Prognostic Factors and Outcome for Nasopharyngeal Carcinoma

Farias, Terence Pires de; Dias, Fernando Luiz; Lima, Roberto A.; Kligerman, Jacob; Sá, Geraldo Matos de; Barbosa, Mauro Marques; Gonçalves, Fernando B.

doi:10.1001/archotol.129.7.794

Cited by 89 publications

(84 citation statements)

References 40 publications

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“…Currently, radiation therapy is preferred for newly diagnosed nonmetastatic nasopharyngeal cancer, particularly intensity-modulated radiation therapy, allowing a 5-y survival rate of approximately 50% (2). Advanced age, local extension, and advanced disease stage adversely affect the prognosis in patients with nasopharyngeal carcinoma after treatment (3). Despite significant improvements in local control due to advances in radiotherapy, local recurrence and residual disease remain the main reasons for failure in patients with advanced nasopharyngeal carcinoma (4).…”

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¹⁸F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

et al. 2015

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The aim of this work was to assess the overall value of 18 F-FDG PET/ CT in the diagnosis of residual or recurrent nasopharyngeal carcinoma using a metaanalysis. Methods: The literature published between January 1990 and September 2014 was searched in the PubMed, EMBASE, Cochrane Library, EBSCO, VIP, CNKI, and Wanfang databases to identify eligible studies on PET/CT of residual or recurrent lesions. The methodologic quality of the included studies was evaluated using the "quality assessment for studies of diagnostic accuracy" tool. Summary sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and receiver-operating characteristic curve were obtained using Meta-DiSc freeware. Subgroups were also analyzed. Results: A total of 23 studies, involving 1,253 subjects, were included in the metaanalysis. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio, with 95% confidence intervals in parentheses, for 18 F-FDG PET or PET/CT were 0.93 (0.91-0.95), 0.87 (0.84-0.89), 5.52 (3.96-7.71), 0.12 (0.09-0.15), and 55.31 (34.94-87.57), respectively. The area under the receiver-operating characteristic curve and Q* index estimate of PET/CT were 0.9473 and 0.8869, respectively. There was no significant difference between the area under the curve of PET and PET/CT (P . 0.05). Conclusion: Our study has confirmed that 18 F-FDG PET/ CT has high sensitivity and specificity but significant heterogeneity in the diagnosis of residual or recurrent nasopharyngeal carcinoma.

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¹⁸F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

et al. 2015

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“…3 Although NPC is radiosensitive, the 5-year survival rate remains between 50 and 60%. Regional lymph node and distant metastasis and locoregional recurrence are the 2 major reasons resulted in failure of treatment for this cancer.…”

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Upregulation of caveolin‐1 and CD147 expression in nasopharyngeal carcinoma enhanced tumor cell migration and correlated with poor prognosis of the patients

Hu²,

Shao

et al. 2009

Intl Journal of Cancer

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Expression of caveolin-1 (Cav-1) and extracellular matrix metalloproteinase inducer (EMMPRIN/CD147) and their prognostic significance were analyzed in archive NPC samples. Cav-1 and CD147 were overexpressed in 49. 48% (96/194) and 59.39% (117/ 197) of NPC, respectively. Both Cav-1 and CD147 expression levels correlated significantly with metastasis (p 5 0.025 and 0.017, respectively) and a lower 5-year survival rate (p 5 0.02 and 0.0009, respectively). In addition, Cav-1 expression levels correlated significantly with local recurrence (p 5 0.038). Multivariate Cox regression analysis indicated that combination of high Cav-1 and CD147 expression was a significant, independent prognosis predictor in patients with NPC (HR 5 2.135; p 5 0.006). Functional studies revealed that overexpression of Cav-1 promoted secretion of MMP-3 and MMP-11 (active) proteins, as well as an increase in the migratory ability of CNE1 and CNE2 cells, while siRNA-mediated silencing of Cav-1 or CD147 led to reduced levels of MMP-3 and MMP-11(active) secretion, and reduced migration capacity of CNE1 and CNE2 cells. We observed a positive correlation between Cav-1 and CD147 expression in NPC (q 5 0.330, p 5 0.000), CD147 protein levels were upregulated in Cav-1 overexpressing CNE1 and CNE2 cells, whereas siRNA-mediated silencing of Cav-1 led to the downregulation of CD147 expression. Our results indicate that Cav-1 and CD147 overexpression predict poor NPC prognosis and enhanced tumor cell migration, which is associated with MMP-3 and MMP-11 (active) secretion. ' 2009 UICC

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“…The parotids contribute 60%-70% of the total salivary gland secretion [21] . With the advent of IMRT, better sparing of the parotids can be obtained and has been shown to have lower rates of xerostomia compared to 2DRT and 3DCRT [22][23] .…”

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confidence: 99%

Retrospective analysis of treatment results for nasopharyngeal carcinoma in Philippine Oncology Centre Corporation from 2002-2009

Chong

Arnold

Mario

2015

J Nasopharyng Carcinoma

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Objective:This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in Philippine Oncology Centre Corporation (POCC). Materials and Methods: The patients with NPC referred for treatment at POCC from 2002-2009 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), loco-regional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 106 patients with newly diagnosed NPC were treated in POCC during this period. Late presentation was common, with 19.8% presenting with T3-4 disease, 88.7% with N1-3 disease and 73.5% with AJCC stage 3-4 disease. Radical RT was given to 96 patients with 23.6% having RT alone and 67.4% having CCRT. The stipulated OTT was 7 weeks and 72% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 13.5% while adjuvant chemotherapy was administered to 17%. The 5 years OS was 51.5% with a median follow up of 56 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.9%, respectively. RT related late effects were documented in 71.7%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (18.2%), visual deficit (4.2%), neck stiffness (4.2%), dysphagia (2.3%), cranial nerve palsy (2.4%), pneumonitis (0.9%) and hypothyroidism (1.3%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

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Prognostic Factors and Outcome for Nasopharyngeal Carcinoma

Cited by 89 publications

References 40 publications

¹⁸F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

¹⁸F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

Upregulation of caveolin‐1 and CD147 expression in nasopharyngeal carcinoma enhanced tumor cell migration and correlated with poor prognosis of the patients

Retrospective analysis of treatment results for nasopharyngeal carcinoma in Philippine Oncology Centre Corporation from 2002-2009

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Prognostic Factors and Outcome for Nasopharyngeal Carcinoma

Cited by 89 publications

References 40 publications

18F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

18F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

Upregulation of caveolin‐1 and CD147 expression in nasopharyngeal carcinoma enhanced tumor cell migration and correlated with poor prognosis of the patients

Retrospective analysis of treatment results for nasopharyngeal carcinoma in Philippine Oncology Centre Corporation from 2002-2009

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¹⁸F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis

¹⁸F-FDG PET/CT for the Diagnosis of Residual or Recurrent Nasopharyngeal Carcinoma After Radiotherapy: A Metaanalysis