Use of Radiation Therapy in Metastatic Nasopharyngeal Cancer Improves Survival: A SEER Analysis.
Use of Radiation Therapy in Metastatic Nasopharyngeal Cancer Improves Survival: A SEER Analysis.
复制标题
DOI：
10.1038/s41598-017-00655-1
复制
发表时间：
2017-04-07
影响因子：
4.6
通讯作者：
Lu JJ
中科院分区：
文献类型：
--
作者：
Hu J;Kong L;Gao J;Hu W;Guan X;Lu JJ
有限的数据表明，放射治疗可能为远处转移的鼻咽癌(MNPC)患者提供生存益处。我们使用监测流行病学和最终结果数据库来检查放射治疗在mNPC治疗中的作用。纳入1988-2012年间确诊的中鼻咽癌患者。感兴趣的结果包括总存活率(OS)和癌症特异性存活率(CS)。总共确定了679名患者，平均随访时间为13个月。448名患者接受了放射治疗，231名患者没有接受放射治疗。在单变量和多变量分析中，放射治疗与OS和CS的显著改善有关。使用倾向评分(PS)的逆治疗概率加权加权COX回归显示，接受放射治疗的患者死亡风险分别比接受放射治疗的OS(HR：0.5，95%CI：0.4-0.60，p <； 0.001)和CS(HR：0.5，95%CI：0.4-0.61，p <； 0.001)降低50%。此外，2003年后诊断为非角化性癌或未分化癌、年龄较小(65岁)、接受手术的患者在OS和CS方面都有较好的结果。局部放射治疗与改善mNPC患者的存活率有关。我们的发现为临床试验中的前瞻性研究提供了依据。
Limited data indicated radiotherapy might provide survival benefits to patients with distantly metastatic nasopharyngeal carcinoma (mNPC). We used the Surveillance Epidemiology and End Results database to examine the role of radiotherapy in the treatment of mNPC. Patients with mNPC at presentation diagnosed between 1988 and 2012 were enrolled. The outcome of interest included overall survival (OS) and cancer-specific survival (CSS). A total of 679 patients with a median follow-up of 13 months were identified. Four hundred forty-eight patients received radiotherapy and 231 did not. Radiotherapy was associated with significantly improved OS and CSS in both univariate and multivariate analyses. Weighted Cox regression by inverse probability of treatment weighting (IPTW) using propensity score (PS) showed a 50% reduced risk of mortality in patients who received radiotherapy with regards to both OS (HR: 0.50, 95% CI: 0.41–0.60, p < 0.001) and CSS (HR: 0.50, 95% CI: 0.40–0.61, p < 0.001), respectively. Further, patients with a younger age (<65 year-old), diagnosed after 2003, with non-keratinizing carcinoma or undifferentiated carcinoma, and who received surgery had better outcomes for both OS and CSS. Local radiotherapy was associated with improved survival in patients with mNPC. Our findings warrant prospective investigation in clinical trials.