Cancer Research and Treatment

Original Articles

Silence of Transmembrane Channel-Like 5 Inhibits Cell Proliferation, Migration, and Invasion While Promoting Apoptosis Via Deactivating the AKT Pathway in Breast Cancer: Jinnan Wan, Yang Li, Zhimin Liu; Received July 30, 2025 Accepted December 7, 2025 Published online December 9, 2025; DOI: https://doi.org/10.4143/crt.2025.805 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
Transmembrane channel-like 5 (TMC5) plays a tumor-promoting role in the progression of various tumors. However, its effect on regulating breast cancer cell function remains scarce. The current study aimed to evaluate the effect of TMC5 silence on the proliferation, apoptosis, migration, and invasion of breast cancer cell lines.
Materials and Methods
TMC5-specific small interfering RNA (siTMC5) and siNC were transfected into MDA-MB-231 and MCF-7 cell lines; subsequently, cells were treated with 740Y-P. Then, the proliferation, apoptosis, migration, invasion, and p-AKT expression were determined.
Results
In MDA-MB-231 and MCF-7 cell lines, silence of TMC5 could reduce the proliferation rate at 48 hours and 72 hours, migration rate, and invasion rate, while elevating the apoptosis rate. Besides, silence of TMC5 could decrease the p-AKT/AKT expression. The combination of 740Y-P with the silence of TMC5 could reversely increase the proliferation rate at 48 hours and 72 hours, migration rate, and invasion rate compared with the silence of TMC5 only. The apoptosis rate showed the opposite trend.
Conclusion
The silence of TMC5 could inhibit the proliferation, migration, and invasion while promoting apoptosis of breast cancer cells, while further in vivo validation is needed to explore its potential to be a treatment target for patients with breast cancer.

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Pediatric cancer

Stratified Treatment in Pediatric Anaplastic Large Cell Lymphoma: Result of a Prospective Open-Label Multiple-Institution Study: Tingting Chen, Chenggong Zeng, Juan Wang, Feifei Sun, Junting Huang, Jia Zhu, Suying Lu, Ning Liao, Xiaohong Zhang, Zaisheng Chen, Xiuli Yuan, Zhen Yang, Haixia Guo, Liangchun Yang, Chuan Wen, Wenlin Zhang, Yang Li, Xuequn Luo, Zelin Wu, Lihua Yang, Riyang Liu, Mincui Zheng, Xiangling He, Xiaofei Sun, Zijun Zhen; Cancer Res Treat. 2024;56(4):1252-1261. Published online May 28, 2024; DOI: https://doi.org/10.4143/crt.2024.104

Abstract PDF Supplementary Material PubReader ePub

Purpose
The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored.
Materials and Methods
On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL).
Results
A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse.
Conclusion
This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Citations

Citations to this article as recorded by

Primary Cutaneous ALK+ Anaplastic Large Cell Lymphoma With Minimal Bone Marrow Involvement: A Treatment Challenge
Minja Coelho, Hannah Walker, Natalie Ling, Colleen D'Arcy, Stacie S. Wang
Pediatric Blood & Cancer.2026;[Epub] CrossRef
Risk Stratification in Pediatric Non-Hodgkin Lymphoma Using Maximum Tumor Dissemination and Metabolic Tumor Burden on Baseline 18F-FDG PET/CT
Sang Hyun Hwang, Won Kee Ahn, Hojin Cho, Hae Won Lee, Jung Woo Han, Seung Min Hahn, Won Jun Kang
Clinical Nuclear Medicine.2026;[Epub] CrossRef
Advances and updates in pediatric anaplastic large cell lymphoma
Lianna J. Marks, Eric Lowe, Kala Kamdar
Blood Advances.2025; 9(19): 4870. CrossRef

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Genitourinary cancer

Physical Activity and Bladder Cancer Risk: Findings of the Japan Collaborative Cohort Study: Hang An, Keyang Liu, Kokoro Shirai, Ryo Kawasaki, Akiko Tamakoshi, Hiroyasu Iso; Cancer Res Treat. 2024;56(2):616-623. Published online October 6, 2023; DOI: https://doi.org/10.4143/crt.2023.962

Abstract PDF Supplementary Material PubReader ePub

Purpose
The association of physical activity with the risk of bladder cancer remains inconsistent among Asian populations. We aimed to examine the association in a large Japanese cohort.
Materials and Methods
In a population-based prospective cohort study, a total of 50,374 Japanese adults aged 40-79 years without a history of cancer or cardiovascular disease who had information on physical activity from self-administrated questionnaires were used for analysis. We performed Cox proportional hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident bladder cancer after adjusting for several potential confounders.
Results
During the median 17.5 years of follow-up, 153 incident bladder cancers (116 men and 37 women) were identified. After the multivariable adjustment, HRs (95% CI) of bladder cancer concerning those with recreational sports participation of 1-2 hr/wk, 3-4 hr/wk, and 5 hr/wk and more were 0.67 (0.38-1.20), 0.79 (0.36-1.74), and 0.28 (0.09-0.89), respectively (p for trend=0.017). Compared with mostly sitting at the workplace, occupational physical activity of standing and walking were associated with a lower risk of bladder cancer (HR, 0.53 [95% CI, 0.32 to 0.85]). Hours of daily walking were not associated with the risk. The lower risk of bladder cancer was more evident for recreational sports (HR, 0.33 [95% CI, 0.10 to 1.00]), and for occupational standing and walking activity at work (HR, 0.57 [95% CI, 0.33 to 0.98]) among men.
Conclusion
Recreational sports participation and occupational physical activity were inversely associated with the risk of bladder cancer among Japanese, especially in men.

Citations

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The association of physical activity with urological cancer risk: a systematic review and meta-analysis
Fangfang Xie, Chaoqu Xie, Hongyu Yue, Jiahe Cui, Jianwen Ma, Jiatuo Xu, Fei Yao
Nature Communications.2026;[Epub] CrossRef
Physical Activity and Cancer Incidence and Mortality: Current Evidence and Biological Mechanisms
Joanna Kruk, Basil Hassan Aboul-Enein, Marta Ewelina Gołębiewska, Ewa Duchnik, Urszula Czerniak, Mariola Marchlewicz
Cancers.2025; 17(9): 1410. CrossRef
Occupational physical activity and incidence and mortality of 14 cancers in 404,249 adults
Cristina Cadenas-Sanchez, Miguel Adriano Sanchez-Lastra, Jakob Tarp, Ulf Ekelund, Knut Eirik Dalene
Nature Communications.2025;[Epub] CrossRef

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Gastrointestinal cancer

Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study: Yuting Li, Ehab S. Eshak, Renzhe Cui, Kokoro Shirai, Keyang Liu, Hiroyasu Iso, Satoyo Ikehara, Akiko Tamakoshi, Shigekazu Ukawa, JACC Study Group; Cancer Res Treat. 2021;53(2):497-505. Published online October 27, 2020; DOI: https://doi.org/10.4143/crt.2020.327

Abstract PDF Supplementary Material PubReader ePub

Purpose
Sedentary behavior attributes to the increased risk of some cancers and all-cause mortality. The evidence is limited for the association between television (TV) viewing time, a major sedentary behavior, and risk of colorectal cancer death. We aimed to examine this association in Japanese population.
Materials and Methods
A prospective cohort study encompassed of 90,834 men and women aged 40-79 years with no prior history of colorectal cancer who completed a self-administered food frequency questionnaire, and provided their TV viewing information. The participants were followed-up from 1988-1990 to the end of 2009. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazard regression for risk of colorectal cancer mortality according to TV viewing time.
Results
During the median 19.1-year follow-up period, we documented 749 (385 men and 364 women) colorectal cancer deaths. The multivariable-adjusted HRs for mortality from colorectal cancer were 1.11 (0.88-1.41) for 1.5 to < 3 hr/day, 1.14 (0.91-1.42) for 3 to < 4.5 hr/day and 1.33 (1.02-1.73) for ≥ 4.5 hr/day in comparison to < 1.5 hr/day TV watching; p-trend=0.038, and that for 1-hour increment in TV viewing time was 1.06 (1.01-1.11). Moreover, the multivariable-adjusted HR (95%CI) of colon cancer for 1-hour increment in TV viewing time was 1.07 (1.02-1.13). Age, body mass index, and level of leisure-physical activity did not show significant effect modifications on the observed associations.
Conclusion
TV viewing time is associated with the increased risk of colorectal cancer mortality among Japanese population, more specifically colon rather than rectal cancer.

Citations

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Sedentary Behavior and Health Consequences: A Systematic Scoping Review of Prospective and Longitudinal Studies in Japan
Ai Shibata, Kaori Ishii, Neville Owen, Koichiro Oka
Journal of Epidemiology.2026; 36(1): 1. CrossRef
Unravelling behavioural contributions to IBS risk: evidence from univariate and multivariate Mendelian randomisation
Hongyu Chu, Yumin Zhong, Jiayi Zhao, Yuezhan Shan, Xuedong Fang
Journal of Global Health.2025;[Epub] CrossRef
Sex differences in the association of physical activity patterns with all-cause and cardiovascular mortality: a prospective cohort study from NHANES 2007–2018
Ailing He, Yunkai Wang, Chaopin Du, Yu Wang, Jiajie Wu, Dapeng Kuang, Yajun Zhao, Zhihui Li, Hanbin Cui, Guannan Bai, Wenbin Jiang, Lin Zhang
Scientific Reports.2025;[Epub] CrossRef
Comprehensive Genetic Analysis Exploring Sedentary Lifestyle, Physical Activity, and Respiratory Diseases: A Bidirectional Mendelian Randomization with over 500,000 Participants
Wei Wan, Junhao Tu, Xinyi Huang, Yingxiang Ren, Zhiqiang Zhang, Xinyu Huang, Mengyuan Liu, Yi Qiu, Chunping Yang
International Archives of Allergy and Immunology.2024; 186(8): 758. CrossRef
The causal effects of leisure screen time on irritable bowel syndrome risk from a Mendelian randomization study
Liesheng Lu, Changqin Liu, Kunpeng Liu, Chenzhang Shi, Zhongchen Liu, Xun Jiang, Feng Wang
Scientific Reports.2023;[Epub] CrossRef
Association of Physical Activity and Sedentary Behavior With the Risk of Colorectal Cancer
Sanghyun An, Sungjin Park
Journal of Korean Medical Science.2022;[Epub] CrossRef
Sedentary behavior and cancer–an umbrella review and meta-analysis
Rafael Hermelink, Michael F. Leitzmann, Georgios Markozannes, Kostas Tsilidis, Tobias Pukrop, Felix Berger, Hansjörg Baurecht, Carmen Jochem
European Journal of Epidemiology.2022; 37(5): 447. CrossRef

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CNS cancer

Mutant IDH1 Enhances Temozolomide Sensitivity via Regulation of the ATM/CHK2 Pathway in Glioma: Lin Lin, Jinquan Cai, Zixiao Tan, Xiangqi Meng, Ruiyan Li, Yang Li, Chuanlu Jiang; Cancer Res Treat. 2021;53(2):367-377. Published online October 13, 2020; DOI: https://doi.org/10.4143/crt.2020.506

Abstract PDF PubReader ePub

Purpose
Isocitrate dehydrogenase 1 (IDH1) mutations are the most common genetic abnormalities in low-grade gliomas and secondary glioblastomas. Glioma patients with these mutations had better clinical outcomes. However, the effect of IDH1 mutation on drug sensitivity is still under debate.
Materials and Methods
IDH1-R132H mutant cells were established by lentivirus. IDH1-R132H protein expression was confirmed by western blot. The expression of ataxia telangiectasia mutated (ATM) signaling pathway and apoptosis-related proteins were detected by immunofluorescence and western blot. Temozolomide (TMZ) induced cell apoptosis was detected by flow cytometry. Tumor cell proliferation was detected by Cell Counting Kit-8. In vivo nude mice were used to confirm the in vitro roles of IDH1 mutation.
Results
We established glioma cell lines that expressed IDH1-R132H mutation stably. We found that TMZ inhibited glioma cells proliferation more significantly in IDH1 mutant cells compared to wild type. The IC₅₀ of TMZ in IDH1-R132H mutant group was less than half that of wild-type group (p < 0.01). TMZ significantly induced more DNA damage (quantification of γH2AX expression in IDH1 mutation vs. wild type, p < 0.05) and apoptosis (quantification of AnnexinV+propidium iodide–cells in IDH1 mutation versus wild type, p < 0.01) in IDH1 mutant gliomas compared to wild-type gliomas. The ATM-associated DNA repair signal was impaired in IDH1 mutant cells. Inhibiting the ATM/checkpoint kinase 2DNA repair pathway further sensitized IDH1 mutant glioma cells to chemotherapy. We found that IDH1 mutation significantly inhibited tumor growth in vivo (the tumor size was analyzed statistically, p < 0.05). Moreover, we confirmed that gliomas with IDH1 mutation were more sensitive to TMZ in vivo compared to wild type significantly and the results were consistent with the in vitro experiment.
Conclusion
These results provide evidence that combination of TMZ and ATM inhibitor enhances the antitumor effect in IDH1 mutant gliomas.

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Gastrointestinal cancer

Systemic Inflammatory Biomarkers, Especially Fibrinogen to Albumin Ratio, Predict Prognosis in Patients with Pancreatic Cancer: Lin Fang, Fei-Hu Yan, Chao Liu, Jing Chen, Dan Wang, Chun-Hui Zhang, Chang-Jie Lou, Jie Lian, Yang Yao, Bo-Jun Wang, Rui-Yang Li, Shu-Ling Han, Yi-Bing Bai, Jia-Ni Yang, Zhi-Wei Li, Yan-Qiao Zhang; Cancer Res Treat. 2021;53(1):131-139. Published online August 24, 2020; DOI: https://doi.org/10.4143/crt.2020.330

Abstract PDF Supplementary Material PubReader

Purpose
Systemic inflammatory response is a critical factor that promotes the initiation and metastasis of malignancies including pancreatic cancer (PC). This study was designed to determine and compare the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and fibrinogen-to-albumin ratio (FAR) in resectable PC and locally advanced or metastatic PC.
Materials and Methods
Three hundred fifty-three patients with resectable PC and 807 patients with locally advan-ced or metastatic PC were recruited in this study. These patients were classified into a training set (n=758) and a validation set (n=402). Kaplan-Meier survival plots and Cox proportional hazards regression models were used to analyze prognosis.
Results
Overall survival (OS) was significantly better for patients with resectable PC with low preoperative PLR (p=0.048) and MLR (p=0.027). Low FAR, MLR, NLR (p < 0.001), and PLR (p=0.003) were significantly associated with decreased risk of death for locally advanced or metastatic PC patients. FAR (hazard ratio [HR], 1.522; 95% confidential interval [CI], 1.261 to 1.837; p < 0.001) and MLR (HR, 1.248; 95% CI, 1.017 to 1.532; p=0.034) were independent prognostic factors for locally advanced or metastatic PC.
Conclusion
The prognostic roles of FAR, MLR, NLR, and PLR in resectable PC and locally advanced or metastatic PC were different. FAR showed the most prognostic power in locally advanced or metastatic PC. Low FAR was positively correlated with OS in locally advanced or metastatic PC, which could be used to predict the prognosis.

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A Modified NHL-BFM-95 Regimen Produces Better Outcome Than HyperCVAD in Adult Patients with T-Lymphoblastic Lymphoma, a Two-Institution Experience: Chun Li, Zhi-Jun Wuxiao, Xiaoqin Chen, Guanjun Chen, Yue Lu, Zhongjun Xia, Yang Liang, Hua Wang; Cancer Res Treat. 2020;52(2):573-585. Published online December 6, 2019; DOI: https://doi.org/10.4143/crt.2019.542

Abstract PDF Supplementary Material PubReader ePub

Purpose
Lymphoblastic lymphoma (LBL) is an invasive neoplasm of precursor T-cell or B-cell lineage. A broadly accepted standard treatment for adult LBL has not yet been defined.
Materials and Methods
To address this issue, we compared two chemotherapy regimens: a modified non-Hodgkin lymphoma Berlin–Frankfurt–Münster-95 (NHL-BFM-95) regimen and HyperCVAD/MA. This retrospective study consecutively enrolled 207 adult LBL patients at two hospitals from 2000 to 2018. Univariate and multivariate analysis were used to assess prognostic factors.
Results
In the present study, most clinical characteristics were similar between the two treatment groups except for age and lactate dehydrogenase (LDH) level. Patients treated with modified NHL-BFM-95 regimen tended to be younger and with elevated LDH level. The modified NHL-BFM- 95 regimen produced better treatment outcomes than those with HyperCVAD/MA in patients with T-LBL or patients < 40 years. Treatment with HyperCVAD/MA, high Eastern Cooperative Oncology Group scores, and bone marrow involvement were independent risk factors in T-LBL. No patients interrupted treatment for severe adverse events.
Conclusion
The results suggested that the modified regimen is well-tolerated and can produce the promising outcomes in patients with T-LBL or patients < 40 years.

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Optimal timing and impact of allogeneic peripheral blood stem cell transplantation in adult T-cell lymphoblastic lymphoma: insights from a large cohort multi-center real-world study in Shanghai
Fangfang Yu, Jiahua Niu, Jianmin Yang, Jian Hou, Siguo Hao, Aibin Liang, Hong Xiong, Qi Zhu, Ligen Liu, Jun Shi, Juan Du, Bobin Chen, Rong Wei, Wenli Zhao, Lihua Sun, Yunhua Hou, Rong Tao, Xianmin Song
Bone Marrow Transplantation.2025; 60(3): 380. CrossRef
Cutaneous Involvement in a Case of T-lymphoblastic Lymphoma: A Rare Presentation
Priyanka Kowe, Madhusmita Sethy, Biswanath Behera, Pritinanda Mishra, Ashutosh Panigrahi
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Wenqing Su, Melisa Stricherz, Alison Martin, Jonathan Belsey, Eric Kemadjou, Daniel J. DeAngelo
American Journal of Hematology.2025; 100(5): 847. CrossRef
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Xiaodan Luo, Zhiping Fan, Runhui Zheng, Fen Huang, Na Xu, Pengfei Qin, Jingren Lin, Chunyan Wang, Huiqiang Huang, Huo Tan, Qifa Liu
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Television Viewing Time and Breast Cancer Incidence for Japanese Premenopausal and Postmenopausal Women: The JACC Study: Jinhong Cao, Ehab Salah Eshak, Keyang Liu, Isao Muraki, Renzhe Cui, Hiroyasu Iso, Akiko Tamakoshi, JACC Study Group; Cancer Res Treat. 2019;51(4):1509-1517. Published online March 21, 2019; DOI: https://doi.org/10.4143/crt.2018.705

Abstract PDF PubReader ePub

Purpose
The evidence on effects of TV viewing time among premenopausal and postmenopausal women for breast cancer risk remains controversial and limited.
Materials and Methods
A prospective study encompassing 33,276 (17,568 premenopausal, and 15,708 postmenopausal) women aged 40-79 years in whom TV viewing time, menstrual, and reproductive histories were determined by a self-administered questionnaire. The follow-up was from 1988 to 2009 and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for longer TV viewing time in reference to shorter TV viewing time by Cox proportional hazard models.
Results
During 16.8-year median follow-up, we found positive associations between TV viewing time and breast cancer incidence with a borderline significant trend among total women and a significant trend among postmenopausal women. Among total women, the multivariable HRs (95% CIs) for risk of breast cancer in reference to < 1.5 hr/day of TV viewing time were 0.89 (0.59-1.34) for 1.5 to < 3.0 hr/day, 1.19 (0.82-1.74) for 3.0 to < 4.5 hr/day, and 1.45 (0.91-2.32) for ≥ 4.5 hr/day (p for trend=0.053) and among postmenopausal women, the corresponding risk estimates were 1.10 (0.42-2.88), 2.54 (1.11-5.80), and 2.37 (0.92-6.10) (p for trend=0.009), respectively.
Conclusion
Prolonged TV viewing time was associated with increased risk of breast cancer, especially among postmenopausal women.

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Ai Shibata, Kaori Ishii, Neville Owen, Koichiro Oka
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Sidney M. Donzella, Molly Rogers, Katie M. O’Brien, Ann Von Holle, Dale P. Sandler, Clarice R. Weinberg, Mary V. Diaz Santana
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Xiaodong Yu, Yaxun Li, Fanshuang Kong, Qun Xu
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Yu-Chiao Wang, Ching-Hung Lin, Shih-Pei Huang, Mingchih Chen, Tian-Shyug Lee
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Feifei Chong, Yanli Wang, Mengmeng Song, Qiuyu Sun, Weihong Xie, Chunhua Song
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Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study
Yuting Li, Ehab S. Eshak, Renzhe Cui, Kokoro Shirai, Keyang Liu, Hiroyasu Iso, Satoyo Ikehara, Akiko Tamakoshi, Shigekazu Ukawa
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Gita Nirmala Sari, Ehab Salah Eshak, Kokoro Shirai, Yoshihisa Fujino, Akiko Tamakoshi, Hiroyasu Iso
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Risk Assessment of Secondary Primary Malignancies in Nasopharyngeal Carcinoma: A Big-Data Intelligence Platform-Based Analysis of 6,377 Long-term Survivors from an Endemic Area Treated with Intensity-Modulated Radiation Therapy during 2003-2013: Lu-Lu Zhang, Guo-Hong Li, Yi-Yang Li, Zhen-Yu Qi, Ai-Hua Lin, Ying Sun; Cancer Res Treat. 2019;51(3):982-991. Published online October 11, 2018; DOI: https://doi.org/10.4143/crt.2018.298

Abstract PDF PubReader ePub

Purpose
The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized.
Methods
and Materials Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival.
Results
Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival.
Conclusion
This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.

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International Journal of Cancer.2022; 151(8): 1291. CrossRef
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Inmaculada Salcedo‐Bellido, Pilar Requena, Rocío Mateos, Carmen Ortega‐Rico, Rocío Olmedo‐Requena, Macarena Lozano‐Lorca, Juan Pedro Arrebola, Rocío Barrios‐Rodríguez
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Chao Liu, Lieqiang Liao, Guoying Wu, Honghong Yan, Xiaoqi Chen, Chao Wang, Xiajing Zheng, Ziyi Zeng, Zheng Zhao, Di Wu, Xuekui Liu
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James C.H. Chow, Anthony H.P. Tam, Ka-Man Cheung, Victor H.F. Lee, Chi-Leung Chiang, Macy Tong, Edwin C.Y. Wong, Alice K.W. Cheung, Sunny P.C. Chan, Jessica W.Y. Lai, Roger K.C. Ngan, Wai-Tong Ng, Anne W.M. Lee, Kwok-Hung Au
Oral Oncology.2020; 111: 105012. CrossRef

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Induction Chemotherapy Plus Concurrent Chemoradiotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma in Children and Adolescents: A Matched Cohort Analysis: Yang Li, Lin-Quan Tang, Li-Ting Liu, Shan-Shan Guo, Yu-Jing Liang, Xue-Song Sun, Qing-Nan Tang, Jin-Xin Bei, Jing Tan, Shuai Chen, Jun Ma, Chong Zhao, Qiu-Yan Chen, Hai-Qiang Mai; Cancer Res Treat. 2018;50(4):1304-1315. Published online January 8, 2018; DOI: https://doi.org/10.4143/crt.2017.463

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to evaluate the long-term clinical outcome and toxicity of induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) compared with CCRT alone for the treatment of children and adolescent locoregionally advanced nasopharyngeal carcinoma (LACANPC).
Materials and Methods
A total of 194 locoregionally advanced nasopharyngeal carcinoma patients youngerthan 21 years who received CCRT with or without IC before were included in the study population. Overall survival (OS) rate, progression-free survival (PFS) rate, locoregional recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate were assessed by the Kaplan-Meier method and a log-rank test. Treatment toxicities were clarified and compared between two groups.
Results
One hundred and thiry of 194 patients received IC+CCRT. Patients who were younger and with more advanced TNM stage were more likely to receive IC+CCRT and intensive modulated radiotherapy. The addition of IC before CCRT failed to improve survival significantly. The matched analysis identified 43 well-balanced patients in both two groups. With a median follow-up of 51.5 months, no differences were found between the IC+CCRT group and the CCRT group in 5-year OS (83.7% vs. 74.6%, p=0.153), PFS (79.2% vs. 73.4%, p=0.355), LRFS (97.7% vs. 88.2%, p=0.083), and DMFS (81.6% vs. 81.6%, p=0.860). N3 was an independent prognostic factor predicting poorer OS, PFS, and DMFS. The addition of IC was associated with increased rates of grade 3 to 4 neutropenia.
Conclusion
This study failed to demonstrate that adding IC before CCRT could provide a significant additional survival benefit for LACANPC patients. Further investigations are warranted.

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Nasopharyngeal Carcinoma in Children, Current Treatment Approach
Tal Ben-Ami
Journal of Pediatric Hematology/Oncology.2024; 46(3): 117. CrossRef
Concurrent chemoradiotherapy with or without neoadjuvant chemotherapy in pediatric patients with stage III-IVa nasopharyngeal carcinoma: a real-world propensity score-matched cohort study
Ya-Nan Jin, Zhao-Hui Ruan, Wan-Wei Cao, Lin Yang, Wei Yao, Xiao-Feng Pei, Wang-Jian Zhang, Tia Marks, Ji-Jin Yao, Liang-Ping Xia
Journal of Cancer Research and Clinical Oncology.2023; 149(13): 11929. CrossRef
Epidemiology and treatment of head and neck malignancies in the AYA generation
Takahiro Asakage
International Journal of Clinical Oncology.2022; 27(3): 465. CrossRef
Association of Treatment Advances With Survival Rates in Pediatric Patients With Nasopharyngeal Carcinoma in China, 1989-2020
Yu-Jing Liang, Li-Ting Liu, Yang Li, Pan Wang, Mei-Juan Luo, Dong-Xiang Wen, Qiu-Yan Chen, Hai-Qiang Mai
JAMA Network Open.2022; 5(3): e220173. CrossRef
LHX2 facilitates the progression of nasopharyngeal carcinoma via activation of the FGF1/FGFR axis
Tao Xie, Kunpeng Du, Wei Liu, Chunshan Liu, Baiyao Wang, Yunhong Tian, Rong Li, Xiaoting Huang, Jie Lin, Haifeng Jian, Jian Zhang, Yawei Yuan
British Journal of Cancer.2022; 127(7): 1239. CrossRef
Exploring the Optimal Chemotherapy Strategy for Locoregionally Advanced Children and Adolescent Nasopharyngeal Carcinoma Based on Pretreatment Epstein-Barr Virus DNA Level in the Era of Intensity Modulated Radiotherapy
Ziyi Zeng, Chen Chen, Lanlan Guo, Cheng Zhang, Lei Chen, Chuanping Yuan, Lixia Lu
Frontiers in Oncology.2021;[Epub] CrossRef
Optimal cumulative cisplatin dose during concurrent chemoradiotherapy among children and adolescents with locoregionally advanced nasopharyngeal carcinoma: A real-world data study
Ya-Nan Jin, Ji-Jin Yao, Ya-Fei You, Hui-Jiao Cao, Zi-Zi Li, Dan-Ling Dai, Wang-Jian Zhang, Tia Marks, Bei Zhang, Liang-Ping Xia
Radiotherapy and Oncology.2021; 161: 83. CrossRef
Nasopharyngeal carcinoma in children: Multimodal treatment and long‐term outcome of 92 patients in a single center over a 28‐year period
Rejin Kebudi, Sema Bay Buyukkapu, Omer Gorgun, Kübra Ozkaya, Rasim Meral, Inci Ayan, Musa Altun
Pediatric Blood & Cancer.2021;[Epub] CrossRef
Induction or adjuvant chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in paediatric nasopharyngeal carcinoma in the IMRT era: A recursive partitioning risk stratification analysis based on EBV DNA
Yu-Jing Liang, Dong-Xiang Wen, Mei-Juan Luo, Lin-Quan Tang, Shan-Shan Guo, Pan Wang, Qiu-Yan Chen, Li-Ting Liu, Hai-Qiang Mai
European Journal of Cancer.2021; 159: 133. CrossRef
Time-to-Event Supervised Genetic Algorithm Enables Induction Chemotherapy Decision Making for Nasopharyngeal Carcinoma
Demin Liu, Haojiang Li, Liyang Wu, Shuchao Chen, Tianqiao Zhang, Wenjie Huang, Guangying Ruan, Sai Li, Lizhi Liu, Hongbo Chen
IEEE Access.2021; 9: 98701. CrossRef
LHX2 Facilitates the Progression of Nasopharyngeal Carcinoma via Activation of the FGF1/FGFR Axis
Tao Xie, Kunpeng Du, Wei Liu, Chunshan Liu, Baiyao Wang, Yunhong Tian, Rong Li, Xiaoting Huang, Jie Lin, Haifeng Jian, Jian Zhang, Yawei Yuan
SSRN Electronic Journal .2021;[Epub] CrossRef
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Naoya Murakami, Taisuke Mori, Yuko Kubo, Seiichi Yoshimoto, Kimiteru Ito, Yoshitaka Honma, Takao Ueno, Kenya Kobayashi, Hiroyuki Okamoto, Narikazu Boku, Kana Takahashi, Koji Inaba, Kae Okuma, Hiroshi Igaki, Yuko Nakayama, Jun Itami
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The efficacy and safety of induction chemotherapy combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in nasopharyngeal carcinoma patients: a systematic review and meta-analysis
Bi-Cheng Wang, Bo-Ya Xiao, Guo-He Lin, Chang Wang, Quentin Liu
BMC Cancer.2020;[Epub] CrossRef
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Line Claude, Emmanuel Jouglar, Loig Duverge, Daniel Orbach
The British Journal of Radiology.2019;[Epub] CrossRef

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Proposal of a Pretreatment Nomogram for Predicting Local Recurrence after Intensity-Modulated Radiation Therapy in T4 Nasopharyngeal Carcinoma: A Retrospective Review of 415 Chinese Patients: Lu-Lu Zhang, Yi-Yang Li, Jiang Hu, Guan-Qun Zhou, Lei Chen, Wen-Fei Li, Ai-Hua Lin, Jun Ma, Zhen-Yu Qi, Ying Sun; Cancer Res Treat. 2018;50(4):1084-1095. Published online November 15, 2017; DOI: https://doi.org/10.4143/crt.2017.359

Abstract PDF PubReader ePub

Purpose
Local relapse-free survival (LRFS) differs widely among patients with T4 category nasopharyngeal carcinoma (NPC). We aimed to build a nomogram incorporating clinicopathological information to predict LRFS in T4 NPC after definitive intensity-modulated radiation therapy (IMRT).
Materials and Methods
Retrospective study of 415 Chinese patients with non-metastatic T4 NPC treated with definitive IMRT with or without chemotherapy at our cancer center between October 2009 and September 2013. The nomogram for LRFS at 3 and 5 years was generated based on multivariate Cox proportional hazards regression, and validated using bootstrap resampling, assessing discriminative performance using the concordance index (C-index) and determining calibration ability via calibration curves.
Results
Five-year LRFS was 88.8%. We identified and incorporated four independent prognostic factors for LRFS: ethmoid sinus invasion, primary gross tumor volume, age, and pretreatment body mass index. The C-index of the nomogram for local recurrence was 0.732 (95% confidence interval, 0.726 to 0.738), indicating excellent predictive accuracy. The calibration curve revealed excellent agreement between nomogram-predicted and observed LRFS probabilities. Risk subgroups based on total point score cutoff values enabled effective discrimination of LRFS.
Conclusion
This pretreatment nomogram enables clinicians to accurately predict LRFS in T4 NPC after definitive IMRT, and could help to facilitate personalized patient counselling and treatment strategies.

Citations

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An 18F-FDG PET/CT-based radiomics nomogram for predicting progression-free survival in nasopharyngeal carcinoma: A retrospective cohort study
Jianpeng Lin, Jinghua Liu, Yanli Liu, Zhendong Cao, Dong Wen, Yanjun Wu, Zhongxiao Wang, Xiaolei Zhang, Bingzhen Wang, Shuyan Li, Xianling Dong
Medicine.2026; 105(7): e47716. CrossRef
Radiomics and Deep Learning in Nasopharyngeal Carcinoma: A Review
Zipei Wang, Mengjie Fang, Jie Zhang, Linquan Tang, Lianzhen Zhong, Hailin Li, Runnan Cao, Xun Zhao, Shengyuan Liu, Ruofan Zhang, Xuebin Xie, Haiqiang Mai, Sufang Qiu, Jie Tian, Di Dong
IEEE Reviews in Biomedical Engineering.2024; 17: 118. CrossRef
Novel prediction model combining PET/CT metabolic parameters, inflammation markers, and TNM stage: prospects for personalizing prognosis in nasopharyngeal carcinoma
Huan Liang, Weilin Tan, Jie Wang, Mengdan Li, Hua Pang, Xiaohui Wang, Lu Yang, Xingguo Jing
Annals of Nuclear Medicine.2024; 38(10): 802. CrossRef
Can Epstein–Barr virus‐deoxyribonucleic acid load after induction chemotherapy combined with American Joint Committee on Cancer stage determine the chemotherapy intensity of locally advanced nasopharyngeal carcinoma?
Qun Zhang, Zhen‐Wei Peng, Zhuo‐Sheng Gu, Yan Wang, Fang He, Wen‐Bin Zhao, Wei Luo, Yong‐Yu Mei
Cancer Medicine.2023; 12(1): 223. CrossRef
Prioritizing sufficient dose to gross tumor volume over normal tissue sparing in intensity‐modulated radiotherapy treatment of T4 nasopharyngeal carcinoma
Yanyan Chen, Quxia Zhang, Tianzhu Lu, Cairong Hu, Jingfeng Zong, Yun Xu, Wei Zheng, Lisha Chen, Senan Lin, Sufang Qiu, Luying Xu, Jianji Pan, Qiaojuan Guo, Shaojun Lin
Head & Neck.2023; 45(5): 1130. CrossRef
Multi-task deep learning-based radiomic nomogram for prognostic prediction in locoregionally advanced nasopharyngeal carcinoma
Bingxin Gu, Mingyuan Meng, Mingzhen Xu, David Dagan Feng, Lei Bi, Jinman Kim, Shaoli Song
European Journal of Nuclear Medicine and Molecular Imaging.2023; 50(13): 3996. CrossRef
Prognostic significance of AKR1C4 and the advantage of combining EBV DNA to stratify patients at high risk of locoregional recurrence of nasopharyngeal carcinoma
Shan-Shan Guo, Yan-Zhou Chen, Li-Ting Liu, Rong-Ping Liu, Yu-Jing Liang, Dong-Xiang Wen, Jing Jin, Lin-Quan Tang, Hai-Qiang Mai, Qiu-Yan Chen
BMC Cancer.2022;[Epub] CrossRef
DeepMTS: Deep Multi-Task Learning for Survival Prediction in Patients With Advanced Nasopharyngeal Carcinoma Using Pretreatment PET/CT
Mingyuan Meng, Bingxin Gu, Lei Bi, Shaoli Song, David Dagan Feng, Jinman Kim
IEEE Journal of Biomedical and Health Informatics.2022; 26(9): 4497. CrossRef
Development and Validation of Prognostic Nomograms Based on Gross Tumor Volume and Cervical Nodal Volume for Nasopharyngeal Carcinoma Patients With Concurrent Chemoradiotherapy
Cui-Dai Zhang, Mei Li, Ying-Ji Hong, Ze-Man Cai, Kai-Chun Huang, Zhi-Xiong Lin, Zhi-Ning Yang
Frontiers in Oncology.2021;[Epub] CrossRef
Development and Validation of Web-Based Nomograms to Precisely Predict Survival Outcomes of Non-metastatic Nasopharyngeal Carcinoma in an Endemic Area
Ji-Jin Yao, Li Lin, Tian-Sheng Gao, Wang-Jian Zhang, Wayne R. Lawrence, Jun Ma, Ying Sun
Cancer Research and Treatment.2021; 53(3): 657. CrossRef
Nomogram predict relapse-free survival of patients with thymic epithelial tumors after surgery
Yang-Yu Huang, Lei-Lei Wu, Xuan Liu, Shen-Hua Liang, Guo-Wei Ma
BMC Cancer.2021;[Epub] CrossRef
Establishment and validation of a nomogram with intratumoral heterogeneity derived from 18F-FDG PET/CT for predicting individual conditional risk of 5-year recurrence before initial treatment of nasopharyngeal carcinoma
Bingxin Gu, Jianping Zhang, Guang Ma, Shaoli Song, Liqun Shi, Yingjian Zhang, Zhongyi Yang
BMC Cancer.2020;[Epub] CrossRef
Prognostic Nomogram for Patients with Radical Surgery for Non-Metastatic Colorectal Cancer Incorporating Hematological Biomarkers and Clinical Characteristics

Peiyun Long, Youya Zang, Huan Wang, Xiumei Liang, Xuekun Xie, Zhiwei Han, Dongyi Lin, Zongyu Wang, Shan Huang, Chuang Chen
OncoTargets and Therapy.2020; Volume 13: 2093. CrossRef
Impact of Paranasal Sinus Invasion on Oncologic and Dosimetric Outcomes in Nasopharyngeal Carcinoma Following Intensity-Modulated Radiation Therapy—Implications for Risk Stratification and Planning Optimization
Xin Zhou, Xiayun He, Fen Xue, Xiaomin Ou, Chaosu Hu
Frontiers in Oncology.2020;[Epub] CrossRef
Role of IMRT/VMAT-Based Dose and Volume Parameters in Predicting 5-Year Local Control and Survival in Nasopharyngeal Cancer Patients
Nicola Alessandro Iacovelli, Alessandro Cicchetti, Anna Cavallo, Salvatore Alfieri, Laura Locati, Eliana Ivaldi, Rossana Ingargiola, Domenico A. Romanello, Paolo Bossi, Stefano Cavalieri, Chiara Tenconi, Silvia Meroni, Giuseppina Calareso, Marco Guzzo, Ce
Frontiers in Oncology.2020;[Epub] CrossRef
Development of a Nomogram Model for Treatment of Nonmetastatic Nasopharyngeal Carcinoma
Lu-Lu Zhang, Fei Xu, Di Song, Meng-Yao Huang, Yong-Shi Huang, Qi-Ling Deng, Yi-Yang Li, Jian-Yong Shao
JAMA Network Open.2020; 3(12): e2029882. CrossRef
Radiomics on multi-modalities MR sequences can subtype patients with non-metastatic nasopharyngeal carcinoma (NPC) into distinct survival subgroups
En-Hong Zhuo, Wei-Jing Zhang, Hao-Jiang Li, Guo-Yi Zhang, Bing-Zhong Jing, Jian Zhou, Chun-Yan Cui, Ming-Yuan Chen, Ying Sun, Li-Zhi Liu, Hong-Min Cai
European Radiology.2019; 29(10): 5590. CrossRef
Impact of paranasal sinus invasion on advanced nasopharyngeal carcinoma treated with intensity‐modulated radiation therapy: the validity of advanced T stage of AJCC/UICC eighth edition staging system
Ying Wang, Jie Zhao, Yajie Zhao, Zhen Yang, Mingjun Lei, Zhanzhan Li, Rui Wei, Dengming Chen, Yuxiang He, Liangfang Shen
Cancer Medicine.2018; 7(7): 2826. CrossRef

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Combination of Tumor Volume and Epstein-Barr Virus DNA Improved Prognostic Stratification of Stage II Nasopharyngeal Carcinoma in the Intensity Modulated Radiotherapy Era: A Large-Scale Cohort Study: Qiu-Yan Chen, Shao-Yan Guo, Lin-Quan Tang, Tong-Yu Lu, Bo-Lin Chen, Qi-Yu Zhong, Meng-Sha Zou, Qing-Nan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Yang Li, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Chong Zhao, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Mu-Sheng Zeng, Hai-Qiang Mai; Cancer Res Treat. 2018;50(3):861-871. Published online September 13, 2017; DOI: https://doi.org/10.4143/crt.2017.237

Abstract PDF Supplementary Material PubReader ePub

Purpose
Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors.
Materials and Methods
By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above.
Results
Gross tumor volume of cervical lymph nodes (GTVnd, p < 0.001) and total tumor volume (GTVtotal, p < 0.001) were both closely related to pretreatment EBV DNA, while gross tumor volume of nasopharynx (GTVnx, p=0.047) was weakly related to EBV DNA. EBV DNA was significantly correlated with progress-free survival (PFS, p=0.005), locoregional-free survival (LRFS, p=0.039), and distant metastasis-free survival (DMFS, p=0.017), while GTVtotal, regardless of GTVnx and GTVnd, had a significant correlation with PFS and LRFS. The p-values of GTVtotal for PFS and LRFS were 0.008 and 0.001, respectively. According to GTVtotal and pretreatment EBV DNA level, patients were divided into a low-risk group (EBV DNA 0 copy/mL, GTVtotal < 30 cm3; EBV DNA 0 copy/mL, GTVtotal ≥ 30 cm3; or EBV DNA > 0 copy/mL, GTVtotal < 30 cm3) and a high-risk group (EBV DNA > 0 copy/mL, GTVtotal ≥ 30 cm3). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant.
Conclusion
Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.

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Xia Gan, Zhengzheng Yu, Lin Zhang, Wenji Xie, Xiaowen Sun, Yue Li, Jianing Fang, Yanxian Li, Yating Liu, Zhongjie Liu, Yaning Tang, Can Zhou, Zhuolong Xie, Wen Yao, Shuyu Ouyang, Jing Zhang, Pan Chen, Hui Wang, Huai Liu
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Erkan Topkan, Efsun Somay, Melis Selek, Ugur Selek
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Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study: Qiu-Yan Chen, Qing-Nan Tang, Lin-Quan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Chao-Feng Li, Yang Li, Yu-Jing Liang, Xue-Song Sun, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Yu-Ying Fan, Yan He, Ming-Yuan Chen, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Hai-Qiang Mai; Cancer Res Treat. 2018;50(3):701-711. Published online July 14, 2017; DOI: https://doi.org/10.4143/crt.2017.180

Abstract PDF Supplementary Material PubReader ePub

Purpose
The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC.
Materials and Methods
In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary endpoint was progress-free survival (PFS).
Results
The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the highSAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors.
Conclusion
The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.

Citations

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