Zoledronic acid combined with chemotherapy bring survival benefits to patients with bone metastases from nasopharyngeal carcinoma

Jin, Ying; An, Xin; Cai, Yu; Cao, Yongtong; Cai, Xiu Yu; Xia, Qing; Tan, Yu Ting; Jiang, Wen Qi; Shi, Yan

doi:10.1007/s00432-011-1027-8

Cited by 14 publications

(16 citation statements)

References 32 publications

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“…This study showed no significant impact of bisphosphonate treatment on the survival of patients with bone-only metastatic NPC. Our results conflict with a recently published study by Jin et al [34], who retrospectively analyzed the data of 307 patients with bone metastases at primary diagnosis or with recurrent bone disease attended in Sun Yat-sen University Cancer Center from 1999 to 2009 and concluded that bisphosphonates treatment combined with chemotherapy could improve OS for patients with NPC and bone metastases compared with patients receiving chemotherapy alone (HR: 0.548; 95% CI: 0.418-0.719). However, the population included in that study were not patients with bone-only metastatic NPC, and the confounding effects of the metastatic involvement of the other organs and radiotherapy for metastatic lesions were not fully considered.…”

Section: Cmecontrasting

confidence: 99%

M1 Stage Subdivision and Treatment Outcome of Patients With Bone-Only Metastasis of Nasopharyngeal Carcinoma

et al. 2015

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Background. The current M1 stage in nasopharyngeal carcinoma (NPC) does not differentiate patients based on metastatic site and number of metastases. This study aims to subdivide the M1 stage of NPC patients with bone-only metastases and to identify the patients who may benefit from combined chemoradiotherapy (CRT). Methods. Between 1998 and 2007, 312 patients diagnosed with bone-only metastasis at Sun Yat-sen University Cancer Center were enrolled.Various possible subdivisions of M1 stage were considered, including by the time order of metastasis (synchronous vs. metachronous), involvement of specific bone metastatic site, the number of metastatic sites, and the number of metastases. The correlation of the subdivisions of M1 stage with overall survival (OS) was determined by Cox regression. Results. The median OS was 23.4 months. Patients with more than three metastatic sites had significantly poorer OS than patients with three or fewer metastatic sites (16.2 vs. 32.4

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Section: Cmecontrasting

confidence: 99%

M1 Stage Subdivision and Treatment Outcome of Patients With Bone-Only Metastasis of Nasopharyngeal Carcinoma

et al. 2015

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“…A study by Gnant et al on breast cancer suggested that bisphosphonates could be effective for the prevention of bone related events (radiation to bone, spinal cord compression, fracture, and surgery to bone) 18. The studies on nasopharyngeal carcinoma also suggested that bisphosphonates could effectively reduce the tumor invasion and metastasis ability,19 and improve the overall survival, the disease-free survival, as well as reduce bone events in patients with bone metastases 20. The prophylactic use of bisphosphonates in cases with skull base bone destruction may promote the skull bone repair and also reduce the incidence of bone metastases, thus improving the survival rate.…”

Section: Discussionmentioning

confidence: 99%

CT-diagnosed severe skull base bone destruction predicts distant bone metastasis in early N-stage nasopharyngeal carcinoma

Yi¹,

Liu²,

Li³

et al. 2016

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Bone metastasis is the most frequent type of distant metastasis in nasopharyngeal carcinoma (NPC). In this study, we investigated the correlation between the skull base bone destruction and the distant bone metastasis in patients with NPC. A total of 449 cases with NPC who were diagnosed and had definitive radiotherapy from 2001 to 2006 were enrolled in this study. The skull base bone destruction was diagnosed by computed tomography (CT) in all cases, and 191 patients also underwent magnetic resonance imaging scan. Kaplan–Meier method was adopted to perform the univariate analysis; Cox regression model was used to perform multivariate analysis to determine whether the skull base bone destruction when diagnosed by CT was an independent impact factor of the distant bone metastases. The group with skull base bone destruction had a distant bone metastases rate of 9.0% (14/155), whereas the group without skull base bone destruction had rate of 4.1% (12/294). The multivariate analysis showed that the skull base bone destruction, when diagnosed by CT, was an independent impact factor of the distant bone metastases-free survival in the early N-staging cases, but was not an independent impact factor when diagnosed by MRI. The skull base bone destruction diagnosed by CT in patients with NPC had predictive value for the distant bone metastases, especially for the early N-staging cases.

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“…In the past, the tumor evaluation criteria developed by the WHO defined bone tumor response by the change of lesion size in skeletal scintigraphy and plain radiography. However, because the change in osteodestructive lesion size is always slow, this method is not useful in clinical practice ( 9 ). Currently, the most scientific and widely used tumor response criteria in the clinical setting are the Response Evaluation Criteria in Solid Tumors (RECIST), but in this system, bone metastasis is classified as ‘non-measurable’ and a ‘non-target lesion’ ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Serum alkaline phosphatase predicts survival outcomes in patients with skeletal metastatic nasopharyngeal carcinoma

Jin¹,

Ma²,

Chen³

et al. 2015

Clinics

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OBJECTIVE:Bone metastasis is frequently associated with nasopharyngeal carcinoma. The diagnosis and follow-up of bone metastatic patients usually relies on skeletal X-ray and bone scintigraphy, which are time-consuming and costly. This study aimed to evaluate whether serum alkaline phosphatase offers clinical value in predicting the clinical response and survival outcome for skeletal metastatic nasopharyngeal carcinoma.METHODS:Serum alkaline phosphatase was measured at baseline and then before each cycle of treatment in 416 nasopharyngeal carcinoma patients with bone metastasis. The correlations between the pre-treatment and post-treatment alkaline phosphatase levels and the treatment efficacy were analyzed using the chi-square test. Survival was analyzed using the Kaplan–Meier method and then compared using the log-rank test.RESULTS:Patients with elevated pre-treatment alkaline phosphatase (>110 IU/L) had significantly worse progression-free survival (P<0.001) and overall survival (P<0.001) than those with a normal level of this marker (≤110 IU/L). Patients with elevated post-treatment alkaline phosphatase had worse progression-free survival (P<0.001) and overall survival (P<0.001) compared with those with a normal level. Patients with normal pre-treatment and post-treatment alkaline phosphatase showed the most favorable prognosis. The Cox multivariate analysis revealed that only the pre-treatment and post-treatment alkaline phosphatase levels were independent prognostic factors for progression-free survival (HR ϝ 1.656, P<0.001; HR ϝ 2.226, P<0.001) and for overall survival (HR ϝ 1.794, P<0.001; HR ϝ 2.657, P<0.001).CONCLUSIONS:Serum alkaline phosphatase appears to be a significant independent prognostic index in patients with skeletal metastatic nasopharyngeal carcinoma, which could reflect the short-term treatment response of palliative chemotherapy and the long-term survival outcomes.

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Zoledronic acid combined with chemotherapy bring survival benefits to patients with bone metastases from nasopharyngeal carcinoma

Abstract: ZA treatment combined with chemotherapy could reduce SREs and improve PFS and OS for NPC patients with bone metastases.

Cited by 14 publications

References 32 publications

M1 Stage Subdivision and Treatment Outcome of Patients With Bone-Only Metastasis of Nasopharyngeal Carcinoma

M1 Stage Subdivision and Treatment Outcome of Patients With Bone-Only Metastasis of Nasopharyngeal Carcinoma

CT-diagnosed severe skull base bone destruction predicts distant bone metastasis in early N-stage nasopharyngeal carcinoma

Serum alkaline phosphatase predicts survival outcomes in patients with skeletal metastatic nasopharyngeal carcinoma

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