Cancer Research and Treatment

Original Articles

Patterns of Failure and Survival Trends in 3,808 Patients with Stage II Nasopharyngeal Carcinoma Diagnosed from 1990 to 2012: A Large-Scale Retrospective Cohort Study: Xue-Song Sun, Di-Han Liu, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Ming-Huang Hong, Jun Ma, Lin-Quan Tang, Hai-Qiang Mai; Cancer Res Treat. 2019;51(4):1449-1463. Published online March 7, 2019; DOI: https://doi.org/10.4143/crt.2018.688

Purpose
The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years.
Materials and Methods
Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis–free survival (DMFS) were served as the clinical outcome.
Results
After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods.
Conclusion
The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.

Citations

Citations to this article as recorded by

ADAM22 acts as a novel predictive biomarker for unfavorable prognosis and facilitates metastasis via PI3K/AKT signaling pathway in nasopharyngeal carcinoma
Kaixiong Xu, Ping Jiang, Zui Chen, Xiaoqiong Gu, Ting Zhang
Pathology - Research and Practice.2024; 256: 155264. CrossRef
T1-2N1M0 nasopharyngeal carcinoma chemotherapy or not: A retrospective study
Pei-Jing Li, Ming Chen, Ye Tian, Seok Ho Lee
PLOS ONE.2023; 18(3): e0279252. CrossRef
Survival among subgroups of patients with stage II nasopharyngeal carcinoma
Shi-Ting Huang, Dan-Ke Su
Scientific Reports.2022;[Epub] CrossRef
Survival outcome and prognostic factors of patients with nasopharyngeal cancer in Yogyakarta, Indonesia: A hospital-based retrospective study
Susanna Hilda Hutajulu, Daniel Howdon, Kartika Widayati Taroeno-Hariadi, Mardiah Suci Hardianti, Ibnu Purwanto, Sagung Rai Indrasari, Camelia Herdini, Bambang Hariwiyanto, Ahmad Ghozali, Henry Kusumo, Wigati Dhamiyati, Sri Retna Dwidanarti, I. Bing Tan, J
PLOS ONE.2021; 16(2): e0246638. CrossRef
Explore the Usefulness of Concurrent Chemotherapy in Stage II Nasopharyngeal Carcinoma: A Retrospective Study
Pei-Jing Li, Yu-Lin Lai, Fang He, Yuan-Yuan Chen, Zhuo-Sheng Gu, Wei Luo, Qun Zhang
Frontiers in Pharmacology.2021;[Epub] CrossRef
Systemic chemotherapy and sequential locoregional radiotherapy in initially metastatic nasopharyngeal carcinoma: Retrospective analysis with 821 cases
Tianying Huang, Ning Su, Xuanye Zhang, Shuyun Ma, Guangzheng Zhong, Xiaopeng Tian, Qiuyan Chen, Linglong Tang, Lixia Lu, Yu Fang, Jun Cai, Qingqing Cai
Head & Neck.2020; 42(8): 1970. CrossRef
CD47 Overexpression Is Associated with Epstein–Barr Virus Infection and Poor Prognosis in Patients with Nasopharyngeal Carcinoma

Zhi-Hui Wang, Xiao-Feng Pei, Zhi-Quan Zhu, Zhong Lin, Yin-Yan Mao, Xiao-Lu Xu, You-Li Luo, Li Zhang, Pei-Jian Peng
OncoTargets and Therapy.2020; Volume 13: 3325. CrossRef
Identification of miPEP133 as a novel tumor-suppressor microprotein encoded by miR-34a pri-miRNA
Min Kang, Bo Tang, Jixi Li, Ziyan Zhou, Kang Liu, Rensheng Wang, Ziyan Jiang, Fangfang Bi, David Patrick, Dongin Kim, Anirban K. Mitra, Yang Yang-Hartwich
Molecular Cancer.2020;[Epub] CrossRef

7,125 View
154 Download
9 Web of Science
8 Crossref

Subdivision of Nasopharyngeal Carcinoma Patients with Bone-Only Metastasis at Diagnosis for Prediction of Survival and Treatment Guidance: Xue-Song Sun, Yu-Jing Liang, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Xiao-Yun Li, Jin-Jie Yan, Lin-Quan Tang, Hai-Qiang Mai; Cancer Res Treat. 2019;51(4):1259-1268. Published online January 4, 2019; DOI: https://doi.org/10.4143/crt.2018.652

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to subdivide M1 stage nasopharyngeal carcinoma (NPC) patients with bone-only metastases for prognosis prediction while identifying the treatment effect of locoregional radiotherapy (LRRT) and metastasis radiotherapy (MRT) among patients with different risk.
Materials and Methods
From November 2006 to October 2016, a total of 226 patients with bone-only metastasic NPC were retrospectively enrolled. All patients developed distant lesions before receiving treatment. All potential prognostic factors were considered and the correlation of the M1 subdivisions with overall survival (OS) was determined by Cox regression hazards model. Kaplan–Meier curves were used to appraise survival condition and log-rank testing was used to compare the differences.
Results
The median follow-up time was 33.9 months (range, 3 to 126 months). According to multivariate Cox proportional hazard analysis, the number of metastatic lesions and Epstein-Barr virus (EBV) DNA status after palliative chemotherapy (PCT) were independent prognostic factors for OS. Thus, we subdivided patients into three risk groups according to these two factors. Systemic chemotherapy combined with LRRT may benefit patients in low- and intermediate-risk groups but not in the high-risk group. Further aggressive MRT based on systemic chemotherapy showed no survival benefit in any risk group.
Conclusion
The stratification of NPC patients with bone-only metastasis based on EBV DNA after PCT and the number of metastatic lesions provided promising prognostic value and could aid clinicians in person-specific treatment.

Citations

Citations to this article as recorded by

Efficacy of metastatic lesion radiotherapy in patients with metastatic nasopharyngeal carcinoma: A multicenter retrospective study
Yang Liu, Jie Ma, Xiao-Yi Zeng, Zhi-Chao Zuo, Rui-Zhong Chen, Xiao-Yu Li, Zhong-Guo Liang, Kai-Hua Chen, Xin-Bin Pan, Su Pei, Bin-Bin Yu, Ling Li, Song Qu, Yun-Li Yang, Xiao-Dong Zhu
Radiotherapy and Oncology.2024; 196: 110311. CrossRef
Ninth Version of the AJCC and UICC Nasopharyngeal Cancer TNM Staging Classification
Jian-Ji Pan, Hai-Qiang Mai, Wai Tong Ng, Chao-Su Hu, Jin-Gao Li, Xiao-Zhong Chen, James C. H. Chow, Edwin Wong, Victor Lee, Ling-Yu Ma, Qiao-Juan Guo, Qin Liu, Li-Zhi Liu, Ting-Ting Xu, Xiao-Chang Gong, Meng-Yun Qiang, Kwok-Hung Au, Tsz-Chim Liu, Chi Leun
JAMA Oncology.2024;[Epub] CrossRef
Whether Primary Bone‐Only Oligometastatic Nasopharyngeal Carcinoma Patients Benefit From Radiotherapy to the Bones on the Basis of Palliative Chemotherapy Plus Locoregional Radiotherapy?—A Large‐Cohort Retrospective Study
Wan‐Ping Guo, Guo‐Dong Jia, Si‐Yi Xie, Xuan Yu, Xiao‐Han Meng, Lin‐Quan Tang, Xiao‐Yun Li, Dong‐Hua Luo
Cancer Medicine.2024;[Epub] CrossRef
Gemcitabine plus cisplatin versus docetaxel plus cisplatin and fluorouracil induction chemotherapy combined with locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma: A single center prospective phase II clinical trial
Kai Shang, Taotao Li, Yue Chen, Xunyan Luo, Huajing Wu, Yu Zhou, Jiayu Song, Weili Wu, Yuanyuan Li, Xiuling Luo, Xiaoxiao Chen, Xiuyun Gong, Chaofen Zhao, Zhuoling Li, Lina Liu, Qianyong He, Jinhua Long, Feng Jin
Oral Oncology.2024; 159: 107087. CrossRef
Clinical characteristics and prognostic factors affecting survival after radical radiotherapy for early and late post-treatment metastatic nasopharyngeal carcinoma
Guo-Dong Jia, Xue-Song Sun, Xiao-Yun Li, Sai-Lan Liu, Jin-Hao Yang, Qiu-Yan Chen, Li Yuan, Hai-Qiang Mai
BMC Cancer.2023;[Epub] CrossRef
Assessment of bone lesions with 18F-FDG PET/MRI in patients with nasopharyngeal carcinoma
Yuting Fang, Shoucong Chen, Yuanfan Xu, Mengyun Qiang, Changjuan Tao, Shuang Huang, Lei Wang, Xiaozhong Chen, Caineng Cao
Nuclear Medicine Communications.2023; 44(6): 457. CrossRef
The map of bone metastasis in nasopharyngeal carcinoma: A real‐world study
Dong‐Hua Luo, Jia‐Xin Li, Wan‐Ping Guo, Chen‐Guang Guo, Xiao‐Han Meng, Pei‐Jun Xie, Jie‐Yi Lin, Hao‐Yuan Mo, Qun Zhang, Yong Chen, Guo‐Ping Shen
Cancer Medicine.2023; 12(17): 17660. CrossRef
Optimal management of oligometastatic nasopharyngeal carcinoma
Honggen Liu, Peiying Yang, Yingjie Jia
European Archives of Oto-Rhino-Laryngology.2022; 279(2): 567. CrossRef
Optimizing the treatment mode for de novo metastatic nasopharyngeal carcinoma with bone-only metastasis
Cheng Lin, Sheng Lin, Lili Zhu, Shaojun Lin, Jianji Pan, Yun Xu
BMC Cancer.2022;[Epub] CrossRef
A nonendemic analysis of the patterns and prognosis of de novo metastatic nasopharyngeal carcinomas in older patients aged ≥ 65 years
Baoqiu Liu, Mingxing Zhang, Yanqing Cao, Zhe Wang, Xicheng Wang
Scientific Reports.2022;[Epub] CrossRef
Promising response to immunotherapy in metastatic nasopharyngeal carcinoma associated with hepatitis C virus – a case report
Cristina Orlov Slavu, Andreea Paroşanu, Ana-Maria Popa, Mihaela Olaru, Loredana Mitran, Cornelia Niţipir
ORL.ro.2021; 2(51): 30. CrossRef
Diagnostic and prognostic nomograms for bone metastasis in small cell lung cancer
Chenan Liu, Jiahong Yi, Junmei Jia
Journal of International Medical Research.2021;[Epub] CrossRef
Prognostic potential of liquid biopsy tracking in the posttreatment surveillance of patients with nonmetastatic nasopharyngeal carcinoma
Fo‐Ping Chen, Xiao‐Dan Huang, Jia‐Wei Lv, Dan‐Wan Wen, Guan‐Qun Zhou, Li Lin, Jia Kou, Chen‐Fei Wu, Yue Chen, Zi‐Qi Zheng, Zhi‐Xuan Li, Xiao‐Jun He, Ying Sun
Cancer.2020; 126(10): 2163. CrossRef
Oral Maintenance Chemotherapy Using S-1/Capecitabine in Metastatic Nasopharyngeal Carcinoma Patients After Systemic Chemotherapy: A Single-Institution Experience

Qiaojuan Guo, Mengwei Chen, Hanchuan Xu, Tianzhu Lu, Han Zhou, Yanyan Chen, Jingfeng Zong, Yun Xu, Bijuan Chen, Bingyi Wang, Lili Zhu, Jianji Pan, Shaojun Lin
Cancer Management and Research.2020; Volume 12: 1387. CrossRef
Metastatic disease in head & neck oncology
Paolo Pisani, Mario Airoldi, Anastasia Allais, Paolo Aluffi Valletti, Mariapina Battista, Marco Benazzo, Roberto Briatore, Salvatore Cacciola, Salvatore Cocuzza, Andrea Colombo, Bice Conti, Alberto Costanzo, Laura della Vecchia, Nerina Denaro, Cesare Fant
Acta Otorhinolaryngologica Italica.2020; 40(SUPPL. 1): S1. CrossRef
Pattern and prognosis of distant metastases in nasopharyngeal carcinoma: A large‐population retrospective analysis
Weiling Qu, Sihan Li, Miao Zhang, Qiao Qiao
Cancer Medicine.2020; 9(17): 6147. CrossRef
Bone Metastases Pattern in Newly Diagnosed Metastatic Nasopharyngeal Carcinoma: A Real-World Analysis in the SEER Database
Xiaojing Yang, Hanru Ren, Weiwei Yu, Hongling Li, Xinmiao Yang, Jie Fu
BioMed Research International.2020; 2020: 1. CrossRef
Synchronous Metastatic Nasopharyngeal Carcinoma: Characteristics and Survival of Patients Adding Definitive Nasopharyngeal-Neck Radiotherapy to Systematic Chemotherapy

Wenjun Liao, Jinlan He, Qiheng Gou, Baofeng Duan, Lei Liu, Ping Ai, Yanchu Li, Kexing Ren, Nianyong Chen
Cancer Management and Research.2020; Volume 12: 10211. CrossRef

8,065 View
336 Download
21 Web of Science
18 Crossref

Induction Chemotherapy Plus Concurrent Chemoradiotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma in Children and Adolescents: A Matched Cohort Analysis: Yang Li, Lin-Quan Tang, Li-Ting Liu, Shan-Shan Guo, Yu-Jing Liang, Xue-Song Sun, Qing-Nan Tang, Jin-Xin Bei, Jing Tan, Shuai Chen, Jun Ma, Chong Zhao, Qiu-Yan Chen, Hai-Qiang Mai; Cancer Res Treat. 2018;50(4):1304-1315. Published online January 8, 2018; DOI: https://doi.org/10.4143/crt.2017.463

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to evaluate the long-term clinical outcome and toxicity of induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) compared with CCRT alone for the treatment of children and adolescent locoregionally advanced nasopharyngeal carcinoma (LACANPC).
Materials and Methods
A total of 194 locoregionally advanced nasopharyngeal carcinoma patients youngerthan 21 years who received CCRT with or without IC before were included in the study population. Overall survival (OS) rate, progression-free survival (PFS) rate, locoregional recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate were assessed by the Kaplan-Meier method and a log-rank test. Treatment toxicities were clarified and compared between two groups.
Results
One hundred and thiry of 194 patients received IC+CCRT. Patients who were younger and with more advanced TNM stage were more likely to receive IC+CCRT and intensive modulated radiotherapy. The addition of IC before CCRT failed to improve survival significantly. The matched analysis identified 43 well-balanced patients in both two groups. With a median follow-up of 51.5 months, no differences were found between the IC+CCRT group and the CCRT group in 5-year OS (83.7% vs. 74.6%, p=0.153), PFS (79.2% vs. 73.4%, p=0.355), LRFS (97.7% vs. 88.2%, p=0.083), and DMFS (81.6% vs. 81.6%, p=0.860). N3 was an independent prognostic factor predicting poorer OS, PFS, and DMFS. The addition of IC was associated with increased rates of grade 3 to 4 neutropenia.
Conclusion
This study failed to demonstrate that adding IC before CCRT could provide a significant additional survival benefit for LACANPC patients. Further investigations are warranted.

Citations

Citations to this article as recorded by

Nasopharyngeal Carcinoma in Children, Current Treatment Approach
Tal Ben-Ami
Journal of Pediatric Hematology/Oncology.2024; 46(3): 117. CrossRef
Concurrent chemoradiotherapy with or without neoadjuvant chemotherapy in pediatric patients with stage III-IVa nasopharyngeal carcinoma: a real-world propensity score-matched cohort study
Ya-Nan Jin, Zhao-Hui Ruan, Wan-Wei Cao, Lin Yang, Wei Yao, Xiao-Feng Pei, Wang-Jian Zhang, Tia Marks, Ji-Jin Yao, Liang-Ping Xia
Journal of Cancer Research and Clinical Oncology.2023; 149(13): 11929. CrossRef
Epidemiology and treatment of head and neck malignancies in the AYA generation
Takahiro Asakage
International Journal of Clinical Oncology.2022; 27(3): 465. CrossRef
Association of Treatment Advances With Survival Rates in Pediatric Patients With Nasopharyngeal Carcinoma in China, 1989-2020
Yu-Jing Liang, Li-Ting Liu, Yang Li, Pan Wang, Mei-Juan Luo, Dong-Xiang Wen, Qiu-Yan Chen, Hai-Qiang Mai
JAMA Network Open.2022; 5(3): e220173. CrossRef
LHX2 facilitates the progression of nasopharyngeal carcinoma via activation of the FGF1/FGFR axis
Tao Xie, Kunpeng Du, Wei Liu, Chunshan Liu, Baiyao Wang, Yunhong Tian, Rong Li, Xiaoting Huang, Jie Lin, Haifeng Jian, Jian Zhang, Yawei Yuan
British Journal of Cancer.2022; 127(7): 1239. CrossRef
Exploring the Optimal Chemotherapy Strategy for Locoregionally Advanced Children and Adolescent Nasopharyngeal Carcinoma Based on Pretreatment Epstein-Barr Virus DNA Level in the Era of Intensity Modulated Radiotherapy
Ziyi Zeng, Chen Chen, Lanlan Guo, Cheng Zhang, Lei Chen, Chuanping Yuan, Lixia Lu
Frontiers in Oncology.2021;[Epub] CrossRef
Optimal cumulative cisplatin dose during concurrent chemoradiotherapy among children and adolescents with locoregionally advanced nasopharyngeal carcinoma: A real-world data study
Ya-Nan Jin, Ji-Jin Yao, Ya-Fei You, Hui-Jiao Cao, Zi-Zi Li, Dan-Ling Dai, Wang-Jian Zhang, Tia Marks, Bei Zhang, Liang-Ping Xia
Radiotherapy and Oncology.2021; 161: 83. CrossRef
Nasopharyngeal carcinoma in children: Multimodal treatment and long‐term outcome of 92 patients in a single center over a 28‐year period
Rejin Kebudi, Sema Bay Buyukkapu, Omer Gorgun, Kübra Ozkaya, Rasim Meral, Inci Ayan, Musa Altun
Pediatric Blood & Cancer.2021;[Epub] CrossRef
Induction or adjuvant chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in paediatric nasopharyngeal carcinoma in the IMRT era: A recursive partitioning risk stratification analysis based on EBV DNA
Yu-Jing Liang, Dong-Xiang Wen, Mei-Juan Luo, Lin-Quan Tang, Shan-Shan Guo, Pan Wang, Qiu-Yan Chen, Li-Ting Liu, Hai-Qiang Mai
European Journal of Cancer.2021; 159: 133. CrossRef
Time-to-Event Supervised Genetic Algorithm Enables Induction Chemotherapy Decision Making for Nasopharyngeal Carcinoma
Demin Liu, Haojiang Li, Liyang Wu, Shuchao Chen, Tianqiao Zhang, Wenjie Huang, Guangying Ruan, Sai Li, Lizhi Liu, Hongbo Chen
IEEE Access.2021; 9: 98701. CrossRef
LHX2 Facilitates the Progression of Nasopharyngeal Carcinoma via Activation of the FGF1/FGFR Axis
Tao Xie, Kunpeng Du, Wei Liu, Chunshan Liu, Baiyao Wang, Yunhong Tian, Rong Li, Xiaoting Huang, Jie Lin, Haifeng Jian, Jian Zhang, Yawei Yuan
SSRN Electronic Journal .2021;[Epub] CrossRef
Prognostic impact of immunohistopathologic features in definitive radiation therapy for nasopharyngeal cancer patients
Naoya Murakami, Taisuke Mori, Yuko Kubo, Seiichi Yoshimoto, Kimiteru Ito, Yoshitaka Honma, Takao Ueno, Kenya Kobayashi, Hiroyuki Okamoto, Narikazu Boku, Kana Takahashi, Koji Inaba, Kae Okuma, Hiroshi Igaki, Yuko Nakayama, Jun Itami
Journal of Radiation Research.2020; 61(1): 161. CrossRef
The efficacy and safety of induction chemotherapy combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in nasopharyngeal carcinoma patients: a systematic review and meta-analysis
Bi-Cheng Wang, Bo-Ya Xiao, Guo-He Lin, Chang Wang, Quentin Liu
BMC Cancer.2020;[Epub] CrossRef
Update in pediatric nasopharyngeal undifferentiated carcinoma
Line Claude, Emmanuel Jouglar, Loig Duverge, Daniel Orbach
The British Journal of Radiology.2019;[Epub] CrossRef

8,462 View
210 Download
18 Web of Science
14 Crossref

Combination of Tumor Volume and Epstein-Barr Virus DNA Improved Prognostic Stratification of Stage II Nasopharyngeal Carcinoma in the Intensity Modulated Radiotherapy Era: A Large-Scale Cohort Study: Qiu-Yan Chen, Shao-Yan Guo, Lin-Quan Tang, Tong-Yu Lu, Bo-Lin Chen, Qi-Yu Zhong, Meng-Sha Zou, Qing-Nan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Yang Li, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Chong Zhao, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Mu-Sheng Zeng, Hai-Qiang Mai; Cancer Res Treat. 2018;50(3):861-871. Published online September 13, 2017; DOI: https://doi.org/10.4143/crt.2017.237

Abstract PDF Supplementary Material PubReader ePub

Purpose
Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors.
Materials and Methods
By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above.
Results
Gross tumor volume of cervical lymph nodes (GTVnd, p < 0.001) and total tumor volume (GTVtotal, p < 0.001) were both closely related to pretreatment EBV DNA, while gross tumor volume of nasopharynx (GTVnx, p=0.047) was weakly related to EBV DNA. EBV DNA was significantly correlated with progress-free survival (PFS, p=0.005), locoregional-free survival (LRFS, p=0.039), and distant metastasis-free survival (DMFS, p=0.017), while GTVtotal, regardless of GTVnx and GTVnd, had a significant correlation with PFS and LRFS. The p-values of GTVtotal for PFS and LRFS were 0.008 and 0.001, respectively. According to GTVtotal and pretreatment EBV DNA level, patients were divided into a low-risk group (EBV DNA 0 copy/mL, GTVtotal < 30 cm3; EBV DNA 0 copy/mL, GTVtotal ≥ 30 cm3; or EBV DNA > 0 copy/mL, GTVtotal < 30 cm3) and a high-risk group (EBV DNA > 0 copy/mL, GTVtotal ≥ 30 cm3). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant.
Conclusion
Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.

Citations

Citations to this article as recorded by

Risk stratification of LA‐NPC during chemoradiotherapy based on clinical classification and TVRR
Qianlong Tang, Chaorong Mei, Bei Huang, Rui Huang, Le Kang, Ailin Chen, Na lei, Pengcheng Deng, Shouyan Ying, Peng Zhang, Yuan Qin
Cancer Medicine.2024;[Epub] CrossRef
A radiogenomic clinical decision support system to inform individualized treatment in advanced nasopharyngeal carcinoma
Xue-Liang Fang, Lian-Zhen Zhong, Wei Jiang, Cheng-Long Huang, Yuan Lei, Si-Qi Tang, Qing-Jie Li, Li-Zhi Liu, Li Tian, Ying-Qin Li, Yu-Pei Chen, Li Lin, Rui Guo, Wen-Fei Li, Jie Tian, Na Liu, Di Dong, Jun Ma, Ling-Long Tang
iScience.2024; 27(8): 110431. CrossRef
Epstein–Barr virus DNA change level combined with tumor volume reduction ratio after inductive chemotherapy as a better prognostic predictor in locally advanced nasopharyngeal carcinoma
Zhong‐zheng Xiang, Tao He, Yuan‐yuan Zeng, Fang Liu, Bian‐fei Shao, Tian Yang, Jia‐chun Ma, Xi‐ran Wang, Si‐ting Yu, Lei Liu
Cancer Medicine.2023; 12(2): 1102. CrossRef
A prognostic nomogram incorporating tumor size and lymph node size for patients with nasopharyngeal carcinoma
Qi Yi, Jiazuo Cai, Yunen Lin, Zimei Hu, Jie Lin, Zhong Huang, Wei Liu, Ronghui Zheng, YaWei Yuan, Chengcong Chen
American Journal of Otolaryngology.2023; 44(2): 103717. CrossRef
Tumor volume reduction after induction chemotherapy with gemcitabine plus cisplatin in nasopharyngeal carcinoma
Qian Chen, Liangfang Shen, Shan Li
European Archives of Oto-Rhino-Laryngology.2023; 280(5): 2497. CrossRef
High proportion of circulating CD8 + CD28- senescent T cells is an independent predictor of distant metastasis in nasopharyngeal carcinoma after radiotherapy
Xiaotian Xu, Fangze Wei, Lin Xiao, Runye Wu, Baojun Wei, Shengkai Huang, Junlin Yi, Wei Cui
Journal of Translational Medicine.2023;[Epub] CrossRef
MRI-based deep learning model predicts distant metastasis and chemotherapy benefit in stage II nasopharyngeal carcinoma
Yu-Jun Hu, Lin Zhang, You-Ping Xiao, Tian-Zhu Lu, Qiao-Juan Guo, Shao-Jun Lin, Lan Liu, Yun-Bin Chen, Zi-Lu Huang, Ya Liu, Yong Su, Li-Zhi Liu, Xiao-Chang Gong, Jian-Ji Pan, Jin-Gao Li, Yun-Fei Xia
iScience.2023; 26(6): 106932. CrossRef
The influence of tumor volume on the risk of distant metastases in head and neck squamous cell carcinomas
Julie Kjems, Katrin Elisabet Håkansson, Claus Andrup Kristensen, Jesper Grau Eriksen, Morten Horsholt Kristensen, Anne Ivalu Sander Holm, Jens Overgaard, Christian Rønn Hansen, Ruta Zukauskaite, Jørgen Johansen, Ivan Richter Vogelius, Jeppe Friborg
Radiotherapy and Oncology.2023; 186: 109771. CrossRef
The value of integrating tumor volume and plasma Epstein-Barr virus DNA load during sequential chemoradiotherapy for prognostic prediction and therapeutic guidance in high-risk locoregionally advanced nasopharyngeal carcinoma
Gaoyuan Wang, Zhe Dong, Chenglong Huang, Xiaojing Du, Lin Chen, Kunpeng Li, Rui Guo, Linglong Tang, Jun Ma
Oral Oncology.2023; 145: 106500. CrossRef
Clinical Significance of Baseline Epstein–Barr Virus DNA for Recurrent or Metastatic Primary Pulmonary Lymphoepithelioma-Like Carcinoma
Qihua Zou, Kongjia Luo, Liping Kang, Caiwen Huang, Jianliang Mai, Yongbin Lin, Ying Liang
Future Oncology.2023; 19(37): 2481. CrossRef
Predictive Value of ERCC1 mRNA Level from Receiver-Operator Characteristic and Pretreatment EBV-DNA Virus Load in Stage II Nasopharyngeal Carcinoma Patients Receiving Intensity-Modulated Radiotherapy with Concurrent Cisplatin
Li Hua, Shaojun Chen, Mengzhuan Wei, Yongqi Shen, Jianxin Long, Zhan Lin, Yiliang Meng, Chengxian Guo, Haixin Huang, Xiaoning Tu, Min Yao
Cancer Biotherapy and Radiopharmaceuticals.2022; 37(1): 2. CrossRef
Development and prospective validation of a risk score model in guiding individualized concurrent chemoradiotherapy in stage II nasopharyngeal carcinoma in intensity‐modulated radiotherapy era
Shan‐Shan Yang, Ya‐Jun Pang, Zhi‐Qiang Wang, Bao‐Yu Zhang, Zhi‐Qiao Liu, En‐Ni Chen, Pu‐Yun OuYang, Fang‐Yun Xie
Cancer Medicine.2022; 11(4): 1109. CrossRef
Combined Association of Tumoral PD-L1 Expression and Pretreatment Presence of Epstein-Barr Virus DNA With Risk Stratification and Prognosis of Patients With Nasopharyngeal Carcinoma
Xiaoyu Li, Xingchen Peng, Sha Zhao, Hong Zhang, Yong Jiang, Fei Liu, Ping Ai
Frontiers in Oncology.2022;[Epub] CrossRef
Nomogram for distant metastasis-free survival in patients with locoregionally advanced nasopharyngeal carcinoma
Huiyun Yang, Rongjun Zhang, Ruyun Zhang, Bin Zhang, Yuan Xie, Guanjie Qin, Yunyan Mo, Xiaolan Ruan, Wei Jiang
Strahlentherapie und Onkologie.2022; 198(9): 828. CrossRef
Survival among subgroups of patients with stage II nasopharyngeal carcinoma
Shi-Ting Huang, Dan-Ke Su
Scientific Reports.2022;[Epub] CrossRef
Liquid Biopsy in Head and Neck Cancer: Current Evidence and Future Perspective on Squamous Cell, Salivary Gland, Paranasal Sinus and Nasopharyngeal Cancers
Santiago Cabezas-Camarero, Pedro Pérez-Segura
Cancers.2022; 14(12): 2858. CrossRef
Clinical relevance of blood-based ctDNA analysis: mutation detection and beyond
Laura Keller, Yassine Belloum, Harriet Wikman, Klaus Pantel
British Journal of Cancer.2021; 124(2): 345. CrossRef
Treatment Deescalation Strategies for Nasopharyngeal Cancer
Anna Lee, James C. H. Chow, Nancy Y. Lee
JAMA Oncology.2021; 7(3): 445. CrossRef
Clinical and survival analysis of nasopharyngeal carcinoma with consistently negative Epstein–Barr virus DNA
Zhi‐Gong Wei, Xiao‐Lin Hu, Yan He, Hui Guan, Jing‐Jing Wang, Ling He, Xiao‐Li Mu, Zhe‐Ran Liu, Rui‐Dan Li, Xing‐Chen Peng
Head & Neck.2021; 43(5): 1465. CrossRef
Accumulation of LOX-1+ PMN-MDSCs in nasopharyngeal carcinoma survivors with chronic hepatitis B might permit immune tolerance to epstein–barr virus and relate to tumor recurrence
Xing Li, Jin-Long Li, Nan Jiang, Jie Chen, Zi-Ming Liang, Zhen-Lin Zhao, Yan-Fang Xing
Aging.2021; 13(1): 437. CrossRef
A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma
Anne W.M. Lee, Victor H.F. Lee, Wai-Tong Ng, Primož Strojan, Nabil F. Saba, Alessandra Rinaldo, Stefan M. Willems, Juan P. Rodrigo, Arlene A. Forastiere, Alfio Ferlito
European Journal of Cancer.2021; 153: 109. CrossRef
Establishment of a Prognostic Nomogram for Patients With Locoregionally Advanced Nasopharyngeal Carcinoma Incorporating TNM Stage, Post-Induction Chemotherapy Tumor Volume and Epstein-Barr Virus DNA Load
Yu-Ting Jiang, Kai-Hua Chen, Jie Yang, Zhong-Guo Liang, Song Qu, Ling Li, Xiao-Dong Zhu
Frontiers in Oncology.2021;[Epub] CrossRef
Metastasis of nasopharyngeal carcinoma: What we know and do not know
Ling-Ling Guo, Hai-Yun Wang, Li-Sheng Zheng, Ming-Dian Wang, Yun Cao, Yang Li, Zhi-Jie Liu, Li-Xia Peng, Bi-Jun Huang, Jian-Yong Shao, Chao-Nan Qian
Visualized Cancer Medicine.2021; 2: 4. CrossRef
Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature
Chi Leung Chiang, Qiaojuan Guo, Wai Tong Ng, Shaojun Lin, Tiffany Sze Wai Ma, Zhiyuan Xu, Youping Xiao, Jishi Li, Tianzhu Lu, Horace Cheuk Wai Choi, Wenqi Chen, Eric Sze Chun Chau, Peter Ho Yin Luk, Shao Hui Huang, Brian O’Sullivan, Jianji Pan, Anne Wing
Frontiers in Oncology.2021;[Epub] CrossRef
External Validation of a Nomogram to Predict Survival and Benefit of Concurrent Chemoradiation for Stage II Nasopharyngeal Carcinoma
Pui-Lam Yip, Shing-Fung Lee, Cheuk-Wai Horace Choi, Po-Chung Sunny Chan, Ka-Wai Alice Cheung, Chung-Hang James Chow, Ka-Man Cheung, Wing-Yu Jessica Lai, Ho-Fun Victor Lee, Ka-On Lam, Chi-Leung Chiang, Chun-Yin Edwin Wong, Ming-Chun Darren Poon, Macy Tong,
Cancers.2021; 13(17): 4286. CrossRef
The efficacy of chemotherapy in survival of stage II nasopharyngeal carcinoma
Xin-Bin Pan, Ling Li, Song Qu, Long Chen, Shi-Xiong Liang, Xiao-Dong Zhu
Oral Oncology.2020; 101: 104520. CrossRef
Usefulness of Hybrid PET/MRI in Clinical Evaluation of Head and Neck Cancer Patients
Natalia Samolyk-Kogaczewska, Ewa Sierko, Dorota Dziemianczyk-Pakiela, Klaudia Beata Nowaszewska, Malgorzata Lukasik, Joanna Reszec
Cancers.2020; 12(2): 511. CrossRef
Prognostic efficacy of extensive invasion of primary tumor volume for T3-4 nasopharyngeal carcinoma receiving intensity-modulated radiotherapy
Fen Xue, Dan Ou, Xiaomin Ou, Xin Zhou, Chaosu Hu, Xiayun He
Oral Oncology.2020; 100: 104478. CrossRef
Establishment and validation of a nomogram for predicting the benefit of concurrent chemotherapy in stage II nasopharyngeal carcinoma: A study based on a phase III randomized clinical trial with 10-year follow-up
Xue-Song Sun, Xiao-Yun Li, Bei-Bei Xiao, Sai-Lan Liu, Qiu-Yan Chen, Lin-Quan Tang, Hai-Qiang Mai
Oral Oncology.2020; 100: 104490. CrossRef
Metastatic disease in head & neck oncology
Paolo Pisani, Mario Airoldi, Anastasia Allais, Paolo Aluffi Valletti, Mariapina Battista, Marco Benazzo, Roberto Briatore, Salvatore Cacciola, Salvatore Cocuzza, Andrea Colombo, Bice Conti, Alberto Costanzo, Laura della Vecchia, Nerina Denaro, Cesare Fant
Acta Otorhinolaryngologica Italica.2020; 40(SUPPL. 1): S1. CrossRef
BHRF1 Enhances EBV Mediated Nasopharyngeal Carcinoma Tumorigenesis through Modulating Mitophagy Associated with Mitochondrial Membrane Permeabilization Transition
Shujie Song, Zhiying Jiang, David Ethan Spezia-Lindner, Ting Liang, Chang Xu, Haifeng Wang, Ye Tian, Yidong Bai
Cells.2020; 9(5): 1158. CrossRef
Predictive Value of CD8 Expression and FoxP3 Methylation in Nasopharyngeal Carcinoma Patients Treated with Chemoradiotherapy in a Non-endemic Area
E. Muraro, E. Vaccher, C. Furlan, E. Fratta, G. Fanetti, D. A. Fae’, D. Martorelli, M. Cangemi, J. Polesel, F. Navarria, C. Gobitti, E. Comaro, C. Scaini, C. Pratesi, S. Zanussi, V. Lupato, G. Grando, V. Giacomarra, S. Sulfaro, L. Barzan, R. Dolcetti, A.
Pathology & Oncology Research.2020; 26(4): 2459. CrossRef
Prognostic Value of Programmed Cell Death-Ligand 1 Expression in Tumor-Infiltrating Lymphocytes and Viral Load in Peripheral Blood Mononuclear Cells for Epstein–Barr Virus–Positive Nasopharyngeal Carcinoma
Bin Hu, Ming Sun, Zijin Wang, Yanping Zheng, Weifeng Cai, Helen Hsiao-Hsing Shi, Yanzhen Zhuang, Qin Lin
Clinical Chemistry.2020; 66(9): 1219. CrossRef
Molecular Prognostic Value of Circulating Epstein–Barr Viral DNA in Nasopharyngeal Carcinoma: A Meta-Analysis of 27,235 Cases in the Endemic Area of Southeast Asia
Xulin Xie, Yupei Ren, Kun Wang, Bin Yi
Genetic Testing and Molecular Biomarkers.2019; 23(7): 448. CrossRef
Dynamic changes in plasma Epstein–Barr virus DNA load during treatment have prognostic value in nasopharyngeal carcinoma: a retrospective study
Sha‐Sha He, Yan Wang, Yong Bao, Xiu‐Yu Cai, Xing‐Li Yang, Dan‐Ming Chen, Yong Chen, Li‐Xia Lu
Cancer Medicine.2018; 7(4): 1110. CrossRef
Impact of paranasal sinus invasion on advanced nasopharyngeal carcinoma treated with intensity‐modulated radiation therapy: the validity of advanced T stage of AJCC/UICC eighth edition staging system
Ying Wang, Jie Zhao, Yajie Zhao, Zhen Yang, Mingjun Lei, Zhanzhan Li, Rui Wei, Dengming Chen, Yuxiang He, Liangfang Shen
Cancer Medicine.2018; 7(7): 2826. CrossRef
Impact of age on survival of locoregional nasopharyngeal carcinoma: An analysis of the Surveillance, Epidemiology, and End Results program database, 2004‐2013
S.‐J. Huang, Y.‐Y. Tang, H.‐M. Liu, G.‐X. Tan, X. Wang, H. Zhang, F. Yang, S. Yang
Clinical Otolaryngology.2018; 43(5): 1209. CrossRef
Relationship between pretreatment concentration of plasma Epstein‐Barr virus DNA and tumor burden in nasopharyngeal carcinoma: An updated interpretation
Liang Peng, Yi Yang, Rui Guo, Yan‐Ping Mao, Cheng Xu, Yu‐Pei Chen, Ying Sun, Jun Ma, Ling‐Long Tang
Cancer Medicine.2018; 7(12): 5988. CrossRef

8,948 View
294 Download
38 Web of Science
38 Crossref

Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study: Qiu-Yan Chen, Qing-Nan Tang, Lin-Quan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Chao-Feng Li, Yang Li, Yu-Jing Liang, Xue-Song Sun, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Yu-Ying Fan, Yan He, Ming-Yuan Chen, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Hai-Qiang Mai; Cancer Res Treat. 2018;50(3):701-711. Published online July 14, 2017; DOI: https://doi.org/10.4143/crt.2017.180

Abstract PDF Supplementary Material PubReader ePub

Purpose
The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC.
Materials and Methods
In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary endpoint was progress-free survival (PFS).
Results
The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the highSAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors.
Conclusion
The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.

Citations

Citations to this article as recorded by

Development and application of a serious adverse events risk model for concurrent chemoradiotherapy in patients with nasopharyngeal carcinoma
Jiahui Li, Qianwen Liu, Huiying Qin
Medicine.2024; 103(34): e39377. CrossRef
Selection of induction chemotherapy cycles for stage N3 nasopharyngeal carcinoma based on pre-treatment plasma EBV DNA
Youliang Weng, Sunqin Cai, Chao Li, Yun Xu, Yuhui Pan, Zongwei Huang, Ying Li, Zijie Wu, Yu Chen, Sufang Qiu
Scientific Reports.2024;[Epub] CrossRef
Maintenance therapy improves the survival outcomes of patients with metastatic nasopharyngeal carcinoma responding to first-line chemotherapy: a multicentre, randomized controlled clinical study
Ying Lu, Haixin Huang, Hui Yang, Xiaohua Hu, Meilian Liu, Changjie Huang, Xianbin Feng, Xishan Chen, Zhou Jiang
Journal of Cancer Research and Clinical Oncology.2023; 149(8): 4327. CrossRef
Association of Epstein–Barr virus DNA and SAA with S1 maintenance therapy outcomes in patients with metastatic nasopharyngeal carcinoma
Ying Lu, Zhou Jiang, Huan Lin, Hui Yang, Xishan Chen, Haixin Huang
Future Oncology.2022; 18(22): 2441. CrossRef
Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma
Wanxia Li, Jing Chen, Bijun Liang, Zonghua Li, Junzheng Li, Xiaofei Yuan, Shuting Wu, Fangfang Zeng, Xinyu Peng, Yanfei Li, Juan Lu, Feipeng Zhao, Xiong Liu
Cancer Medicine.2021; 10(3): 883. CrossRef
A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma
Anne W.M. Lee, Victor H.F. Lee, Wai-Tong Ng, Primož Strojan, Nabil F. Saba, Alessandra Rinaldo, Stefan M. Willems, Juan P. Rodrigo, Arlene A. Forastiere, Alfio Ferlito
European Journal of Cancer.2021; 153: 109. CrossRef
Prognostic value of Epstein–Barr virus DNA level for nasopharyngeal carcinoma: a meta-analysis of 8128 cases
Hongling Qu, Yuli Huang, Shufen Zhao, Yuanqing Zhou, Weibiao Lv
European Archives of Oto-Rhino-Laryngology.2020; 277(1): 9. CrossRef
The prognostic value of integration of pretreatment serum amyloid A (SAA)–EBV DNA (S‐D) grade in patients with nasopharyngeal carcinoma
Jianpei Li, Changchun Lai, Songguo Peng, Hao Chen, Lei Zhou, Yufeng Chen, Shulin Chen
Clinical and Translational Medicine.2020;[Epub] CrossRef
Utility of a Simple Scoring System in Differentiating Bacterial Infections in Cases of Fever of Unknown Origin
Teng Xu, Li Wang, Shi Wu, Fenfen Zhou, Haihui Huang
Clinical Infectious Diseases.2020; 71(Supplement): S409. CrossRef
The prognostic value of serum amyloid A in solid tumors: a meta-analysis
Hai-yingjie Lin, Guo-qiang Tan, Yan Liu, Shao-qiang Lin
Cancer Cell International.2019;[Epub] CrossRef
Molecular Prognostic Value of Circulating Epstein–Barr Viral DNA in Nasopharyngeal Carcinoma: A Meta-Analysis of 27,235 Cases in the Endemic Area of Southeast Asia
Xulin Xie, Yupei Ren, Kun Wang, Bin Yi
Genetic Testing and Molecular Biomarkers.2019; 23(7): 448. CrossRef
Rapid detection of quantum dot immune chromatography nasopharyngeal carcinoma EBNA1 antibody
Jian He, Jing Xu, Ping Wu, Lingfeng Liao, Huatao Quan, Jing Kang, Yongquan Tian, Yaoyun Tang
Oncology Letters.2018;[Epub] CrossRef

9,186 View
268 Download
15 Web of Science
12 Crossref

The Prognostic Value of Treatment-Related Lymphopenia in Nasopharyngeal Carcinoma Patients: Li-Ting Liu, Qiu-Yan Chen, Lin-Quan Tang, Shan-Shan Guo, Ling Guo, Hao-Yuan Mo, Ming-Yuan Chen, Chong Zhao, Xiang Guo, Chao-Nan Qian, Mu-Sheng Zeng, Jin-Xin Bei, Jing Tan, Shuai Chen, Ming-Huang Hong, Jian-Yong Shao, Ying Sun, Jun Ma, Hai-Qiang Mai; Cancer Res Treat. 2018;50(1):19-29. Published online April 5, 2017; DOI: https://doi.org/10.4143/crt.2016.595

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to evaluate the prognostic value of treatment-related lymphopenia in patients with nasopharyngeal carcinoma (NPC).
Materials and Methods
A total of 413 consecutive stage II-IVb NPC patients treated with concurrent chemoradiotherapy (CCRT) were enrolled. The overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) were calculated with the Kaplan-Meier method, and differences were compared using the log-rank test.
Results
A minimum (mini)–absolute lymphocyte counts (ALC) of < 390 cells/μL or ALC after 3 months of CCRT (post3m-ALC) < 705 cells/μL was significantly associated with worse outcome than mini-ALC ≥ 390 cells/μL (OS, p=0.002; PFS, p=0.005; DMFS, p=0.004) or post3m-ALC ≥ 705 cells/μL (OS, p < 0.001; PFS, p < 0.001; DMFS, p=0.001). Patients with lymphopenia (mini-ALC < 390 cells/μL and post3m-ALC < 705 cells/μL) had a worse prognosis than those without lymphopenia (mini-ALC ≥ 390 cells/μL and post3m-ALC ≥ 705 cells/μL) (OS, p < 0.001; PFS, p < 0.001; DMFS, p < 0.001). Multivariate analysis revealed that post3m-ALC was an independent prognostic factor for OS (hazard ratio [HR], 1.76; 95% confidence interval [CI], 1.12 to 2.78; p=0.015), PFS (HR, 1.86; 95% CI, 1.23 to 2.82; p=0.003), and DMFS (HR, 1.87; 95% CI, 1.13 to 3.08; p=0.014). Multivariate analysis also revealed that patients with lymphopenia had a high risk of death (HR, 3.79; 95% CI, 1.75 to 8.19; p=0.001), disease progression (HR, 2.93; 95% CI, 1.59 to 5.41; p=0.001), and distant metastasis (HR, 3.89; 95% CI, 1.67 to 9.10; p=0.002). Multivariate analysis performed with time dependent Cox regression demonstrated ALC was an independent prognostic factor for OS (HR, 0.995; 95% CI, 0.991 to 0.999; p=0.025) and PFS (HR, 0.993; 95% CI, 0.988 to 0.998; p=0.006).
Conclusion
Treatment-related lymphopenia was a poor prognostic factor in NPC patients.

Citations

Citations to this article as recorded by

Nomograms containing body dose parameters for predicting survival in patients with nasopharyngeal carcinoma
Jianyun Jiang, Ruiping Zhai, Fangfang Kong, Chengrun Du, Hongmei Ying
European Archives of Oto-Rhino-Laryngology.2024; 281(1): 181. CrossRef
Radiotherapy alone versus concurrent chemoradiotherapy in patients with stage II and T3N0 nasopharyngeal carcinoma with adverse features: A propensity score-matched cohort study
Wei-Wei Zhang, Jia-Yi Lin, Gao-Yuan Wang, Cheng-Long Huang, Ling-Long Tang, Yan-Ping Mao, Guan-Qun Zhou, Li-Zhi Liu, Li Tian, Ji-Bin Li, Jun Ma, Rui Guo
Radiotherapy and Oncology.2024; 194: 110189. CrossRef
Reduced-Volume Irradiation of Uninvolved Neck in Patients With Nasopharyngeal Cancer: Updated Results From an Open-Label, Noninferiority, Multicenter, Randomized Phase III Trial
Cheng-Long Huang, Ning Zhang, Wei Jiang, Fang-Yun Xie, Xiao-Qing Pei, Shao Hui Huang, Xue-Yan Wang, Yan-Ping Mao, Kun-Peng Li, Qing Liu, Ji-Bin Li, Shao-Qiang Liang, Guan-Jie Qin, Wei-Han Hu, Guan-Qun Zhou, Jun Ma, Ying Sun, Lei Chen, Ling-Long Tang
Journal of Clinical Oncology.2024; 42(17): 2021. CrossRef
Immunological effects of radiopharmaceutical therapy
Amanda G. Shea, Malick Bio Idrissou, Ana Isabel Torres, Tessa Chen, Reiner Hernandez, Zachary S. Morris, Quaovi H. Sodji
Frontiers in Nuclear Medicine.2024;[Epub] CrossRef
Current Status and Future Directions of Proton Therapy for Head and Neck Carcinoma
Sara Lillo, Alfredo Mirandola, Alessandro Vai, Anna Maria Camarda, Sara Ronchi, Maria Bonora, Rossana Ingargiola, Barbara Vischioni, Ester Orlandi
Cancers.2024; 16(11): 2085. CrossRef
Treatment-Related Lymphopenia is Possibly a Marker of Good Prognosis in Nasopharyngeal Carcinoma: a Propensity-Score Matching Analysis
Ke-gui Weng, Hai-ke Lei, De-Song Shen, Ying Wang, Xiao-Dong Zhu
Cancer Management and Research.2024; Volume 16: 603. CrossRef
A prognostic nomogram for patients with III–IV nasopharyngeal carcinoma based on dynamic changes in the inflammatory and nutrition index
Guangyi Cheng, Shiwang Yuan, Jiang Wang, Sijia Deng, Yang Wu, Yuyan Wang, Yu Shen, Liantao Li
Clinical and Translational Oncology.2024;[Epub] CrossRef
Impact of Radiation Dose to Circulating Immune Cells on Tumor Control and Survival in Esophageal Cancer
Shang Cai, Yawen Fan, Qi Guo, Yanze Sun, Peifeng Zhao, Ye Tian, Qiuhong Fan
Cancer Biotherapy and Radiopharmaceuticals.2023; 38(6): 380. CrossRef
Meta-analysis and Critical Review: Association Between Radio-induced Lymphopenia and Overall Survival in Solid Cancers
Yasmine El Houat, Christophe Massard, Veronique Quillien, Renaud de Crevoisier, Joël Castelli
Advances in Radiation Oncology.2023; 8(2): 101038. CrossRef
The prognostic predictive value of systemic immune index and systemic inflammatory response index in nasopharyngeal carcinoma: A systematic review and meta-analysis
Li Wang, Xianfei Qin, Yu Zhang, Shouyu Xue, Xicheng Song
Frontiers in Oncology.2023;[Epub] CrossRef
Prognostic Significance of the Post-Treatment Neutrophil-to-Lymphocyte Ratio in Pharyngeal Cancers Treated with Concurrent Chemoradiotherapy
Ji Min Yun, Man Ki Chung, Chung Hwan Baek, Young Ik Son, Myung Ju Ahn, Dongryul Oh, Ki Won Kim, Yoon Kyoung So
Cancers.2023; 15(4): 1248. CrossRef
Analysis of risk characteristics for metachronous metastasis in different period of nasopharyngeal carcinoma
Zhaodong Fei, Huiling Hong, Ting Xu, Yiying Xu, Jiawei Chen, Xiufang Qiu, Jianming Ding, Ye Feng, Chaoxiong Huang, Li Li, Mengying Li, Chuanben Chen
BMC Cancer.2023;[Epub] CrossRef
Higher radiation dose on immune cells is associated with radiation-induced lymphopenia and worse prognosis in patients with locally advanced esophageal squamous cell carcinoma
Jianjian Qiu, Hancui Lin, Dongmei Ke, Yilin Yu, Jiaying Xu, Hejin Qiu, Qunhao Zheng, Hui Li, Hongying Zheng, Lingyun Liu, Zhiping Wang, Qiwei Yao, Jiancheng Li
Frontiers in Immunology.2023;[Epub] CrossRef
Prognostic value of absolute lymphocyte count in oral cavity squamous cell carcinoma
Rema Shah, Christina Liu, Hemali P. Shah, Benjamin L. Judson
Laryngoscope Investigative Otolaryngology.2023; 8(4): 870. CrossRef
Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation
Jinliang Zhang, Li Yang, Hui Li, Jeff W. Chan, Eric K.W. Lee, Min Liu, Lingyu Ma, Qin Liu, Jian-Yue Jin, Pingfu Fu, Zhiyuan Xu, Feng-Ming (Spring) Kong
Advances in Radiation Oncology.2023; 8(6): 101260. CrossRef
Lymphopénie radio-induite : les lymphocytes comme nouvel organe à risque
P.A. Laurent, É. Deutsch
Cancer/Radiothérapie.2023; 27(6-7): 511. CrossRef
Impact of chemotherapeutic agents on liver microenvironment: oxaliplatin create a pro-metastatic landscape
Yuanyuan Ma, Chang Guo, Xijun Wang, Xundong Wei, Jie Ma
Journal of Experimental & Clinical Cancer Research.2023;[Epub] CrossRef
CT-based dosiomics and radiomics model predicts radiation-induced lymphopenia in nasopharyngeal carcinoma patients
Qingfang Huang, Chao Yang, Jinmeng Pang, Biao Zeng, Pei Yang, Rongrong Zhou, Haijun Wu, Liangfang Shen, Rong Zhang, Fan Lou, Yi Jin, Albert Abdilim, Hekun Jin, Zijian Zhang, Xiaoxue Xie
Frontiers in Oncology.2023;[Epub] CrossRef
Developing the POTOMAC Model: A Novel Prediction Model to Study the Impact of Lymphopenia Kinetics on Survival Outcomes in Head and Neck Cancer Via an Ensemble Tree-Based Machine Learning Approach
Carmen Kut, Doug Midthune, Emerson Lee, Peyton Fair, Tia Cheunkarndee, Todd McNutt, Theodore DeWeese, Carole Fakhry, Victor Kipnis, Harry Quon
JCO Clinical Cancer Informatics.2023;[Epub] CrossRef
Preoperative prognostic nutritional index predicts prognosis of patients with oral cavity cancer
Ku‐Hao Fang, Sheng‐Wei Chang, Yi‐Chan Lee, Ethan I. Huang, Chia‐Hsuan Lai, Geng‐He Chang, Ming‐Shao Tsai, Cheng‐Ming Hsu, Yao‐Te Tsai
Oral Diseases.2022; 28(7): 1816. CrossRef
A comprehensive model based on temporal dynamics of peripheral T cell repertoire for predicting post-treatment distant metastasis of nasopharyngeal carcinoma
Yajing Zhang, Yujie Zhu, Jiaqi Wang, Yi Xu, Zekun Wang, Yang Liu, Xuebing Di, Lin Feng, Ye Zhang
Cancer Immunology, Immunotherapy.2022; 71(3): 675. CrossRef
Identifying distinct risks of treatment failure in nasopharyngeal carcinoma: Study based on the dynamic changes in peripheral blood lymphocytes, monocytes, N classification, and plasma Epstein‐Barr virus DNA
Li‐Ting Liu, Yu‐Jing Liang, Shan‐Shan Guo, Yao Xie, Guo‐Dong Jia, Dong‐Xiang Wen, Lin‐Quan Tang, Qiu‐Yan Chen, Hai‐Qiang Mai
Head & Neck.2022; 44(1): 34. CrossRef
Taxane/gemcitabine-containing chemotherapy plus locoregional IMRT for patients with de novo metastatic nasopharyngeal carcinoma: the treatment outcomes and prognostic factors analysis
Chengrun Du, Mengshan Ni, Jianyun Jiang, Fangfang Kong, Ruiping Zhai, Yingchen Lv, Chaosu Hu, Hongmei Ying
European Archives of Oto-Rhino-Laryngology.2022; 279(8): 3947. CrossRef
The impact of radiation induced lymphopenia in the prognosis of head and neck cancer: A systematic review and meta-analysis
Dongjun Dai, Qiaoying Tian, Yongjie Shui, Jinfan Li, Qichun Wei
Radiotherapy and Oncology.2022; 168: 28. CrossRef
Systematic construction and external validation of an immune‐related prognostic model for nasopharyngeal carcinoma
Weiqun Lin, Di Cao, Annan Dong, Shaobo Liang, Yongyi Zhao, Cuibing Liu, Yinghua Yan, Xiaoliu Luo, Lizhi Liu, Xinchen Zeng, Qiaowen Ou
Head & Neck.2022; 44(5): 1086. CrossRef
Radiation Induced Lymphopenia Is Associated With the Effective Dose to the Circulating Immune Cells in Breast Cancer
Fang Chen, Jian-Yue Jin, Timothy S.K. Hui, Haiman Jing, Hong Zhang, Yaqing Nong, Ying Han, Weili Wang, Lingyu Ma, Fan Yi, Qingqing Chen, Yongsheng Zhang, Pingfu Fu, Li Yang, Zhiyuan Xu, Feng-Ming Spring Kong
Frontiers in Oncology.2022;[Epub] CrossRef
RuleFit-Based Nomogram Using Inflammatory Indicators for Predicting Survival in Nasopharyngeal Carcinoma, a Bi-Center Study
Chao Luo, Shuqi Li, Qin Zhao, Qiaowen Ou, Wenjie Huang, Guangying Ruan, Shaobo Liang, Lizhi Liu, Yu Zhang, Haojiang Li
Journal of Inflammation Research.2022; Volume 15: 4803. CrossRef
Head and neck cancers volume reduction: should we reduce our prophylactic node radiation to spare the antitumor immune response?
Y. El Houat, L. Bouvier, M. Baty, X. Palard-Novello, Y. Pointreau, R. de Crevoisier, J. Castelli
Cancer/Radiothérapie.2022; 26(6-7): 916. CrossRef
Establishment of a prognostic nomogram for patients with locoregionally advanced nasopharyngeal carcinoma incorporating clinical characteristics and dynamic changes in hematological and inflammatory markers
Qin Liu, Lingyu Ma, Huangrong Ma, Li Yang, Zhiyuan Xu
Frontiers in Oncology.2022;[Epub] CrossRef
The Current and Future Promises of Combination Radiation and Immunotherapy for Genitourinary Cancers
Ava Saidian, Isabella Dolendo, Andrew Sharabi, Tyler F. Stewart, Brent Rose, Rana R. McKay, Aditya Bagrodia, Amirali Salmasi
Cancers.2022; 15(1): 127. CrossRef
Hypofractionated concurrent chemoradiotherapy related lymphopenia and its association with survival in locally advanced non-small cell lung cancer patients
FangJie Liu, YingJia Wu, JianHui Shao, Bo Qiu, SuPing Guo, QiaoTing Luo, JinYu Guo, DaQuan Wang, Chu Chu, Rui Zhou, NaiBin Chen, XinLei Ai, Hui Liu
Frontiers in Oncology.2022;[Epub] CrossRef
Combined radiotherapy and immunotherapy in urothelial bladder cancer: harnessing the full potential of the anti-tumor immune response
Mame Daro-Faye, Wassim Kassouf, Luis Souhami, Gautier Marcq, Fabio Cury, Tamim Niazi, Paul Sargos
World Journal of Urology.2021; 39(5): 1331. CrossRef
Lymphopenia During Definitive Chemoradiotherapy in Esophageal Squamous Cell Carcinoma: Association with Dosimetric Parameters and Patient Outcomes
Hui Xu, Maosheng Lin, Yingying Hu, Li Zhang, Qiaoqiao Li, Jinhan Zhu, Shi Wang, Mian Xi
The Oncologist.2021; 26(3): e425. CrossRef
Lymphopenia and intratumoral lymphocytic balance in the era of cancer immuno-radiotherapy
Michael I. Koukourakis, Alexandra Giatromanolaki
Critical Reviews in Oncology/Hematology.2021; 159: 103226. CrossRef
Hematological toxicity in patients with solid malignant tumors treated with radiation – Temporal analysis, dose response and impact on survival
Cynthia Terrones-Campos, Bruno Ledergerber, Ivan Richter Vogelius, Marie Helleberg, Lena Specht, Jens Lundgren
Radiotherapy and Oncology.2021; 158: 175. CrossRef
Prognosis of severe lymphopenia after postoperative radiotherapy in non-small cell lung cancer: Results of a long-term follow up study
Wang Jing, Yufei Liu, Hui Zhu, James Welsh, Saumil Gandhi, Melenda Jeter, Quynh Nguyen, Aileen B. Chen, Michael O'Reilly, Zhongxing Liao, Joe Y. Chang, Percy Lee, Steven H. Lin
Clinical and Translational Radiation Oncology.2021; 28: 54. CrossRef
Prognostic value of neutrophils for patients with nasopharyngeal carcinoma
Lisha Chen, Mengying Li, Ting Xu, Xiufang Qiu, Chuanben Chen
Laryngoscope Investigative Otolaryngology.2021; 6(2): 219. CrossRef
The Influence of Severe Radiation-Induced Lymphopenia on Overall Survival in Solid Tumors: A Systematic Review and Meta-Analysis
Pim J.J. Damen, Tiuri E. Kroese, Richard van Hillegersberg, Ewoud Schuit, Max Peters, Joost J.C. Verhoeff, Steven H. Lin, Peter S.N. van Rossum
International Journal of Radiation Oncology*Biology*Physics.2021; 111(4): 936. CrossRef
Prognostic Significance of Circulating Lymphocyte Subsets Before Treatment in Patients with Nasopharyngeal Carcinoma
De-Song Shen, Chang Yan, Yu Liang, Kai-Hua Chen, Xiao-Dong Zhu
Cancer Management and Research.2021; Volume 13: 8109. CrossRef
Proton therapy for locally advanced non-small cell lung cancer
Olsi Gjyshi, Zhongxing Liao
The British Journal of Radiology.2020;[Epub] CrossRef
Prognostic role of pretreatment blood lymphocyte count in patients with solid tumors: a systematic review and meta-analysis
Jiawen Zhao, Weijia Huang, Yongxian Wu, Yihuan Luo, Bo Wu, Jiwen Cheng, Junqiang Chen, Deyun Liu, Chengyang Li
Cancer Cell International.2020;[Epub] CrossRef
Prognosis and Risk Factors of Radiation-Induced Lymphopenia in Early-Stage Lung Cancer Treated With Stereotactic Body Radiation Therapy
Qianqian Zhao, Tingting Li, Gang Chen, Zhaochong Zeng, Jian He
Frontiers in Oncology.2020;[Epub] CrossRef
Prediction of Severe Lymphopenia During Chemoradiation Therapy for Esophageal Cancer: Development and Validation of a Pretreatment Nomogram
Peter S.N. van Rossum, Wei Deng, David M. Routman, Amy Y. Liu, Cai Xu, Yutaka Shiraishi, Max Peters, Kenneth W. Merrell, Christopher L. Hallemeier, Radhe Mohan, Steven H. Lin
Practical Radiation Oncology.2020; 10(1): e16. CrossRef
Radiation-induced lymphopenia correlates with survival in nasopharyngeal carcinoma: impact of treatment modality and the baseline lymphocyte count
Xiaoxue Xie, Shenglan Gong, Hekun Jin, Pei Yang, Ting Xu, Yilong Cai, Chengxian Guo, Rong Zhang, Fan Lou, Wenjuan Yang, Hui Wang
Radiation Oncology.2020;[Epub] CrossRef
Lymphopenia after induction chemotherapy correlates with incomplete surgical resection in patients with advanced ovarian cancer
Yasunori Yoshino, Ayumi Taguchi, Maki Takao, Tomoko Kashiyama, Akiko Furusawa, Masaya Uno, Satoshi Okada, Nao Kino, Toshiharu Yasugi
International Journal of Clinical Oncology.2019; 24(4): 428. CrossRef
Radiation-related Lymphopenia after Pelvic Nodal Irradiation for Prostate Cancer
Michael D. Schad, Sunil W. Dutta, Donald M. Muller, Krishni Wijesooriya, Timothy N. Showalter
Advances in Radiation Oncology.2019; 4(2): 323. CrossRef
Clinical predictors of radiation-induced lymphopenia in patients receiving chemoradiation for glioblastoma: clinical usefulness of intensity-modulated radiotherapy in the immuno-oncology era
Hwa Kyung Byun, Nalee Kim, Hong In Yoon, Seok-Gu Kang, Se Hoon Kim, Jaeho Cho, Jong Geol Baek, Jong Hee Chang, Chang-Ok Suh
Radiation Oncology.2019;[Epub] CrossRef
Acute severe lymphopenia by radiotherapy is associated with reduced overall survival in hepatocellular carcinoma
Hwa Kyung Byun, Nalee Kim, Sangjoon Park, Jinsil Seong
Strahlentherapie und Onkologie.2019; 195(11): 1007. CrossRef
Treatment-Related Lymphopenia Predicts Pathologic Complete Response and Recurrence in Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemoradiotherapy
Qiaoqiao Li, Sha Zhou, Shiliang Liu, Songran Liu, Hong Yang, Lei Zhao, Mengzhong Liu, Yonghong Hu, Mian Xi
Annals of Surgical Oncology.2019; 26(9): 2882. CrossRef
Assessing the interactions between radiotherapy and antitumour immunity
Clemens Grassberger, Susannah G. Ellsworth, Moses Q. Wilks, Florence K. Keane, Jay S. Loeffler
Nature Reviews Clinical Oncology.2019; 16(12): 729. CrossRef
Overview of Hematopoietic Stem Cells in Systemic Cancer Treatment, Aging, Pregnancy, and Radiation Hormesis
Aleksei N. Shoutko
Advances in Molecular Imaging.2019; 09(02): 19. CrossRef
Irradiation-Related Lymphopenia for Bone Metastasis from Hepatocellular Carcinoma
Sangjoon Park, Hwa Kyung Byun, Jinsil Seong
Liver Cancer.2019; 8(6): 468. CrossRef
Neutropenia during the First Cycle of Induction Chemotherapy Is Prognostic for Poor Survival in Locoregionally Advanced Nasopharyngeal Carcinoma: A Real-World Study in an Endemic Area
Cheng Xu, Shi-Ping Yang, Yuan Zhang, Ling-Long Tang, Guan-Qun Zhou, Xu Liu, Yan-Ping Mao, Rui Guo, Wen-Fei Li, Lei Chen, Ai-Hua Lin, Ying Sun, Jun Ma
Cancer Research and Treatment.2018; 50(3): 777. CrossRef
Field size effects on the risk and severity of treatment-induced lymphopenia in patients undergoing radiation therapy for solid tumors
Susannah G. Ellsworth
Advances in Radiation Oncology.2018; 3(4): 512. CrossRef
Turning cold tumors into hot tumors: harnessing the potential of tumor immunity using nanoparticles
Anne Rodallec, Guillaume Sicard, Raphaelle Fanciullino, Sébastien Benzekry, Bruno Lacarelle, Gerard Milano, Joseph Ciccolini
Expert Opinion on Drug Metabolism & Toxicology.2018; : 1. CrossRef

11,647 View
355 Download
61 Web of Science
55 Crossref

First
Prev
Page of 1
Next
Last

Search