Nomogram Predicting the Benefits of Adding Concurrent Chemotherapy to Intensity-Modulated Radiotherapy After Induction Chemotherapy in Stages II–IVb Nasopharyngeal Carcinoma

Liu, Sai-Lan; Sun, Xia; Lu, Zheng; Chen, Qiuyan; Lin, Huan‐Xin; Tang, Lin‐Quan; Bei, Jin‐Xin; Guo, Ling

doi:10.3389/fonc.2020.539321

Cited by 9 publications

(5 citation statements)

References 35 publications

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“…In the study by Zhang et al [ 22 ], grade 3–4 toxicities happened in 75.7% of patients treated with CCRT, and only 38.9% of patients completed the established 3 cycles of CCT. Recently, several retrospective studies explored the de-intensified treatment of omitting CCT after IC, but the results were inconsistent [ 10 , 11 , 12 , 13 ]. In the study by He et al [ 11 ], the toxicities and survival rates were not different in IC + RT and CCRT groups.…”

Section: Discussionmentioning

confidence: 99%

“…After RT, compliance with adjuvant chemotherapy (AC) was also poor [ 8 , 9 ]. Recently, several retrospective studies have explored the de-intensified treatment of RT alone versus CCRT after IC for LA-NPC, but the results were inconsistent [ 10 , 11 , 12 , 13 ]. Due to the heterogeneity of LA-NPC, de-intensified treatment for unselected patients may cause treatment failure.…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy Alone Versus Concurrent or Adjuvant Chemoradiotherapy for Nasopharyngeal Carcinoma Patients with Negative Epstein–Barr Virus DNA after Induction Chemotherapy

Kong

Pan

et al. 2023

Cancers

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The purpose of this study was to compare the efficacy and toxicity of induction chemotherapy (IC) plus radiotherapy (RT) and IC plus concurrent or adjuvant chemoradiotherapy (CCRT/AC) in nasopharyngeal carcinoma (NPC) patients with negative Epstein–Barr virus DNA (EBV DNA) after IC. A total of 547 NPC patients with negative plasma EBV DNA post-IC were included. Patients were classified into the IC + RT group and the IC + CCRT/AC group. Locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), overall survival (OS), and progression-free survival (PFS) were estimated and compared using the Kaplan–Meier method. Propensity score matching (PSM) was performed to balance the variables. The median follow-up time was 37 months. The 3-year LRFS, DMFS, OS, and PFS rates for the whole group were 92.2%, 92.4%, 96.4%, and 84.4%, respectively. There was no significant difference in LRFS, DMFS, OS, and PFS between the IC + RT and the IC + CCRT/AC groups, both before PSM (3-year rates of 91.1% vs. 92.6%, p = 0.94; 95.6% vs. 91.5%, p = 0.08; 95.2% vs. 96.8%, p = 0.80; 85.9% vs. 84.0%, p = 0.38) and after PSM (90.7% vs. 92.7%, p = 0.77; 96.8% vs. 93.7%, p = 0.29; 94.5% vs. 93.9%, p = 0.57; 84.7% vs. 85.6%, p = 0.96). Multivariate analysis demonstrated that the treatment schedule was not an independent predictor for survival rates. Patients in the IC + RT group had fewer treatment-related acute toxicities and better tolerance. IC + RT displayed similar survival outcomes as IC + CCRT/AC for NPC patients with negative post-IC EBV DNA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiotherapy Alone Versus Concurrent or Adjuvant Chemoradiotherapy for Nasopharyngeal Carcinoma Patients with Negative Epstein–Barr Virus DNA after Induction Chemotherapy

Kong

Pan

et al. 2023

Cancers

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“…Distant organ metastasis is currently the primary reason for treatment failure in NPC patients. 2,25 Effective targeted therapy can improve the clinical treatment efficacy in patients with locally advanced and advanced NPC. 26 Hence, it is required to identify effective molecular targets for enhancing the NPC treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the widespread application of RT modulated by intensity, induction, and concurrent chemotherapy and the advancement of an accurate cancer staging system, the management of NPC has been greatly improved in recent decades. 2 The reported 5-year local control rates are outstanding, ranging from 70% to 90%. However, approximately about 20–30% of patients eventually develop distant metastasis or local recurrence resulting in treatment failure after the administration of radical chemoradiotherapy for locoregionally advanced NPC (stages III–IVB).…”

Section: Introductionmentioning

confidence: 99%

Expression of cytoskeleton-associated protein 4 is associated with poor prognosis and metastasis in nasopharyngeal carcinoma

Cai

Deng

et al. 2023

Exp Biol Med (Maywood)

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Cytoskeleton-associated protein 4 (CKAP4) acts as a key transmembrane protein that connects the endoplasmic reticulum (ER) to microtubule dynamics. Researchers have not examined the roles of CKAP4 in nasopharyngeal carcinoma (NPC). The study aimed at evaluating the prognostic value and metastasis-regulating effect of CKAP4 in NPC. CKAP4 protein could be observed in 86.36% of 557 NPC specimens but not in normal nasopharyngeal epithelial tissue. According to immunoblot assays, NPC cell lines presented high CKAP4 expression relative to NP69 immortalized nasopharyngeal epithelial cells. Moreover, CKAP4 was highly expressed at the NPC tumor front and in matched liver, lung, and lymph node metastasis samples. Furthermore, high CKAP4 expression reported poor overall survival (OS) and presented a positive relevance to tumor (T) classification, recurrence, and metastasis. According to multivariate analysis, CKAP4 could independently and negatively predict patients’ prognosis. Stable knockdown of CKAP4 expression in NPC cells inhibited cell migration, invasion and metastasis in vitro and in vivo. Moreover, CKAP4 promoted epithelial-mesenchymal transition (EMT) in NPC cells. CKAP4 knockdown was followed by the downregulation of the interstitial marker vimentin, and upregulation of the epithelial marker E-cadherin. In NPC tissues, high CKAP4 expression exhibited a positive relevance to vimentin expression and a negative relevance to E-cadherin expression. In conclusion, CKAP4 is an independent predictor of NPC, and CKAP4 might contribute NPC progression and metastasis, which may be involved in EMT with vimentin and E-cadherin.

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“…As one of the most common head and neck tumors, nasopharyngeal carcinoma has achieved very good therapeutic results through the multidisciplinary treatment[1-2]. In addition to the first choice of radiotherapy, combined with different stages of chemotherapy, such as neoadjuvant chemotherapy (NACT) before radiotherapy, concurrent chemotherapy while radiotherapy and adjuvant chemotherapy after radiotherapy, the progression free survival rate(PFS) and overall survival rate(OS) were further improved [3][4][5]. Common chemotherapy regimens include PF (DDP + 5-FU), carboplatin + 5-FU, paclitaxel + cisplatin / carboplatin, paclitaxel + cisplatin + 5-FU and cisplatin + gemcitabine and so on.…”

mentioning

confidence: 99%

A new discovery of folic acid derivatives to improve the efficacy of PF regimen in the treatment of nasopharyngeal carcinoma

Huang

Mao

Liang

et al. 2023

Preprint

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Objective The purpose of this study is to investigate the acute toxicity, progression-free survival and overall survival in patients of nasopharyngeal carcinoma (NPC) treated with or without calcium folinate. Methods 1. Total of 422 patients with nasopharyngeal carcinoma were recruited from July 1, 2002 to December 31, 2014, including chemotherapy regimen of PF and CPF regimen. 2. The imformation of acute toxicities, recurrence and metastasis, and survival time were collected. 3. Data processing and analysis by Graphpad prism 6 software. Results 1. The overall survival of the Group CPF as compared to the Group PF at 3, 5,10 and 12 years were 97.42% vs. 91.24%，94.61% vs. 87.44%，88.74% vs. 81.98% and 88.74% vs. 78.57%, respectively. The OS of Group CPF got higher than that of Group PF (P=0.0269). 2. The overall survival rate of CPF group was significantly higher than that of group PF in clinical stage I-III, the overall survival was 90.83% vs. 82.12%，respectively（P=0.0348）. 3. The local control rate of the Group CPF as compared to the Group PF were 97.06% vs. 73.91% in stage T4 (P=0.0133). 4. No significant difference in other indicators between the two groups in hematological toxicity, except for Grade 3 neutropenia. 5. The incident of side effects of digestive system, such as nausea and vomiting, the Group CPF as compared to the Group PF were 45.06% vs. 67.31% and 33.95% vs. 46.15%，respectively（P=0.0000，P=0.0036）. Conclusions 1. Calcium folinate can significantly prolong the overall survival rate of patients with nasopharyngeal carcinoma, especially in Stage I-III（90.83%）. 2. Calcium folinate can significantly improve the local control rate in patients with T4（97.06%）. 3. It shows obvious protective effects on digestive system（33.95%）

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Nomogram Predicting the Benefits of Adding Concurrent Chemotherapy to Intensity-Modulated Radiotherapy After Induction Chemotherapy in Stages II–IVb Nasopharyngeal Carcinoma

Cited by 9 publications

References 35 publications

Radiotherapy Alone Versus Concurrent or Adjuvant Chemoradiotherapy for Nasopharyngeal Carcinoma Patients with Negative Epstein–Barr Virus DNA after Induction Chemotherapy

Radiotherapy Alone Versus Concurrent or Adjuvant Chemoradiotherapy for Nasopharyngeal Carcinoma Patients with Negative Epstein–Barr Virus DNA after Induction Chemotherapy

Expression of cytoskeleton-associated protein 4 is associated with poor prognosis and metastasis in nasopharyngeal carcinoma

A new discovery of folic acid derivatives to improve the efficacy of PF regimen in the treatment of nasopharyngeal carcinoma

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