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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2018.688    [Accepted]
Patterns of Failure and Survival Trends in 3,808 Patients with Stage II Nasopharyngeal Carcinoma Diagnosed from 1990 to 2012: A Large-Scale Retrospective Cohort Study
Xue-Song Sun1,2, Di-Han Liu1,3, Sai-Lan Liu1,2, Qiu-Yan Chen1,2, Shan-Shan Guo1,2, Yue-Feng Wen1,2, Li-Ting Liu1,2, Hao-Jun Xie1,2, Qing-Nan Tang1,2, Yu-Jing Liang1,2, Xiao-Yun Li1,2, Jin-Jie Yan1,2, Ming-Huang Hong1,4, Jun Ma1,5, Lin-Quan Tang1,2, Hai-Qiang Mai1,2
1Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
2Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
3Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
4Department of Good Clinical Practice Center, Sun Yat-sen University Cancer Center, Guangzhou, China
5Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
Correspondence  Lin-Quan Tang ,Tel: 86-20-87343155, Fax: 86-20-87343392, Email: tanglq@sysucc.org.cn
Hai-Qiang Mai ,Tel: 86-20-87343380, Fax: 86-20-87343392, Email: maihq@sysucc.org.cn
Received: December 12, 2018;  Accepted: March 6, 2019.  Published online: March 7, 2019.
*Xue-Song Sun, Di-Han Liu and Sai-Lan Liu contributed equally to this work.
ABSTRACT
Purpose
The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years.
Materials and Methods
Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), loco-regional relapse free survival (LRFS), and distant metastasis free survival (DMFS) were served as the clinical outcome.
Results
After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods.
Conclusion
The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.
Key words: Nasopharyngeal carcinoma, Radiotherapy, Prognosis
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