Intensity-modulated radiotherapy for stage IVA/IVB nasopharyngeal carcinoma: Clinical outcomes and patterns of failure in an endemic area in China

Purpose The purpose of this study was to analyze the mode of relapse patterns and survival of 209 patients with stage IVA and IVB nasopharyngeal carcinoma (NPC). Patients and materials A total of 209 patients who underwent magnetic resonance imaging (MRI) and were subsequently histologically diagnos...

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Published in:	Strahlentherapie und Onkologie 2014-10, Vol.190 (11), p.993-1000
Main Authors:	Zeng, Lei, Tian, Yun-Ming, Sun, Xue-Ming, Huang, Ying, Chen, Chun-Yan, Han, Fei, Liu, Shuai, Lan, Mei, Guan, Ying, Deng, Xiao-Wu, Lu, Tai-Xiang
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Age Distribution Aged Carcinoma China - epidemiology Disease-Free Survival Endemic Diseases - prevention & control Endemic Diseases - statistics & numerical data Female Humans Male Medicine Medicine & Public Health Middle Aged Nasopharyngeal Carcinoma Nasopharyngeal Neoplasms - mortality Nasopharyngeal Neoplasms - pathology Nasopharyngeal Neoplasms - radiotherapy Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - prevention & control Neoplasm Staging Oncology Original Article Prevalence Radiotherapy Radiotherapy, Conformal - mortality Retrospective Studies Risk Factors Sex Distribution Survival Rate Treatment Failure Young Adult
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Summary:	Purpose The purpose of this study was to analyze the mode of relapse patterns and survival of 209 patients with stage IVA and IVB nasopharyngeal carcinoma (NPC). Patients and materials A total of 209 patients who underwent magnetic resonance imaging (MRI) and were subsequently histologically diagnosed with nondisseminated stage IV NPC received intensity-modulated radiotherapy (IMRT) as their primary treatment and were included in this retrospective study. Results Median follow-up time was 65 months (range, 3–108 months). The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates for patients with stage IVA and stage IVB NPC were 72.7 vs. 60.0 % ( p = 0.319), 62.9 vs. 51.3 % ( p = 0.070), 82.9 vs. 93.1 % ( p = 0.070), 82.9 vs. 82.9 % ( p = 0.897), 76.4 vs. 58.5 % ( p = 0.003), respectively. Age older than 44 years was found to be a statistically significant adverse independent prognostic factor for OS. Patients with advanced N status had worse OS, DFS, and DMFS rates. Patients with a primary gross tumor volume (GTV-P) ≥ 55.11 ml had worse OS, DFS, and LRRFS rates. Conclusion The results of treating stage IVA NPC with IMRT were excellent. Distant metastasis remains the most difficult treatment challenge for patients with stage IVA and IVB NPC, and more effective systemic chemotherapy should be explored.
ISSN:	0179-7158 1439-099X