFS) and overall survival (OS) rates with CCD ≥ 300 mg/m 2 in concurrent CT, especially for patients with N2-3 lesions. On the other hand, Peng et al [16] reported significantly higher diseasefree survival with CCD ≥ 240 mg/m 2 in concurrent CT.…”

Identifying pretreatment baseline factors predictive of distant metastasis in patients with nasopharyngeal carcinoma after radiotherapy

“…Several molecular markers have shown values in predicting the survival and DM among NPC patients, yet technical challenges and high costs associated with detecting these markers generally preclude their use in clinic. [ 10 , 12 , 13 ] Although other risk factors also influence survival, [ 3 , 4 , 9 , 14 , 15 ] few studies have assessed the pretreatment baseline parameters to DM. These factors could play a significant role in the choice of treatment NPC patients upon initial diagnosis.…”