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Wang F, Jiang C, Wang L, Yan F, Sun Q, Ye Z, Liu T, Fu Z, Jiang Y. Influence of concurrent chemotherapy on locoregionally advanced nasopharyngeal carcinoma treated with neoadjuvant chemotherapy plus intensity-modulated radiotherapy: A retrospective matched analysis. Sci Rep 2020; 10:2489. [PMID: 32051492 PMCID: PMC7016014 DOI: 10.1038/s41598-020-59470-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/29/2020] [Indexed: 01/29/2023] Open
Abstract
Neoadjuvant chemotherapy (NAC) combined with intensity-modulated radiotherapy (IMRT) plus concurrent chemotherapy (CC) will be the new standard treatment for locoregionally advanced nasopharyngeal carcinoma (NPC) patients. However, many patients fail to receive CC for multiple reasons. We aimed to investigate long-term survival outcomes and toxicities in these patients with NPC treated with additional NAC plus concurrent chemoradiotherapy (CCRT) or IMRT alone. In total, 1,378 previously untreated, newly diagnosed locoregionally advanced NPC patients receiving NAC plus IMRT with or without CC were retrospectively reviewed. We used a propensity score-matched (PSM) method with 1:1 matching to identify paired patients according to various covariates. Survival outcomes and toxicities were compared between the two groups. In total, 288 pairs were identified. With a median follow-up of 86 (range: 8–110) months, the estimated 5-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival (PFS), and overall survival rates in patients treated with NAC plus CCRT vs. NAC plus IMRT alone were 96.1% vs. 94.7% (P = 0.201), 93.7% vs. 89.8% (P = 0.129), 91.3% vs. 85.1% (P = 0.024), and 93.0% vs. 90.6% (P = 0.362), respectively. Multivariate analysis showed that CC omission was a prognostic factor for worse PFS. In a subgroup analysis, PFS did not differ significantly between two groups of female patients or aged <60 years or stage T1–2 or stage N0-1 disease. However, fewer acute complications were observed in the NAC plus IMRT alone group. NAC with IMRT alone confers similar survival rates and less acute toxicities. Specifically, NAC plus IMRT alone may be enough for female patients <60 years with stage T1-2 or stage N0-1. However, a prospective randomised trial is needed to validate these results.
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Affiliation(s)
- Fangzheng Wang
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China. .,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China. .,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China. .,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China.
| | - Chuner Jiang
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Breast Tumor Surgery, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Breast Tumor Surgery, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Lai Wang
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China.,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Fengqin Yan
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China.,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Quanquan Sun
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China.,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Zhimin Ye
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China.,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Tongxin Liu
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China.,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Zhenfu Fu
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, Hangzhou, 310022, People's Republic of China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, 310022, People's Republic of China.,Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang, Hangzhou, 310022, People's Republic of China
| | - Yangming Jiang
- Department of Didital Earth, Institute of Remote Sensing and Digital Earth, CAS, Beijing, 100101, People's Republic of China.
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Fangzheng W, Chuner J, Haiyan Q, Quanquan S, Zhimin Y, Tongxin L, Jiping L, Peng W, Kaiyuan S, Zhenfu F, Yangming J. Survival without concurrent chemotherapy for locoregionally advanced nasopharyngeal carcinoma treated with induction chemotherapy plus intensity-modulated radiotherapy: Single-center experience from an endemic area. Medicine (Baltimore) 2019; 98:e18484. [PMID: 31861031 PMCID: PMC6940191 DOI: 10.1097/md.0000000000018484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Although induction chemotherapy (IC) combined with intensity-modulated radiotherapy (IMRT) plus concurrent chemotherapy (CC) is the new standard treatment option in locoregionally advanced nasopharyngeal carcinoma (NPC), many patients fail to receive CC. The aim of this study was to investigate long-term survival outcomes and toxicities in these patients who are treated with IC before IMRT without CC.We retrospectively reviewed 332 untreated, newly diagnosed locoregionally advanced NPC patients who received IC before IMRT alone at our institution from May 2008 through April 2014. The IC was administered every 3 weeks for 1 to 4 cycles. Acute and late radiation-related toxicities were graded according to the acute and late radiation morbidity scoring criteria of the radiation therapy oncology group. The accumulated survival was calculated according to the Kaplan-Meier method. The log-rank test was used to compare the difference in survival.With a median follow-up duration of 65 months (range: 8-110 months), the 5-year estimated locoregional relapse-free survival, distant metastasis-free survival, progression-free survival (PFS), and overall survival rates were 93.4%, 91.7%, 85.8%, and 82.5%, respectively. Older age and advanced T stage were adverse prognostic factors for overall survival, and the absence of comorbidity was a favorable prognostic factor for PFS. However, acceptable acute complications were observed in these patients.IC combined with IMRT alone provides promising long-term survival outcomes with manageable toxicities. Therefore, the omission of CC from the standard treatment did not affect survival outcomes.
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Affiliation(s)
- Wang Fangzheng
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital
- Key Laboratory of Radiation Oncology of Zhejiang Province
| | - Jiang Chuner
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Breast Tumor Surgery, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Breast Surgery, Zhejiang Cancer Hospital, Zhejiang, Hangzhou
| | - Qin Haiyan
- Department of Radiation Oncology, People's Hospital of Kecheng, Zhejiang, Quzhou
| | - Sun Quanquan
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital
- Key Laboratory of Radiation Oncology of Zhejiang Province
| | - Ye Zhimin
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital
- Key Laboratory of Radiation Oncology of Zhejiang Province
| | - Liu Tongxin
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital
- Key Laboratory of Radiation Oncology of Zhejiang Province
| | - Liu Jiping
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Physics
| | - Wu Peng
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Pathology
| | - Shi Kaiyuan
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Ultrasonography, Zhejiang Cancer Hospital, Zhejiang, Hangzhou
| | - Fu Zhenfu
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital
- Key Laboratory of Radiation Oncology of Zhejiang Province
| | - Jiang Yangming
- Department of Digital Earth, Institute of Remote Sensing and Digital Earth, CAS, Beijing, People's Republic of China
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Saga R, Hasegawa K, Murata K, Chiba M, Nakamura T, Okumura K, Tsuruga E, Hosokawa Y. Regulation of radiosensitivity by 4-methylumbelliferone via the suppression of interleukin-1 in fibrosarcoma cells. Oncol Lett 2019; 17:3555-3561. [PMID: 30867797 DOI: 10.3892/ol.2019.9990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/17/2019] [Indexed: 12/28/2022] Open
Abstract
Tumor recurrence and distant metastasis following radiotherapy, which can lead to poor prognosis, are caused by residual cancer cells that acquire radioresistance. Chemotherapy or a combination of targeted inhibitors can potentially enhance radiation sensitivity and prevent metastasis. It was previously reported that co-administration of the hyaluronan synthesis inhibitor 4-methylumbelliferone (4-MU) enhanced the lethality of X-ray irradiation in HT1080 human fibrosarcoma cells and decreased their invasiveness to a greater extent than either treatment alone. To clarify the molecular basis of these effects, the present study conducted mRNA expression profiling by cDNA microarray to identify the signaling pathways that are altered under this combination treatment. The activation state of the signaling pathways was classified by z-scores in the Ingenuity Pathway Analysis. The results revealed that the pro-inflammatory cytokines interleukin (IL)-6 and IL-8 were activated by 2 Gy X-ray irradiation, an effect that was abolished by co-administration of 4-MU. Similar trends were observed for the upstream signaling component IL-1. These results indicate that the radiosensitivity of fibrosarcoma cells is improved by suppressing inflammation through the administration of 4-MU.
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Affiliation(s)
- Ryo Saga
- Department of Radiation Sciences, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - Kazuki Hasegawa
- Department of Radiation Sciences, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - Kosho Murata
- Department of Radiation Sciences, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - Mitsuru Chiba
- Department of Bioscience and Laboratory Medicine, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - Toshiya Nakamura
- Department of Bioscience and Laboratory Medicine, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - Kazuhiko Okumura
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari-gun, Hokkaido 061-0293, Japan
| | - Eichi Tsuruga
- Department of Radiation Sciences, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - Yoichiro Hosokawa
- Department of Radiation Sciences, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
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