• ISSN 1674-8301
  • CN 32-1810/R
Volume 36 Issue 4
Jul.  2022
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Article Contents
Fanyu Peng, Yizhi Ge, Rongrong Wang, Dingdong Hu, Xiang Cao, Yujie Zhang, Dan Zong, Xia He. Identifying nasopharyngeal carcinoma patients with metachronous metastasis sensitive to local treatment: a real-world study[J]. The Journal of Biomedical Research, 2022, 36(4): 221-230. doi: 10.7555/JBR.36.20220060
Citation: Fanyu Peng, Yizhi Ge, Rongrong Wang, Dingdong Hu, Xiang Cao, Yujie Zhang, Dan Zong, Xia He. Identifying nasopharyngeal carcinoma patients with metachronous metastasis sensitive to local treatment: a real-world study[J]. The Journal of Biomedical Research, 2022, 36(4): 221-230. doi: 10.7555/JBR.36.20220060

Identifying nasopharyngeal carcinoma patients with metachronous metastasis sensitive to local treatment: a real-world study

doi: 10.7555/JBR.36.20220060
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  • Corresponding author: Xia He, Department of Radiation Oncology, Jiangsu Cancer Hospital, 42 Baiziting Road, Xuanwu District, Nanjing, Jiangsu 210009, China. Tel: +86-25-83284634, E-mail: hexiabm@163.com
  • Received: 2022-03-23
  • Revised: 2022-04-18
  • Accepted: 2022-04-28
  • Published: 2022-05-28
  • Issue Date: 2022-07-28
  • It is difficult for physicians to identify patients with metastatic nasopharyngeal carcinoma (NPC) who are sensitive to local treatment of metastases. Here, we aimed to establish a prognostic model for survival and individualize treatments for patients with metastatic NPC. Data were collated from 240 NPC patients diagnosed with metachronous metastasis between 2006 and 2020 who received palliative chemotherapy with or without local treatment. Multivariable Cox regression was implemented to construct a nomogram which had a concordance index of 0.764 when predicting 1-, 3-, and 5-year overall survival (OS). We then classified patients according to risk, creating low- and high-risk groups using the nomogram. Differences in OS between the two groups were significant (P<0.001). In the low-risk group, the OS for patients who received local treatment was longer than those without (P=0.009). This novel nomogram shows good performance in classifying patients according to risk and may also be a promising tool for determining who responds best to local treatment. Further validation using external center data is warranted.


  • CLC number: R739.6, Document code: A
    The authors reported no conflict of interests.
    These authors contributed equally to this work.
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  • [1]
    Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394–424. doi: 10.3322/caac.21492
    Mao Y, Tang L, Chen L, et al. Prognostic factors and failure patterns in non-metastatic nasopharyngeal carcinoma after intensity-modulated radiotherapy[J]. Chin J Cancer, 2016, 35(1): 103. doi: 10.1186/s40880-016-0167-2
    Lee N, Xia P, Quivey JM, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience[J]. Int J Radiat Oncol Biol Phys, 2002, 53(1): 12–22. doi: 10.1016/S0360-3016(02)02724-4
    Lai S, Li W, Chen L, et al. How does intensity-modulated radiotherapy versus conventional two-dimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients?[J]. Int J Radiat Oncol Biol Phys, 2011, 80(3): 661–668. doi: 10.1016/j.ijrobp.2010.03.024
    Wu L, Liu Y, Jiang N, et al. Ten-year survival outcomes for patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy: an analysis of 614 patients from a single center[J]. Oral Oncol, 2017, 69: 26–32. doi: 10.1016/j.oraloncology.2017.03.015
    Yeo W, Leung TWT, Leung SF, et al. Phase II study of the combination of carboplatin and 5-fluorouracil in metastatic nasopharyngeal carcinoma[J]. Cancer Chemother Pharmacol, 1996, 38(5): 466–470. doi: 10.1007/s002800050512
    Hong S, Zhang Y, Yu G, et al. Gemcitabine plus cisplatin versus fluorouracil plus cisplatin as first-line therapy for recurrent or metastatic nasopharyngeal carcinoma: final overall survival analysis of GEM20110714 phase III study[J]. J Clin Oncol, 2021, 39(29): 3273–3282. doi: 10.1200/JCO.21.00396
    Au E, Ang PT. A phase Ⅱ trial of 5-fluorouracil and cisplatinum in recurrent or metastatic nasopharyngeal carcinoma[J]. Ann Oncol, 1994, 5(1): 87–89. doi: 10.1093/oxfordjournals.annonc.a058703
    Weichselbaum R, Hellman S. Oligometastases revisited[J]. Nat Rev Clin Oncol, 2011, 8(6): 378–382. doi: 10.1038/nrclinonc.2011.44
    You R, Liu Y, Huang P, et al. Efficacy and safety of locoregional radiotherapy with chemotherapy vs chemotherapy alone in de novo metastatic nasopharyngeal carcinoma: a multicenter phase 3 randomized clinical trial[J]. JAMA Oncol, 2020, 6(9): 1345–1352. doi: 10.1001/jamaoncol.2020.1808
    Huang J, Li Q, Zheng Y, et al. Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature[J]. BMC Cancer, 2014, 14: 818. doi: 10.1186/1471-2407-14-818
    Jin Y, Cai Y, Cao Y, et al. Radiofrequency ablation combined with systemic chemotherapy in nasopharyngeal carcinoma liver metastases improves response to treatment and survival outcomes[J]. J Surg Oncol, 2012, 106(3): 322–326. doi: 10.1002/jso.23034
    Ma J, Wen Z, Lin P, et al. The results and prognosis of different treatment modalities for solitary metastatic lung tumor from nasopharyngeal carcinoma: a retrospective study of 105 cases[J]. Chin J Cancer, 2010, 29(9): 787–795. doi: 10.5732/cjc.010.10098
    Lievens Y, Guckenberger M, Gomez D, et al. Defining oligometastatic disease from a radiation oncology perspective: an ESTRO-ASTRO consensus document[J]. Radiother Oncol, 2020, 148: 157–166. doi: 10.1016/j.radonc.2020.04.003
    Guckenberger M, Lievens Y, Bouma AB, et al. Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation[J]. Lancet Oncol, 2020, 21(1): E18–E28. doi: 10.1016/S1470-2045(19)30718-1
    Harrell FE Jr. Rms: Regression Modeling Strategies[EB/OL]. [2021-03-18]. https://github.com/harrelfe/rms.
    Zhang J, Jin Z. nomogramFormula[EB/OL]. [2019-08-17]. https://github.com/yikeshu0611/nomogramFormula.
    Du Z, Hao Y. nomogramEx: Extract Equations from a Nomogram[EB/OL]. [2017-08-29]. https://cran.r-project.org/web/packages/nomogramEx/index.html.
    Zheng W, Zong J, Huang C, et al. Multimodality treatment may improve the survival rate of patients with metastatic nasopharyngeal carcinoma with good performance status[J]. PLoS One, 2016, 11(1): e0146771. doi: 10.1371/journal.pone.0146771
    Tian Y, Zou W, Xiao W, et al. Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: a subset with better overall survival[J]. Head Neck, 2016, 38(8): 1152–1157. doi: 10.1002/hed.24345
    Zhao Z, Liu D, Wang Y, et al. Pulmonary metastasectomy in patients with lung metastases from nasopharyngeal carcinoma[J]. Ann Surg Oncol, 2021, 28(8): 4542–4550. doi: 10.1245/s10434-021-09597-5
    Shen L, Dong J, Li S, et al. M1 stage subdivision and treatment outcome of patients with bone-only metastasis of nasopharyngeal carcinoma[J]. Oncologist, 2015, 20(3): 291–298. doi: 10.1634/theoncologist.2014-0206
    Cao X, Han Y, He L, et al. Risk subset of the survival for nasopharyngeal carcinoma patients with bone metastases: who will benefit from combined treatment?[J]. Oral Oncol, 2011, 47(8): 747–752. doi: 10.1016/j.oraloncology.2011.05.010
    Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial[J]. Lancet, 2019, 393(10185): 2051–2058. doi: 10.1016/S0140-6736(18)32487-5
    Gomez DR, Tang C, Zhang J, et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non–small-cell lung cancer: long-term results of a multi-institutional, phase II, randomized study[J]. J Clin Oncol, 2019, 37(18): 1558–1565. doi: 10.1200/JCO.19.00201
    Iyengar P, Wardak Z, Gerber DE, et al. Consolidative radiotherapy for limited metastatic non-small-cell lung cancer: a phase 2 randomized clinical trial[J]. JAMA Oncol, 2018, 4(1): e173501. doi: 10.1001/jamaoncol.2017.3501
    Ruers T, van Coevorden F, Punt CJA, et al. Local treatment of unresectable colorectal liver metastases: results of a randomized phase Ⅱ trial[J]. J Natl Cancer Inst, 2017, 109(9): djx015. doi: 10.1093/jnci/djx015
    Li W, Lv S, Liu G, et al. Development of a prognostic model to identify the suitable definitive radiation therapy candidates in de novo metastatic nasopharyngeal carcinoma: a real-world study[J]. Int J Radiat Oncol Biol Phys, 2021, 109(1): 120–130. doi: 10.1016/j.ijrobp.2020.08.045
    Chee J, Liu X, Eu D, et al. Defining a cohort of oligometastatic nasopharyngeal carcinoma patients with improved clinical outcomes[J]. Head Neck, 2020, 42(5): 945–954. doi: 10.1002/hed.26061
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