Oral oncology · 2026
Efficacy of radiotherapy to metastatic lesion in de novo metastatic nasopharyngeal carcinoma patients: A multicenter, propensity score matching study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Zhao Ze-Yu, He Shui-Qing, Liu Guo-Ying, Lv Shu-Hui, Yu Ya-Hui, Zhang Guo-Yi, Peng Ding-Sheng, Bei Wei-Xin, Chen Chun-Lan, Huang Ying, Xiang Yan-Qun, Wang Lin
Аннотация
OBJECTIVE: This study investigates the efficacy of metastatic lesion radiotherapy (MLRT) in patients with de novo metastatic nasopharyngeal carcinoma (dmNPC).
MATERIALS AND METHODS: This study included patients with dmNPC from four institutions. To ensure comparability between groups, propensity score matching (PSM) was employed. Overall survival (OS) rates were assessed using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors were identified through univariate and multivariate Cox hazard analyses. Subgroup analyses were conducted to evaluate the effects of MLRT on specific patient populations.
RESULTS: We analyzed data from 1,503 patients with dmNPC. Following PSM analysis, 122 patients were included in the MLRT group, while 366 patients comprised the non-MLRT group. Patients who received MLRT exhibited significantly better OS compared to those who did not, both in the matched cohort (3-year OS rate: 79.0% vs. 65.8%) and in the original cohort. In multivariate analyses, MLRT was identified as an independent favorable predictor of OS, with a hazard ratio of 0.64. Results from the subgroup analyses demonstrated that MLRT effectively treated patients with bone metastases, oligo-metastases, 5 or fewer metastatic lesions, and those with undetectable EBV DNA2-6 cycles. Furthermore, higher total radiation doses of MLRT (biologically effective dose (BED) > 72 Gy, corresponding to an equivalent dose in 2-Gy fractions (EQD2) > 60 Gy) were associated with improved OS.
CONCLUSIONS: MLRT provides survival advantages for patients diagnosed with dmNPC, particularly for those with a limited metastatic burden. The BED exceeding 72 Gy (EQD2 exceeding 60 Gy) was found to yield greater survival benefits.
MATERIALS AND METHODS: This study included patients with dmNPC from four institutions. To ensure comparability between groups, propensity score matching (PSM) was employed. Overall survival (OS) rates were assessed using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors were identified through univariate and multivariate Cox hazard analyses. Subgroup analyses were conducted to evaluate the effects of MLRT on specific patient populations.
RESULTS: We analyzed data from 1,503 patients with dmNPC. Following PSM analysis, 122 patients were included in the MLRT group, while 366 patients comprised the non-MLRT group. Patients who received MLRT exhibited significantly better OS compared to those who did not, both in the matched cohort (3-year OS rate: 79.0% vs. 65.8%) and in the original cohort. In multivariate analyses, MLRT was identified as an independent favorable predictor of OS, with a hazard ratio of 0.64. Results from the subgroup analyses demonstrated that MLRT effectively treated patients with bone metastases, oligo-metastases, 5 or fewer metastatic lesions, and those with undetectable EBV DNA2-6 cycles. Furthermore, higher total radiation doses of MLRT (biologically effective dose (BED) > 72 Gy, corresponding to an equivalent dose in 2-Gy fractions (EQD2) > 60 Gy) were associated with improved OS.
CONCLUSIONS: MLRT provides survival advantages for patients diagnosed with dmNPC, particularly for those with a limited metastatic burden. The BED exceeding 72 Gy (EQD2 exceeding 60 Gy) was found to yield greater survival benefits.