ArticleRadiation oncology (London, England)2023
Proposed prognostic subgroups and facilitated clinical decision-making for additional locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma: a retrospective study based on recursive partitioning analysis.
Article in Radiation oncology (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 18 citations in OpenAlex.
- Integration of geriatric nutritional risk index and sarcopenia for prognostic assessment in nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: a large-scale long-term retrospective study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Article
- Real-world treatment practices and survival outcomes of patients with de novo metastatic nasopharyngeal carcinoma after chemoimmunotherapy.Cancer immunology, immunotherapy : CII · 2025Article
- Article
- Ninth Version of the AJCC and UICC Nasopharyngeal Cancer TNM Staging Classification.JAMA oncology · 2024Article
- Deciphering the Prognostic Efficacy of MRI Radiomics in Nasopharyngeal Carcinoma: A Comprehensive Meta-Analysis.Diagnostics (Basel, Switzerland) · 2024Article
- Precision Medicine for Nasopharyngeal Cancer-A Review of Current Prognostic Strategies.Cancers · 2024Review
- Recursive partitioning staging system based on the log odds of the negative lymph node/T stage ratio in colon mucinous adenocarcinoma.Frontiers in immunology · 2024Article
- Immunotherapy combined with chemotherapy without locoregional radiotherapy inFrontiers in immunology · 2024Review
- Long-term outcomes of metastasis-directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma.Cancer medicine · 2024Article
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe high heterogeneity of de novo metastatic nasopharyngeal carcinoma (dmNPC) makes its prognosis and treatment challenging. We aimed to accurately stage dmNPC and assess the patterns of treatment strategies for different risk groups.
methodsThe study enrolled a total of 562 patients, 264 from 2007 to 2013 in the training cohort and 298 from 2014 to 2017 in the validation cohort. Univariate and multivariate Cox regression analyses were conducted to determine the independent variables for overall survival (OS). Recursive partitioning analysis (RPA) was applied to establish a novel risk-stratifying model based on these variables.
resultsAfter pairwise comparisons of OS, three risk groups were generated: low-risk (involved lesions ≤ 4 without liver involvement), intermediate-risk (involved lesions ≤ 4 with liver involvement or involved lesions > 4 with Epstein-Barr virus (EBV)-DNA < 62,000 copies/ml), and high-risk (involved lesions > 4 with EBV-DNA > 62,000 copies/ml). The 3-year OS rate differed significantly between groups (80.4%, 42.0%, and 20.4%, respectively, all P < 0.05). Adding locoregional intensity-modulated radiotherapy (LRRT) followed by palliative chemotherapy (PCT) resulted in a significant OS benefit over PCT alone for the low- and intermediate-risk groups (P = 0.0032 and P = 0.0014, respectively). However, it provided no survival benefits for the high-risk group (P = 0.6). Patients did not benefit from concurrent chemotherapy during LRRT among the three subgroups (P = 0.12, P = 0.13, and P = 0.3, respectively). These results were confirmed with the validation cohort.
conclusionsThe novel RPA model revealed superior survival performance in subgroup stratification and could facilitate more effective treatment strategies for dmNPC.
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