AI Article Synopsis
- The study aimed to enhance treatment strategies for patients with de novo metastatic nasopharyngeal carcinoma (mNPC) by identifying survival outcomes based on specific radiological characteristics of metastases.
- Researchers analyzed three patient cohorts and successfully created new subcategories within the M1 stage of mNPC, which significantly correlated with varying overall survival rates: M1a (best), M1b (intermediate), and M1c (worst).
- The findings suggest that certain treatments, like systemic chemotherapy combined with radiotherapy, may be beneficial for M1a and M1b patients, but not for M1c patients, highlighting the need for tailored therapy approaches based on M1 classification.
Article Abstract
Background: To better manage patients with de novo metastatic NPC (mNPC) including easily identifying individuals' survival outcomes and accurately choosing the most suitable treatment.
Materials And Methods: Three independent cohorts of mNPC patients (a training set of n = 462, an internal prospective validation set of n = 272 and an external prospective validation set of n = 243) were studied. The radiological characteristics of distant metastases, including number of metastatic locations, number of metastatic lesions and size of metastatic lesions, were carefully defined based on imaging data. These three factors and other potential prognostic factors were comprehensively analysed and were further integrated into new subdivisions of stage M1 using a Cox proportional hazards model.
Results: We successfully subdivided the M1 stage into three categories: M1a, oligo metastasis without liver involvement; M1b, multiple metastases without liver involvement; and M1c, liver involvement irrespective of metastatic lesions. The 3-year overall survival ranged from 54.5% to 72.8%, from 34.3% to 41.6% and from 22.6.0%-23.6% for M1a, M1b and M1c, respectively (P < 0.001). Systemic chemotherapy combined with radical loco-regional radiotherapy may benefit patients in M1a and M1b, not in M1c. Further aggressive treatment of metastatic lesions based on systemic chemotherapy and definitive loco-regional radiotherapy showed no survival benefit, even for patients in M1a (P > 0.05).
Conclusion: The subdividing of M1 provided promising prognostic value and could aid clinicians in choosing the most suitable treatment for de novo mNPC patients.
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| http://dx.doi.org/10.1016/j.ejca.2017.02.029 | DOI Listing |
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