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. 2016 Dec 27;7(52):86914-86925.
doi: 10.18632/oncotarget.13564.

Investigation of long-term survival outcomes and failure patterns of patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy: a retrospective analysis

Wei Zhao  1 , Hao Lei  1   2 , Xiaodong Zhu  1 , Ling Li  1 , Song Qu  1 , Xia Liang  1
Affiliations

Investigation of long-term survival outcomes and failure patterns of patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy: a retrospective analysis

Wei Zhao et al. Oncotarget. .

Abstract

Intensity-modulated radiotherapy (IMRT) has replaced the conventional radiotherapy (2D-RT) and improved clinical efficacy in Nasopharyngeal Carcinoma (NPC) patients. In the present study, we retrospectively analyzed the clinical characteristics of patients with NPC treated with IMRT to assess the long-term survival outcomes and failure patterns. Of the 527 patients, One hundred and twenty-one patients experienced treatment failure, 86 patients developed distant metastases, and 12 patients developed a second primary tumor. The local and regional recurrence rates were 31.4% and 14.0%, respectively. The 5-year overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), regional relapse-free survival (RRFS), and distant metastatic relapse-free survival (DMFS) rates were 80.9%, 75.6%, 91.7%, 96.2%, and 83.0%, respectively. The 5-year LRFS rates of Stage T1-4 patients were 100.0%, 93.1%, 92.0%, and 85.8%, respectively. The 5-year DMFS rates of Stage N0-3 patients were 95.0%, 86.1%, 79.5%, and 67.2%, respectively. Multivariate analysis showed age and T-stage were independent predictors of OS, T-stage was an independent predictor of LRFS, and age and N-stage were independent predictors of PFS and DMFS.In summary, the improved treatment results with IMRT are primarily due to the achievement of a higher local tumor control rate and OS in NPC patients. However, distant metastasis was the most commonly observed failure pattern after treatment. These results provide deep insights about the value of IMRT in the treatment and prognosis of NPC patients.

Keywords: failure pattern; intensity-modulated radiotherapy; long-term outcome; nasopharyngeal carcinoma; retrospective analysis.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no actual or potential conflicts of interest to declare.

Figures

Figure 1
Figure 1. Kaplan-Meier survival curves for the overall survival (1-1), progression-free survival (1-2), regional recurrence-free survival (1-4), distant metastasis-free survival (1-5), and local recurrence-free survival (1-3) rate of all the patients with nasopharyngeal carcinoma
Figure 2
Figure 2. Local recurrence-free survival rates of 527 patients with nasopharyngeal carcinoma at different T stages
Figure 3
Figure 3. Distant metastasis-free survival rates of 527 patients with nasopharyngeal carcinoma at different N stages
See this image and copyright information in PMC

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