Multimodality Treatment May Improve the Survival Rate of Patients with Metastatic Nasopharyngeal Carcinoma with Good Performance Status

Abstract

The aim of the present study was to evaluate the benefit of chemotherapy, combined with palliative radiotherapy (PRT) and other local treatments to the metastatic sites, for patients with metastatic nasopharyngeal carcinoma (NPC) who had a performance status 0–2. We conducted a retrospective review of available data from 197 biopsy-proven NPC patients who developed metastasis after their initial definitive treatment. These patients were grouped into three categories according to the different treatment paths that were followed: the best supportive care (64 patients), chemotherapy alone (55 patients), and multimodality treatment with chemotherapy combined with PRT and other local treatments to metastatic sites (78 patients). The 2-year metastatic survival rate of patients in the multimodality treatment group was 57.7%, which was significantly better than that of the patients in both the chemotherapy alone group and the best supportive care group (32.7% and 1.6%, respectively). The independent significant factors affecting survival were the disease-free interval prior to the detection of metastatic disease, the number of metastases, the number of chemotherapy cycles and the biological effective dose of PRT. In conclusion, multimodality treatment may improve survival of select patients with recurrent NPC with distant metastases.

Anti‐epidermal growth factor receptor monoclonal antibody plus palliative chemotherapy as a first‐line treatment for recurrent or metastatic nasopharyngeal carcinoma

“…In addition, poor KPS was identified as an independent risk factor for OS, even if there was no effect on PFS. This finding is consistent with the results of Zheng et al, who found that multimodal treatment could improve the survival of metastatic NPC patients who exhibited a good performance status. Patients with favorable KPS had increased opportunity for posterior‐line therapy.…”

“…The poor PFS of metachronous metastasis compared to synchronous metastasis may be attributed to greater therapeutic resistance. [23][24][25] We also found that while the combined chemotherapy regimen was an independent prognostic factor for PFS, the optimal chemotherapy regimens were not determined in the current study. Recently, a meta-analysis showed that the triple combination regimen was associated with the best short-term efficacy but failed to improve the patient prognosis among the four commonly used first-line chemotherapy regimens (PF, GP, TP, and triplet combination regimen) for RM-NPC.…”

AIMP2-DX2 Promotes the Proliferation, Migration, and Invasion of Nasopharyngeal Carcinoma Cells

“…People of smoke, alcohol abuse, and exposure to dangerous chemicals show higher risk of NPC [ 7 ]. Until now, the treatment of NPC still remains as the greatest obstacle, due to the high rate of metastasis [ 8 , 9 ]. Thus, elucidating the mechanisms and screening biomarkers for early diagnosis show great clinical significance.…”

Survival Benefit with Palliative Local Radiotherapy in Metastatic Nasopharyngeal Carcinoma

“…(18) Wei et al showed that among patients with and without multimetastasis, survival was signi cantly better for those receiving chemoradiotherapy than for those receiving chemotherapy alone; moreover, prognosis was better for patients with oligometastasis. (19) To date, however, no studies have reported the e cacy of radiotherapy for improving survival in mNPC patients with single-organ vs. multiorgan metastases. In the clinic, the attending doctor tends to choose patients with single-organ metastasis for primary local radiotherapy, because these patients have better treatment tolerance and better prognosis, and are more likely to have a longer survival time.…”