Intensity-modulated radiotherapy controls nasopharyngeal carcinoma distant metastasis and improves survival of patients.

Xiaoqian Chen,Zhongguo Liang,Hao Lei,Song Qu,Xiaodong Zhu,Ling Li

doi:10.1186/s40064-016-3117-1

Xiaoqian Chen, Zhongguo Liang + Show 4 more

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https://doi.org/10.1186/s40064-016-3117-1

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Journal: SpringerPlus	Publication Date: Aug 31, 2016
Citations: 9	License type: CC BY 4.0

Affiliation: Guangxi Medical University

Abstract

BackgroundThis study evaluated the distant metastatic outcomes in nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT) plus chemotherapy.Methods530 Non-metastatic NPC patients were retrospectively collected and reviewed after receiving IMRT with or without chemotherapy between June 2006 and December 2011. Patients were treated with one fraction of IMRT daily for 5 days a week for 69.96–74.09 Gy, while 473 (89.2 %) of patients also received chemotherapy.ResultsPatients were followed up for a median follow-up duration of 49 months (range from 5 to 98 months). After treatment, 91 (17.3 %) patients developed distant metastasis. Distant metastasis after treatment was significantly associated with advanced 2010 Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) T staging (p = 0.034), N stage (p < 0.001), 2010 UICC/AJCC stage (p < 0.001), and tumor recurrence (p = 0.029). However, chemotherapy failed to reduce cancer distant metastasis in early stage patients, the distant metastasis rate was 17.5 % in stage III and 24.2 % in stage IVA–B diseases, after IMRT and chemotherapy. The multivariate analysis showed that cancer remission duration, treatment modality, and metastatic site (p < 0.001, p = 0.027 and p = 0.022, respectively) were all independent predictors for overall survival of NPC patients after IMRT and chemotherapy.ConclusionsThis study provided insight into the effects of IMRT plus chemotherapy in the treatment of NPC. Future studies will explore the efficacy of more aggressive systemic therapies for high-risk patients with distant metastasis.

Highlights

This study evaluated the distant metastatic outcomes in nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT) plus chemotherapy
Pathology classification of NPC was based on the World Health Organization (WHO) Grade I, Grade II and Grade III (Shanmugaratnam and Sobin 1993)
We found that the distant metastasis rate in NPC patients was 17.2 %, which was similar to the results published in other IMRT studies (Sun et al 2014; Yue et al 2014; Lee et al 2009; Leung et al 2005)

Summary

Introduction

This study evaluated the distant metastatic outcomes in nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT) plus chemotherapy. NPC is more sensitive to radiotherapy and chemotherapy, compared with other cancers, which often. Cancer metastasis is a multiple step process in which cancer cells migrate from the primary tumor site and. Multiple steps occur during metastasis, including angiogenesis, attachment of cancer cells to other cells and/or matrix proteins, translocation of neoplastic cells across the extracellular matrix barriers and proliferation at the secondary site (Woodhouse et al 1997). IMRT and chemotherapy induce apoptosis in cancer cells (Marin et al 2015), thereby inhibiting cancer metastasis. During treatment, cancer cells can develop resistance to apoptosis inducing agents; increasing the likelihood cancer recurrence may occur

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