Yonsei Med J.  2016 Jul;57(4):840-845. 10.3349/ymj.2016.57.4.840.

Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy

• Lu T
• Guo Q
• Cui X
• Chen Z
• Lin S
• Xu L
• Lin J
• Zong J
• Pan J

• KMID: 2374113
• DOI: http://doi.org/10.3349/ymj.2016.57.4.840

Abstract

PURPOSE
To evaluate the prognosis of nasopharyngeal carcinoma (NPC) patients who developed bone-only metastasis after primary treatment and the stratification of these patients into different risk groups based on independent prognostic factors.
MATERIALS AND METHODS
Eighty NPC patients who developed bone-only metastasis after definitive radiotherapy from October 2005 to December 2010 were enrolled. All these patients received palliative treatment for bone metastasis, including chemotherapy and/or radiotherapy. Clinical features, treatment modality, and laboratory parameters were examined with univariate and multivariate analyses.
RESULTS
The median follow-up time was 15.5 months (range, 2-67 months) for the whole cohort. The median overall metastatic survival (OMS) time and the 2-year estimate OMS rate were 26.5 months and 52%, respectively. Multivariate analysis indicated that patients with short metastases-free interval, multiple bone metastases sites, high serum lactic dehydrogenase levels, and treated with radiotherapy or chemotherapy alone had significantly worse outcomes. Patients were stratified into three different risk groups based on the number of adverse factors present. The OMS curves of the three groups were all significantly different (p<0.001).
CONCLUSION
Severl prognostic factors were found to be associated with worse outcomes. According to the number of adverse factors present, bone-only metastasis patients can be stratified into three risk groups with significantly different prognoses. Such grouping may help in improving the design of clinical trials and in guiding individualized treatment for NPC patients with bone-only metastasis.

Keyword

Nasopharyngeal neoplasm; neoplasm metastasis; prognosis

MeSH Terms

Adolescent
Adult
Aged
Bone Neoplasms/mortality/*secondary/therapy
Combined Modality Therapy
Female
Humans
Male
Middle Aged
Multivariate Analysis
Nasopharyngeal Neoplasms/mortality/*pathology/therapy
Neoplasm Staging
Prognosis
Retrospective Studies
Survival Rate
Young Adult

Figure

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  Fig. 1 (A) The overall metastasis survival of 80 patients who developed bone-only metastasis after definitive radiotherapy. (B) Overall metastasis survival curves according to different treatment arms in patients.

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  Fig. 2 Overall metastasis survival curves according to three different risk groups.

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