Head and Neck Cancer
PV QA 2 - Poster Viewing Q&A 2
MO_25_2600 - Long-Term Therapeutic Outcome and Prognostic Factors for Patients with Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiation Therapy: An Analysis of 608 Patients from Low-Endemic Regions of China
Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3
Long-Term Therapeutic Outcome and Prognostic Factors for Patients with Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiation Therapy: An Analysis of 608 Patients from Low-Endemic Regions of China
J. Huang1, G. Wu1, K. Yang1, G. Peng1, Q. Ding1, Y. Qin1, T. Wang2, and Z. Yin2; 1Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 2Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology,1277 JieFang Avenue, Wuhan 430022, China
Purpose/Objective(s): This study aimed at evaluating the long-term outcome and prognostic factors of patients with nasopharyngeal carcinoma (NPC) from low-endemic regions of China who received definitive intensity-modulated radiotherapy (IMRT).
Materials/Methods: Clinical data from 608 patients with newly-diagnosed non-metastatic NPC who have received initial treatment at our cancer center from January, 2008 to December, 2013 were retrospectively reviewed. All patients received definitive IMRT, and 87.7% received platinum-based chemotherapy. Survival data were analyzed by Kaplan-Meier method, and Log-rank test and Cox regression analyses were performed to determine the prognostic factors.
Results: The median follow-up duration was 51 months (follow-up rate, 98.5%; range, 10-106 months) for the entire cohort. The 5-year overall survival (OS) rate was 79.6%. The 5-year local relapse-free survival rate (LRFS), region relapse-free survival rate (RRFS), distant metastasis-free survival rate (DMFS) and progression-free survival rate (PFS) were 92.4%, 93.4%, 79.2% and 74.2%, respectively. 153 patients have experienced treatment failure, with distant metastasis as the primary cause in 77.1% (118/153). Patients with T4 or N3 diseases had much poorer prognosis than other subcategories. 5-year OS rates for patients with T1-T4 diseases were 87.9%, 82.1%, 83.3% and 69.2%, respectively. 5-year OS rates for patients with N1-N3 were Stage T4 and N3 were closely associated with distant metastasis, with metastatic rate of 29.2% and 45.5%, respectively. Multivariate analysis revealed that prognosis was primarily influenced by T stage, N stage and clinical stage, with N stage and T stage acting as the independent prognostic factor for OS, PFS, RRFS and DMFS, and clinical stage for OS, PFS, LRFS and DMFS.
Conclusion: IMRT provides patients with non-metastatic NPC with satisfactory long-term survival. T stage, N stage and clinical stage are important prognostic factors for NPC patients. Patients with T4 or N3 diseases have significantly increased distant metastatic rates and poor survival.
Author Disclosure: J. Huang: None. G. Wu: None. K. Yang: None. Y. Qin: None.