Head and Neck Cancer

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MO_26_2628 - Failure Patterns of Distant Metastasis after Intensity-Modulated Radiation Therapy in Patients With Nasopharyngeal Carcinoma

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Failure Patterns of Distant Metastasis after Intensity-Modulated Radiation Therapy in Patients With Nasopharyngeal Carcinoma
M. Kang1, X. Liao2, Y. Lu3, B. Yu4, M. Xu2, Y. Bin2, P. Zhou5, Z. Yang2, and R. Wang6; 1Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China, 2Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, nanning, China, 3Department of Radiation Oncology, the Fourth Affiliated Hospital of Guangxi Medical University, liu zhou, China, 4Department of Radiation Oncology, the People’s Hospital of Liuzhou, liuzhou, China, 5Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China, 6Guangxi tumor radiation therapy clinical medical research center, nanning, China

Purpose/Objective(s): This study aimed to explore factors associated with distant metastasis after intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC), and to provide evidence that could be used to design new treatment strategies for NPC.

Materials/Methods: We performed a retrospective analysis of 645 patients with NPC at three treatment centers in China, from January 2009 to December 2011. All patients had untreated, non-metastatic NPC prior to receiving IMRT. The Kaplan-Meier method was used to calculate patient survival rates, and log-rank testing was used to compare survival differences. Univariate analysis and Cox proportional hazard analysis were performed to explore treatment failure patterns and risk factors for distant metastasis after radiotherapy.

Results: Of the 645 patients, 17.5% (113/645) had distant metastasis 5 years after treatment. The median metastatic age was 47 years (range: 20-74 years), and the median metastatic time was 24 months after IMRT (range: 6-79 months). The 5-year overall survival rate (OS) was 84.2% and the 5-year recurrence-free survival (RFS) rate was 90.1%. The 1-year, 3-year, and 5-year distant metastasis-free survival (DMFS) rates were 96.6%, 87.4%, and 82.8%, respectively. Univariate and multivariate analysis showed that N staging, the size of the cervical lymph node, the presence of lower cervical lymph node metastasis, residual cervical lymph nodes at the end of radiotherapy, the residual cervical lymph node lesion size, and the time of cervical lymph node lesion complete remission were independent prognostic factors for DMFS (P <0.05).

Conclusion: Radiotherapy combined with chemotherapy can reduce the incidence of distant metastasis after IMRT. The risk of distant metastasis after IMRT was positively correlated with N staging, lower cervical lymph node metastasis, the size of the cervical lymph nodes, residual NPC in cervical lymph nodes at the end of radiotherapy, and the residual cervical lymph node lesion size. Persistent residual cervical lymph node lesions three months after IMRT was a risk factor for poor prognosis, therefore more effective interventions should be explored.

Author Disclosure: M. Kang: None. Y. Lu: None. Y. Bin: None.

Min Kang, PhD

Biography:
Min Kang, female,Ph.D., Associate Professor, Master Tutor. Research direction: Basic and clinical investigation of nasopharyngeal carcinoma. The reviewer for several academic journals, and the member of the editorial board of Chinese Journal of Metastatic Tumors.
The member of the First Chinese Tumor Radiotherapy Cooperation Group of the World Association of Chinese Oncologists, the member of the Tumor Radiotherapy Professional Committee of the Wu Jieping Medical Foundation, the director of the West China Society of Therapeutic and Radiation Oncology, the standing committee member of the Youth Committee of the West China Society of Therapeutic and Radiation Oncology, the member of the Tumor Nutrition Professional Committee of the China Anti-aging Promoting Association, the member of the Translational Medicine Branch of the Medical Doctor Association of the Overseas-educated Scholars Association of China, the standing committee member and the secretary of the Radiation Oncology Branch of the Guangxi Medical Association, the vice-chairmen and the secretary of the Youth Committee of the Radiation Oncology Branch of the Guangxi Medical Association, the member and the secretary of the Nasopharyngeal Carcinoma Group of the Radiation Oncology Branch of the Guangxi Medical Association, the associate director and the secretary of the Nasopharyngeal Carcinoma Group of the Oncology Branch of the Guangxi Medical Association, the Secretary-general of the Guangxi Union of Oncology Management, and the vice-chairmen and the secretary of the Nasopharyngeal Carcinoma Professional Committee of the Guangxi Union of Oncology Management.
In the past five years, published over 40 academic articles, as the first/corresponding author in 15 articles (SCI), presided 3 national projects, 2 provincial projects from the Guangxi Natural Science Foundation, and won the third prize in the Science and Technology Progress Award of Guangxi, and the first prize in the Promotion Award for the Appropriate Medical and Health Technique of Guangxi.

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