Abstract
The aim of this study was to retrospectively compare the treatment efficacy of systemic chemotherapy combined with sequential CT-guided radiofrequency ablation (Chemo-RFA) to chemotherapy alone (Chemo-only) in the management of nasopharyngeal carcinoma (NPC) with liver metastasis. Between 2003 and 2011, 328 NPC patients diagnosed with liver metastasis at Sun Yat-sen University Cancer Center were enrolled. One-to-one matched pairs between Chemo-RFA group with the Chemo-only group were generated using propensity score matching. The associations of treatment modality with overall survival (OS) and progression-free survival (PFS) were determined by Cox regression. Of the patients enrolled, 37 patients (11.8 %) received combined treatment, 291 (82.2) received chemotherapy alone. The patients in Chemo-RFA group were more frequently classified as lower number (≤3) of liver metastatic lesions (P<0.001), had lower rates of bi-lobar liver metastasis (P<0.001) and extra-hepatic metastasis (P<0.001) than patients in Chemo-only group. After propensity score matching, 37 pairs of well-matched liver metastatic NPC patients were selected from different treatment groups. The adjusted hazard ratio in OS and PFS of the choice for Chemo-RFA approach to Chemo-only was 0.53 (95%CI, 0.30-0.93) and 0.60 (95%CI, 0.36-0.97), respectively. In conclusion, combined CT-guided RFA and chemotherapy approach offer the chance of improved survival for NPC patients with oligometastasis in liver, and should be considered if the ablation is technically feasible.
Highlights
Nasopharyngeal carcinoma (NPC) is an endemic head and neck epithelial malignancy in Southeast Asia [1, 2]
Jin et al analyzed a consecutive series of 134 LM-nasopharyngeal carcinoma (NPC) patients and found Radiofrequency ablation (RFA) combined with chemotherapy could achieve higher local response and overall survival rates as compared with chemotherapy or RFA alone [13]
Patients who underwent Chemo-RFA were more frequently classified as lower number (≤3) of liver metastatic lesions (P
Summary
Nasopharyngeal carcinoma (NPC) is an endemic head and neck epithelial malignancy in Southeast Asia [1, 2]. Pan et al retrospectively analyzed the data of 17 LM-NPC patients receiving RFA treatment and found it was technically effective and could potentially lead to an improved survival [12]. Jin et al analyzed a consecutive series of 134 LM-NPC patients and found RFA combined with chemotherapy could achieve higher local response and overall survival rates as compared with chemotherapy or RFA alone [13]. These studies still could not provide conclusive evidence due to the small sample size and the potential selection bias
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