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. 2021 Aug;41(4):737-745.
doi: 10.1007/s11596-021-2405-3. Epub 2021 Aug 17.

Long-term Therapeutic Outcome and Prognostic Factors of Patients with Nasopharyngeal Carcinoma Receiving Intensity-modulated Radiotherapy: An Analysis of 608 Patients from Low-endemic Regions of China

Jing Huang #  1 , Zhi-Yong Yang #  2 , Bian Wu  1 , Qian Ding  1 , You Qin  1 , Zhan-Jie Zhang  1 , Zhong-Yuan Yin  3 , Zhi-Wen Liang  4 , Jun Han  4 , Ye Wang  4 , Zhen-Jun Peng  4 , Gang Peng  5 , Qin Li  4 , Gang Wu  3 , Kun-Yu Yang  6
Affiliations

Long-term Therapeutic Outcome and Prognostic Factors of Patients with Nasopharyngeal Carcinoma Receiving Intensity-modulated Radiotherapy: An Analysis of 608 Patients from Low-endemic Regions of China

Jing Huang et al. Curr Med Sci. 2021 Aug.

Abstract

Objective: To evaluate the long-term outcome and prognostic factors of patients with nasopharyngeal carcinoma (NPC) from low-endemic regions of China who received definitive intensity-modulated radiation therapy (IMRT).

Methods: The clinical data from 608 patients with newly-diagnosed non-metastatic NPC who have received initial treatment at our cancer center from January, 2008 to December, 2013 were retrospectively reviewed. All patients received definitive IMRT, and 87.7% received platinum-based chemotherapy.

Results: The median follow-up duration was 51 months (follow-up rate, 98.5%; range, 10-106 months) for the entire cohort. The 5-year overall survival rate was 79.7%. The 5-year local relapse-free survival rate, regional relapse-free survival rate, distant metastasis-free survival rate and progression-free survival rate were 92.4%, 93.3%, 79.2% and 74.3%, respectively. A total of 153 patients had experienced treatment failure, with distant metastasis as the primary cause in 77.1% (118/153). Patients with T4 or N3 diseases had a significantly poorer prognosis than other subcategories. Stage T4 and N3 were closely associated with distant metastasis, with the metastatic rate of 29.3% and 45.5%, respectively.

Conclusion: IMRT provides patients with non-metastatic NPC with satisfactory long-term survival. Both T stage and N stage are important prognostic factors for NPC patients. Patients with T4 or N3 diseases have significantly increased distant metastatic rates and poor survival time.

Keywords: intensity-modulated radiation therapy; long-term therapeutic outcome; low-endemic regions of China; nasopharyngeal carcinoma.

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