Prognostic value of serum uric acid and tumor response to induction chemotherapy in locally advanced nasopharyngeal carcinoma

Yuanji Xu,Zijie Wu,Penggang Bai,Wei Zheng,Chuanben Chen,Youping Xiao,Wangzhong Ye,Zhizhong Lin,Qinyan Chen

doi:10.1186/s12885-021-08285-7

Abstract

BackgroundTo explore the combined predictive value of serum uric acid (SUA) and tumor response to induction chemotherapy (IC) in locally advanced nasopharyngeal carcinoma (LANPC) patients receiving IC followed by concurrent chemoradiation therapy (CCRT).MethodsA total of 341 LANPC patients treated with IC + CCRT were enrolled in this retrospective study. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared by the Kaplan-Meier analysis and the log-rank test, and multivariable survival analysis was carried out to investigate the independent prognostic factors.ResultsUnivariate analysis showed that a low SUA level and unsatisfactory tumor response to two cycles of IC both were negative predictors for OS, PFS, and DMFS in patients with LANPC. multivariable analysis demonstrated that the SUA level after two cycles of IC was an independent prognostic factor for OS (P = 0.012) but of borderline significance for PFS and DMFS (P = 0.055 and P = 0.067, respectively). Furthermore, tumor response to IC was of independent significance for predicting OS, PFS, and DMFS, respectively. Finally, LANPC patients with satisfactory tumor response and a high SUA level after two cycles of IC had a better OS, PFS, and DMFS than those with unsatisfactory tumor response and a low SUA level.ConclusionThe SUA level and the tumor response to two cycles of IC had predictive value for LANPC patients treated with IC plus CCRT. However, more aggressive therapeutic strategies are recommended for those with a low SUA level and unsatisfactory tumor response to two cycles of IC.

Highlights

To explore the combined predictive value of serum uric acid (SUA) and tumor response to induction chemotherapy (IC) in locally advanced nasopharyngeal carcinoma (LANPC) patients receiving IC followed by concurrent chemoradiation therapy (CCRT)
The Creative Commons Public Domain Dedication waiver applies to the data made available in this article, unless otherwise stated in a credit line to the data
The increasing number of randomized controlled trials has demonstrated that the addition of IC to CCRT is of great importance in the treatment of LANPC patients in the intensity-modulated radiation therapy (IMRT) era, which reduces distant metastasis and subsequently improves the overall survival (OS) [3,4,5]

Summary

Introduction

To explore the combined predictive value of serum uric acid (SUA) and tumor response to induction chemotherapy (IC) in locally advanced nasopharyngeal carcinoma (LANPC) patients receiving IC followed by concurrent chemoradiation therapy (CCRT). Nasopharyngeal carcinoma (NPC) is a distinct malignant tumor with the highest number of incidences reported in South China. It is diverse from other types of head and neck squamous cell carcinoma in regard to epidemiology, biological characteristics, and clinical treatment [1]. Followed by adjuvant chemotherapy or induction chemotherapy (IC) in addition to CCRT for locally advanced nasopharyngeal carcinoma (LANPC) was proposed as level 2A evidence by the National Comprehensive Cancer Network (NCCN) guidelines [2]. Explore novel prognostic factors to guide the clinical decision-making for a favorable and precise treatment after IC is an urgent requirement

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