Abstract
ObjectivesThe objective of this study was to investigate the long-term outcomes and prognostic factors for nasopharyngeal carcinoma (NPC) in Han and Uyghur patients treated with intensity-modulated radiotherapy (IMRT) in the Xinjiang region of China.Materials and MethodsOne hundred twenty-one Han and 60 Uyghur patients with newly diagnosed NPC without distant metastasis received IMRT at the Affiliated Tumor Hospital of Xinjiang Medical University between 2005 and 2008. The Kaplan-Meier method was used to estimate survival rates, and the log-rank test was used to evaluate differences in survival.ResultsComparing Han and Uyghur patients, the 5-year overall survival (OS), disease-free survival (DFS), local control (LC), regional control (RC), and distant metastasis-free survival (DMFS) rates were 81.9% vs 77.6% (P = 0.297), 72.1% vs 65.6% (P = 0.493), 88.3% vs 86.5% (P = 0.759), 95.0% vs 94.6% (P = 0.929), and 79.1% vs 75.2% (P = 0.613), respectively. Multivariate Cox proportional hazards regression identified the following independent prognostic factors in Han patients: N stage (P = 0.007) and age (P = 0.028) for OS, and age (P = 0.028) for DFS. OS differed significantly between Han and Uyghur patients >60 years old group (P = 0.036). Among Uyghur patients, the independent prognostic factors were age for OS (P = 0.033), as well as N stage (P = 0.037) and age (P = 0.021) for DFS. Additionally, Uyghur patients were less likely to experience mucositis and dermatitis than Han patients.ConclusionHan and Uyghur patients with NPC had statistically significant differences in age, smoking history, and N staging. There was no significant difference in overall treatment outcomes with IMRT between these 2 ethnic populations in Xinjiang, China.
Highlights
Nasopharyngeal carcinoma (NPC) is among the most common malignancies in China, especially in southeast coastal areas
Studies have demonstrated that NPC has unique pathogenic factors, such as genetic susceptibility, Epstein-Barr virus (EBV) infection, chemical carcinogens, and environmental factors
We found that 84.3% of the Han patients and 91.6% of Uyghur patients had stage III or IV disease
Summary
Nasopharyngeal carcinoma (NPC) is among the most common malignancies in China, especially in southeast coastal areas. NPC commonly demonstrates extensive invasion of adjacent tissues with poorly defined and large tumors in close proximity to critical structures, such as the brain stem, spinal cord, and optic chiasm. These features of NPC can complicate adequate surgical resection. Studies have demonstrated that intensity-modulated radiation therapy (IMRT) can substantially concentrate the radiation dose to target volumes while avoiding or reducing unnecessary radiation to normal tissues and organs, thereby leading to gains in the therapeutic ratio. As obtained using IMRT, the differential dose painting to multiple target volumes may confer a better radiobiological effect. Previous studies have demonstrated that the implementation of IMRT improves quality of life for patients with NPC, in addition to tumor control and survival [2,3]
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