195 results on '"Lin Quan Tang"'
Search Results
2. Toripalimab plus capecitabine in the treatment of patients with residual nasopharyngeal carcinoma: a single-arm phase 2 trial
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Xun Cao, Hao-Yang Huang, Chi-Xiong Liang, Zhuo-Chen Lin, Jia-Yu Zhou, Xi Chen, Ying-Ying Huang, Ze-Jiang Zhan, Liang-Ru Ke, Lu-Jun Han, Wei-Xiong Xia, Lin-Quan Tang, Shan-Shan Guo, Hu Liang, Xiang Guo, and Xing Lv
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Science - Abstract
Abstract Patients with residual nasopharyngeal carcinoma after receiving definitive treatment have poor prognoses. Although immune checkpoint therapies have achieved breakthroughs for treating recurrent and metastatic nasopharyngeal carcinoma, none of these strategies have been assessed for treating residual nasopharyngeal carcinoma. In this single-arm, phase 2 trial, we aimed to evaluate the antitumor efficacy and safety of toripalimab (anti-PD1 antibody) plus capecitabine in patients with residual nasopharyngeal carcinoma after definitive treatment (ChiCTR1900023710). Primary endpoint of this trial was the objective response rate assessed according to RECIST (version 1.1). Secondary endpoints included complete response rate, disease control rate, duration of response, progression-free survival, safety profile, and treatment compliance. Between June 1, 2020, and May 31, 2021, 23 patients were recruited and received six cycles of toripalimab plus capecitabine every 3 weeks. In efficacy analyses, 13 patients (56.5%) had complete response, and 9 patients (39.1%) had partial response, with an objective response rate of 95.7% (95% CI 78.1-99.9). The trial met its prespecified primary endpoint. In safety analyses, 21 of (91.3%) 23 patients had treatment-related adverse events. The most frequently reported adverse event was hand-foot syndrome (11 patients [47.8%]). The most common grade 3 adverse event was hand-foot syndrome (two patients [8.7%]). No grades 4-5 treatment-related adverse events were recorded. This phase 2 trial shows that combining toripalimab with capecitabine has promising antitumour activity and a manageable safety profile for patients with residual nasopharyngeal carcinoma.
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- 2024
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3. Radiomic signatures reveal multiscale intratumor heterogeneity associated with tissue tolerance and survival in re-irradiated nasopharyngeal carcinoma: a multicenter study
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Ting Liu, Di Dong, Xun Zhao, Xiao-Min Ou, Jun-Lin Yi, Jian Guan, Ye Zhang, Lv Xiao-Fei, Chuan-Miao Xie, Dong-Hua Luo, Rui Sun, Qiu-Yan Chen, Lv Xing, Shan-Shan Guo, Li-Ting Liu, Da-Feng Lin, Yan-Zhou Chen, Jie-Yi Lin, Mei-Juan Luo, Wen-Bin Yan, Mei-Lin He, Meng-Yuan Mao, Man-Yi Zhu, Wen-Hui Chen, Bo-Wen Shen, Shi-Qian Wang, Hai-Lin Li, Lian-Zhen Zhong, Chao-Su Hu, De-Hua Wu, Hai-Qiang Mai, Jie Tian, and Lin-Quan Tang
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Recurrent nasopharyngeal carcinoma ,Re-radiotherapy ,Nasopharyngeal necrosis ,Radiomics ,Medicine - Abstract
Abstract Background Post-radiation nasopharyngeal necrosis (PRNN) is a severe adverse event following re-radiotherapy for patients with locally recurrent nasopharyngeal carcinoma (LRNPC) and associated with decreased survival. Biological heterogeneity in recurrent tumors contributes to the different risks of PRNN. Radiomics can be used to mine high-throughput non-invasive image features to predict clinical outcomes and capture underlying biological functions. We aimed to develop a radiogenomic signature for the pre-treatment prediction of PRNN to guide re-radiotherapy in patients with LRNPC. Methods This multicenter study included 761 re-irradiated patients with LRNPC at four centers in NPC endemic area and divided them into training, internal validation, and external validation cohorts. We built a machine learning (random forest) radiomic signature based on the pre-treatment multiparametric magnetic resonance images for predicting PRNN following re-radiotherapy. We comprehensively assessed the performance of the radiomic signature. Transcriptomic sequencing and gene set enrichment analyses were conducted to identify the associated biological processes. Results The radiomic signature showed discrimination of 1-year PRNN in the training, internal validation, and external validation cohorts (area under the curve (AUC) 0.713–0.756). Stratified by a cutoff score of 0.735, patients with high-risk signature had higher incidences of PRNN than patients with low-risk signature (1-year PRNN rates 42.2–62.5% vs. 16.3–18.8%, P
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- 2023
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4. Camrelizumab combined with apatinib in patients with first-line platinum-resistant or PD-1 inhibitor resistant recurrent/metastatic nasopharyngeal carcinoma: a single-arm, phase 2 trial
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Li Yuan, Guo-Dong Jia, Xiao-Fei Lv, Si-Yi Xie, Shan-Shan Guo, Da-Feng Lin, Li-Ting Liu, Dong-Hua Luo, Yi-Fu Li, Shen-Wen Deng, Ling Guo, Mu-Sheng Zeng, Xiu-Yu Cai, Sai-Lan Liu, Xue-Song Sun, Xiao-Yun Li, Su-Chen Li, Qiu-Yan Chen, Lin-Quan Tang, and Hai-Qiang Mai
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Science - Abstract
Abstract Immunotherapy combined with antiangiogenic targeted therapy has improved the treatment of certain solid tumors, but effective regimens remain elusive for refractory recurrent/metastatic nasopharyngeal carcinoma (RM-NPC). We conducted a phase 2 trial to evaluate the safety and activity of camrelizumab plus apatinib in platinum-resistant (cohort 1, NCT04547088) and PD-1 inhibitor resistant NPC (cohort 2, NCT04548271). Here we report on the primary outcome of objective response rate (ORR) and secondary endpoints of safety, duration of response, disease control rate, progression-free survival, and overall survival. The primary endpoint of ORR was met for cohort 1 (65%, 95% CI, 49.6–80.4, n = 40) and cohort 2 (34.3%; 95% CI, 17.0–51.8, n = 32). Grade ≥ 3 treatment-related adverse events (TRAE) were reported in 47 (65.3%) of 72 patients. Results of our predefined exploratory investigation of predictive biomarkers show: B cell markers are the most differentially expressed genes in the tumors of responders versus non-responders in cohort 1 and that tertiary lymphoid structure is associated with higher ORR; Angiogenesis gene expression signatures are strongly associated with ORR in cohort 2. Camrelizumab plus apatinib combination effectiveness is associated with high expression of PD-L1, VEGF Receptor 2 and B-cell-related genes signatures. Camrelizumab plus apatinib shows promising efficacy with a measurable safety profile in RM-NPC patients.
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- 2023
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5. A deep learning-based semiautomated workflow for triaging follow-up MR scans in treated nasopharyngeal carcinoma
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Ying-Ying Huang, Yi-Shu Deng, Yang Liu, Meng-Yun Qiang, Wen-Ze Qiu, Wei-Xiong Xia, Bing-Zhong Jing, Chen-Yang Feng, Hao-Hua Chen, Xun Cao, Jia-Yu Zhou, Hao-Yang Huang, Ze-Jiang Zhan, Ying Deng, Lin-Quan Tang, Hai-Qiang Mai, Ying Sun, Chuan-Miao Xie, Xiang Guo, Liang-Ru Ke, Xing Lv, and Chao-Feng Li
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Health technology ,Applied computing ,Science - Abstract
Summary: It is imperative to optimally utilize virtues and obviate defects of fully automated analysis and expert knowledge in new paradigms of healthcare. We present a deep learning-based semiautomated workflow (RAINMAN) with 12,809 follow-up scans among 2,172 patients with treated nasopharyngeal carcinoma from three centers (ChiCTR.org.cn, Chi-CTR2200056595). A boost of diagnostic performance and reduced workload was observed in RAINMAN compared with the original manual interpretations (internal vs. external: sensitivity, 2.5% [p = 0.500] vs. 3.2% [p = 0.031]; specificity, 2.9% [p
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- 2023
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6. Paclitaxel liposome, cisplatin and 5-fluorouracil-based induction chemotherapy followed by de-escalated intensity-modulated radiotherapy with concurrent cisplatin in stage IVA–IVB childhood nasopharyngeal carcinoma in endemic area: a phase II, single-arm trialResearch in context
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Dong-Hua Luo, Xiao-Yun Li, Shan-Shan Guo, Wan-Ping Guo, Li-Ting Liu, Hao-Yuan Mo, Ling Guo, Xiao-Fei Lv, Li-Zhi Liu, Ji-Bin Li, Qing Liu, Pan Wang, Xue-Song Sun, Sai-Lan Liu, Qiu-Yan Chen, Lin-Quan Tang, and Hai-Qiang Mai
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Nasopharyngeal carcinoma ,Children and adolescents ,Chemoradiotherapy ,Induction chemotherapy ,Survival ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Background: Previous studies demonstrated that induction chemotherapy (IC) followed by de-escalated chemoradiotherapy adapted to tumor response was effective in treating childhood nasopharyngeal carcinoma (NPC), but the toxicity profile of this treatment strategy, and whether childhood patients with advanced stages can obtain enough benefits from it requires further investigation. Methods: We conducted a single-center phase II trial (NCT03020329). All participants received 3 cycles of paclitaxel liposome, cisplatin and 5-fluorouracil (TPF)-based IC. Patients who showed complete or partial response received de-escalated radiotherapy of 60 Gy with 3 cycles of concurrent cisplatin, and those who showed stable or progressive disease received standard-dose radiotherapy of 70 Gy with concurrent cisplatin. The primary endpoint was the complete response (CR) rate at the end of concurrent chemoradiotherapy (CCRT). Findings: From November 2016 to March 2021, 44 patients were recruited in the cohort. The CR rate was 80% (35/44, 95% CI, 65–90) of the whole cohort. All patients achieved CR 3 months after CCRT. By the last follow-up, the 3-year progression-free survival and overall survival were 91% (95% CI, 82–99) and 100% respectively. Dry mouth was the most common late toxicity, with an incidence of 41% (18/44), followed by skin fibrosis and hearing impairment. No patient suffered from severe late toxicity and growth retardation. Interpretation: Our results proved the efficacy and safety of TPF regimen followed by de-escalated radiotherapy with concurrent cisplatin in treating stage IVa-b childhood NPC patients. Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.
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- 2023
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7. The efficacy and safety of apatinib plus capecitabine in platinum-refractory metastatic and/or recurrent nasopharyngeal carcinoma: a prospective, phase II trial
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Lin-Quan Tang, Xiao-Yun Li, Zhi-Ming Li, Zhi-Gang Liu, Miao-Zhen Lin, Huan Zhou, Qi-Wen Yu, Jian Zhou, Chong Zhao, Ze-Bin Chen, Xi-Cheng Wang, Jia-Yu Peng, Qiu-Yan Chen, Wen-Feng Fang, Yun-Peng Yang, Bei Zhang, Liang-Ping Xia, Pi-Li Hu, Wei-Han Hu, Yi-Jie Li, Hai-Qiang Mai, and Xiu-Yu Cai
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Nasopharyngeal carcinoma ,Tyrosine kinase inhibitor ,Apatinib ,Medicine - Abstract
Abstract Background Previous studies have shown that monotherapy with apatinib, an oral tyrosine kinase inhibitor, has promising efficacy for treating recurrent or metastatic (RM) nasopharyngeal carcinoma (NPC) patients. In this study, we aimed to assess the efficacy and safety of apatinib combined with capecitabine as a second-line therapy or beyond for treating RM-NPC patients who failed the first-line platinum-based chemotherapy. Methods In this single-arm, phase II study, we enrolled RM-NPC patients who had at least one measurable lesion according to the Response Evaluation Criteria in Solid Tumors (RECIST v1.1). The sample size was determined using Simon’s two-stage design. All patients were administered with apatinib 500 mg once daily and capecitabine 1000 mg/m2 twice per day on days 1–14 of each 21-day cycle. The primary endpoint was the objective response rate (ORR), and the secondary endpoints comprised disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety. Results We enrolled 64 patients from September 2018 to August 2020. The ORR and DCR were 39.1% (95% CI, 27.1–52.1) and 85.9% (95% CI, 75.0–93.4), respectively. The median DoR was 14.4 months (95% CI, 7.8–21.0). As of April 20, 2021, the median follow-up duration was 12.0 months. The median PFS was 7.5 months (95% CI, 5.0–10.0) and the median OS was 15.7 months (95% CI, 11.3–20.1). The most common toxicities of any grade were anemia (75.0%), hand-foot syndrome (65.6%), and proteinuria (64.0%). Grade 3–4 toxicities were observed in 36 (56.3%) patients, with hypertension (14.1%), mucositis (12.4%), and fatigue (10.9%) most commonly observed. Conclusions Apatinib plus capecitabine shows promising efficacy as a second-line treatment option in pretreated platinum-refractory RM-NPC patients. Dose selection of this combination needs further investigation considering the toxicity. Trial registration Chi-CTR1800017229.
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- 2023
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8. Identifying optimal candidates for postoperative adjuvant therapy among regional persistent/recurrent nasopharyngeal carcinoma patients after neck dissection
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Sai-Lan Liu, Xiao-Yun Li, Xue-Song Sun, Jing-Yun Peng, Chao Lin, Jin-Jie Yan, Qiu-Yan Chen, Lin-Quan Tang, Shan-Shan Guo, Ling Guo, Li-Ting Liu, and Hai-Qiang Mai
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Regional recurrent nasopharyngeal carcinoma ,Neck dissection ,Postoperative adjuvant therapy ,Plasma Epstein–Barr virus ,Prognosis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Purpose To analyze the clinical outcomes of patients with regional persistent/recurrent nasopharyngeal carcinoma (NPC) who received neck dissection, and to evaluate the clinical benefit of postoperative adjuvant therapy (PAT) based on patients’ positive lymph node counts (PLNs), extracapsular spread (ECS) and preoperative plasma EBV DNA levels. Methods From 2003 to 2017, 342 patients with regional persistent/recurrent NPC were included in this study. All patients were treated with neck dissection and 76 patients received PAT. Progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS) and locoregional relapse-free survival (LRFS) were compared between groups using propensity score matching (PSM). Results 152 patients without PAT treatment and 76 patients with PAT treatment were selected by the PSM. There was no significant difference in 2-year PFS (52.4% vs. 61.3%, P = 0.371), 2-year OS (91.9% vs. 90.5%, P = 0.097) or 2-year LRFS (66.3% vs. 67.9%, P = 0.872) between the two groups. However, the application of PAT brought survival benefits to patients in terms of 2-year DMFS (76.5% vs. 84.7%, P = 0.020). PLN, ECS and preoperative EBV DNA level remained independent risk factors for poorer PFS. Accordingly, patients were divided into low-risk and high-risk groups using receiver operating characteristic (ROC) curve; the 2-year PFS rates for two risk groups were 73.4% and 59.1% (P
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- 2022
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9. Meta-analysis of chemotherapy in nasopharynx carcinoma (MAC-NPC): An update on 26 trials and 7080 patients
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Pierre Blanchard, Anne W.M. Lee, Alexandra Carmel, Ng Wai Tong, Jun Ma, Anthony T.C. Chan, Ruey Long Hong, Ming-Yuan Chen, Lei Chen, Wen-Fei Li, Pei-Yu Huang, Dora L.W. Kwong, Sharon S.X. Poh, Roger Ngan, Hai-Qiang Mai, Camille Ollivier, George Fountzilas, Li Zhang, Jean Bourhis, Anne Aupérin, Benjamin Lacas, Jean-Pierre Pignon, Ellen Benhamou, Somvilai Chakrabandhu, Anthony TC Chan, Qiu-Yan Chen, Yong Chen, Richard J Chappell, Horace Choi, Daniel TT Chua, Melvin Lee Kiang Chua, Julian Higgins, Ming-Huang Hong, Ruey-Long Hong, Edwin Pun Hui, C.F. Hsiao, Michael Kam, Georgia Angeliki Koliou, Dora LW Kwong, Shu-Chuan Lai, Ka On Lam, Michael L LeBlanc, Anne WM Lee, Ho Fun Victor Lee, Wen Fei Li, Brigette Ma, Frankie Mo, James Moon, Wai Tong Ng, Brian O'Sullivan, Claire Petit, Jean Pierre Pignon, Sharon X. Poh, Gerta Rücker, Jonathan Sham, Yoke Lim Soong, Ying Sun, Terence Tan, Lin-Quan Tang, Yuk Tung, Joseph Wee, Xuang Wu, Tingting Xu, Yuan Zhang, and Guopei Zhu
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Individual patient data ,Meta-analysis ,Randomized trials ,Chemotherapy ,Nasopharynx carcinoma ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Purpose: Chemotherapy, when added to radiotherapy, improves survival in locally advanced nasopharyngeal carcinoma (NPC). This article presents the second update of the Meta-Analysis of Chemotherapy in NPC. Methods: Published or unpublished randomized trials assessing radiotherapy (±a second chemotherapy timing) with/without chemotherapy in non-metastatic NPC patients were identified. Updated data were sought for studies included in the previous rounds of the meta-analysis. The primary endpoint was overall survival. All trials were analyzed following the intent-to-treat principle using a fixed-effects model. Treatments were classified in five subsets according to chemotherapy timing. The statistical analysis plan was pre-specified. Results: Eighteen new trials were identified. Individual patient data were available for seven. In total, the meta-analysis now included 26 trials and 7,080 patients. The addition of chemotherapy reduced the risk of death, with a hazard ratio (HR) of 0.79 (95% confidence interval (CI) [0.73; 0.85]), and an absolute survival increase at 5 and 10 years of 6.1% [+3.9; +8.3] and + 8.4% [+5.7; +11.1], respectively. The largest effect was observed for concomitant + adjuvant, induction (with concomitant in both arms) and concomitant chemotherapy, with respective HR [95%CI] of 0.68 [0.59; 0.79] (absolute survival increase at 5 years: 12.3% (7.0%;17.6%)), 0.73 [0.63; 0.86] (6.0% (2.5%;9.5%)) and 0.81 [0.70; 0.92] (5.2% (0.8%;9.6%)). The benefit of chemotherapy was also demonstrated by improvement in progression-free survival, cancer mortality, locoregional control and distant control. There was a significant interaction between patient age and chemotherapy effect. Conclusion: This updated meta-analysis confirms the benefit of concomitant chemotherapy and concomitant + adjuvant chemotherapy, and suggests that addition of induction or adjuvant chemotherapy to concomitant chemotherapy improves tumor control and survival. The benefit of chemotherapy decreases with increasing patient age.
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- 2022
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10. Percent change in apparent diffusion coefficient and plasma EBV DNA after induction chemotherapy identifies distinct prognostic response phenotypes in advanced nasopharyngeal carcinoma
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Li-Ting Liu, Shan-Shan Guo, Hui Li, Chao Lin, Rui Sun, Qiu-Yan Chen, Yu-Jing Liang, Qing-Nan Tang, Xue-Song Sun, Lin-Quan Tang, Chuan-Miao Xie, and Hai-Qiang Mai
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Nasopharyngeal carcinoma ,Apparent diffusion coefficient ,EBV DNA ,Response phenotypes ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background To evaluate the prognostic value of the apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (MRI) and monitor the early treatment response to induction chemotherapy (IC) with plasma EBV DNA in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Results A total of 307 stage III-IVb NPC patients were prospectively enrolled. All patients underwent MRI examinations to calculate ADC and plasma EBV DNA measurements pretreatment and post-IC. The participants’ ADC value of 92.5% (284/307) increased post-IC. A higher percent change in ADC value (ΔADC%high group) post-IC was associated with a higher 5-year OS rate (90.7% vs 74.9%, p
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- 2021
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11. Subdivision of de-novo metastatic nasopharyngeal carcinoma based on tumor burden and pretreatment EBV DNA for therapeutic guidance of locoregional radiotherapy
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Jin-Hao Yang, Xue-Song Sun, Bei-Bei Xiao, Li-Ting Liu, Shan-Shan Guo, Jia-Dong Liang, Guo-Dong Jia, Lin-Quan Tang, Qiu-Yan Chen, and Hai-Qiang Mai
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Nasopharyngeal carcinoma ,Distant metastasis ,Locoregional radiotherapy ,EBV DNA ,Risk stratifications ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Nasopharyngeal carcinoma (NPC) is a malignancy predominantly associated with infection by the Epstein-Barr virus (EBV). Approximately 12,900 new cases of NPC occur each year, with more than 70% of cases occurring in the east and southeast Asia. NPC is different from ordinary head and neck squamous cell carcinoma due to its particular biological properties and it is highly sensitive to radiotherapy. With the development of RT technology, the 3-year local control rate and survival rates of non-metastatic NPC reached 80–90% in the intensity-modulated RT (IMRT) era. However, whether distant metastatic NPC (de novo mNPC, dmNPC) should receive locoregional RT (LRRT) needs to be clarified. Results Multivariate analysis identified three independent prognostic factors: Epstein-Barr virus (EBV) DNA, number of metastatic lesions, and number of metastatic organs. Through these factors, all patients were successfully divided into 3 subgroups: low-risk (single metastatic organ, EBV DNA ≤ 25,000 copies/ml, and ≤ 5 metastatic lesions), intermediate-risk (single metastatic organ, EBV DNA > 25,000 copies/ml, and ≤ 5 metastatic lesions), and high-risk (multiple metastatic organs or > 5 metastatic lesions or both). By comparing LRRT and non-LRRT groups, statistical differences were found in OS in the low-risk and intermediate-risk subgroups (p = 0.039 and p = 0.010, respectively) but no significant difference was found in OS in the high-risk subgroup (p = 0.076). Further multivariate analysis of different risk stratifications revealed that LRRT can improve OS of low- and intermediate-risk subgroups. Conclusions The risk stratification of dmNPC may be used as a new prognostic factor to help clinicians organize individualized LRRT treatment to improve the survival outcomes of dmNPC patients.
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- 2021
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12. Establishment and validation of two nomograms to predict the benefit of concurrent chemotherapy in stage II‐IVa nasopharyngeal carcinoma patients with different risk factors: Analysis based on a large cohort
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Xue‐Song Sun, Bei‐Bei Xiao, Chao Lin, Sai‐Lan Liu, Qiu‐Yan Chen, Lin‐Quan Tang, and Hai‐Qiang Mai
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concurrent chemotherapy ,nasopharyngeal carcinoma ,nomogram ,radiotherapy ,survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Objective We aimed to establish and validate two nomograms that predict progression‐free survival (PFS) and overall survival (OS) in patients with stage II–IVa nasopharyngeal carcinoma (NPC) while evaluating the benefit of concurrent chemotherapy. Patients and Methods We randomly divided 3412 patients newly diagnosed with stage II‐IVa NPC between 2008 and 2013 into training and validation ‘A’ cohorts (n = 1706 each). Another set of patients diagnosed between 2014 and 2016 served as validation cohort ‘B’ (n = 1503). A Cox multivariate model using the backward stepwise approach was applied to develop the nomograms, which were assessed for accuracy (Harrel C index) and calibration. Results The 3‐ and 5‐year PFS rates in the training cohort were 86.8% (95% confidence interval [CI] 85.0%‐88.6%) and 82.3% (95% CI 80.1%‐84.5%), respectively. For the PFS nomogram, 5 variables were selected based on a backward procedure in the multivariate Cox model (gender, T stage, N stage, Epstein‐Barr virus DNA, and treatment method). The same variables plus patient age and diabetes mellitus were used for the OS nomogram. The Harrell C indices of the training, validation A, and validation B cohorts were 0.711, 0.700, and 0.703, respectively, for PFS, and 0.775, 0.743, and 0.727, respectively, for OS. Both nomograms performed well in terms of calibration in the training and validation cohorts. Conclusions Our nomograms are reliable prognostic predictors of PFS and OS in patients with stage II‐IVa NPC. These nomograms could robustly estimate an individual's benefit from concurrent chemotherapy, which assists in treatment decision‐making.
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- 2020
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13. Comparing three induction chemotherapy regimens for patients with locoregionally advanced nasopharyngeal carcinoma based on TNM stage and plasma Epstein–Barr virus DNA level
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Sai-Lan Liu, Xue-Song Sun, Hao-Jun Xie, Qiu-Yan Chen, Huan-Xin Lin, Hu Liang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Chao Lin, Zhen-Chong Yang, Shan-Shan Guo, Li-Ting Liu, Qing-Nan Tang, Yu-Yun Du, Lin-Quan Tang, Ling Guo, and Hai-Qiang Mai
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Nasopharyngeal carcinoma ,Induction chemotherapy ,Prognosis ,Plasma Epstein–Barr virus ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background We compared the efficacy and toxicity of three IC regimens (TPF: taxanes, cisplatin, and 5-fluorouracil; TP: taxanes and cisplatin; and PF: cisplatin and 5-fluorouracil) followed by CCRT in locoregionally advanced NPC. Methods The retrospective study involved 1354 patients with newly diagnosed stage III-IVA NPC treated with IC and CCRT. The median follow-up time in our cohort was 50 months. Based on EBV DNA level, all the patients with stage IV were divided into low- (pre-EBV DNA
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- 2020
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14. Alpha-fetoprotein–producing recurrent nasopharyngeal carcinoma: A case report
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Zhen-Chong Yang, Mei-Juan Luo, Li-Li Liu, Mu-Yan Cai, Yu-Jing Liang, Qiu-Yan Chen, Lin-Quan Tang, and Hai-Qiang Mai
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Medicine (General) ,R5-920 - Abstract
Alpha-fetoprotein hardly increased due to nasopharyngeal cancer. In this article, we reported a 57-year-old male nasopharyngeal carcinoma patient who had posttreatment subscapular metastasis with high serum alpha-fetoprotein but negative plasma Epstein–Barr virus DNA. Pathology results indicated that the scapular mass was undifferentiated non-keratinizing carcinoma originated in the nasopharynx. Moreover, no liver lesion was detected by imaging examination. In view of the positive alpha-fetoprotein and alpha-fetoprotein messenger RNA staining result in the right scapular mass fine needle aspiration biopsy sample, we considered the diagnosis of alpha-fetoprotein-producing nasopharyngeal carcinoma that had never been reported before.
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- 2021
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15. Increased Angiogenin Expression Correlates With Radiation Resistance and Predicts Poor Survival for Patients With Nasopharyngeal Carcinoma
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Shan-Shan Guo, Yu-Jing Liang, Li-Ting Liu, Qiu-Yan Chen, Yue-Feng Wen, Sai-Lan Liu, Xue-Song Sun, Qing-Nan Tang, Xiao-Yun Li, Hai-Qiang Mai, and Lin-Quan Tang
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angiongenin ,biomarker ,radio-resistance ,nasopharyngeal carcinoma ,prognosis ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: Despite the development of such multiple therapeutic approaches, approximately 20% patients experience recurrence. Identification of molecular markers for stratifying the different risks of tumour recurrence and progression is considered imperative.Methods: We used a RayBio Human Cytokine Antibody Array that simultaneously detected the levels of 297 proteins and profiled the conditioned medium of HONE1 cells and the radioresistant NPC cells HONE1-IR. We found Angiogenin(ANG) expression to be significantly increased in HONE1-IR and HONE1-IR cells exposed to 4-Gy X-ray radiation.Results: We investigated the expression of ANG in NPC tissues and explored its prognostic significance in patients with NPC. We found that ANG expression was increased in recurrent NPC tissues. Elevated expression of ANG induced radio-resistance in NPC cells, in addition to being significantly associated with shorter PFS, OS, and LRFS in patients with NPC. Multivariate analysis results revealed that ANG was an independent prognostic factor that predicted PFS, OS, and LRFS. Furthermore, a nomogram model was generated to predict OS in terms of ANG expression.Conclusion: Our results found the radioresistant function of ANG and proved the clinical prognostic significance of ANG, and the results could help predict radio-sensitivity and stratify high-risk patients or tumour recurrence.
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- 2021
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16. Identifying optimal candidates for local treatment of the primary tumor among patients with de novo metastatic nasopharyngeal carcinoma: a retrospective cohort study based on Epstein–Barr virus DNA level and tumor response to palliative chemotherapy
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Xue-Song Sun, Li-Ting Liu, Sai-Lan Liu, Shan-Shan Guo, Yue-Feng Wen, Hao-Jun Xie, Qing-Nan Tang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Jun Ma, Qiu-Yan Chen, Lin-Quan Tang, and Hai-Qiang Mai
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Metastatic nasopharyngeal carcinoma ,Epstein–Barr virus DNA ,Tumor response ,Local treatment ,Radiotherapy ,Survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background To evaluate the clinical outcome in patients with de novo metastatic nasopharyngeal carcinoma (NPC) treated or not treated with locoregional radiotherapy (LRRT) based on plasma Epstein–Barr virus (EBV) DNA level and tumor response after palliative chemotherapy (PCT). Methods From 2007 to 2016, 502 patients with de novo metastatic NPC were included in this study. All patients were treated with PCT and 315 patients received LRRT. Our primary study endpoint was overall survival (OS). Results EBV DNA was detected in 461 patients (91.8%) before treatment but was undetectable in 249 patients (49.6%) after PCT. Three hundred and seventeen patients (63.1%) achieved satisfactory response (complete response or partial response) to PCT. Both the post-PCT EBV DNA level and tumor response were independent prognostic factors. Among low-risk patients (patients with undetectable EBV DNA and satisfactory tumor response after PCT), the 3-year OS rate was 80.4% in LRRT-treated patients and 45.3% in patients not treated with LRRT (P
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- 2019
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17. Nomogram Predicting the Benefits of Adding Concurrent Chemotherapy to Intensity-Modulated Radiotherapy After Induction Chemotherapy in Stages II–IVb Nasopharyngeal Carcinoma
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Sai-Lan Liu, Xue-Song Sun, Zi-Jian Lu, Qiu-Yan Chen, Huan-Xin Lin, Lin-Quan Tang, Jin-Xin Bei, Ling Guo, and Hai-Qiang Mai
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nasopharyngeal carcinoma (NPC) ,induction chemotherapy (IC) ,concurrent chemoradiotherapy ,radiotherapy ,nomogram ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundTo compare the efficacy of induction chemotherapy plus concurrent chemoradiotherapy (IC+CCRT) versus induction chemotherapy plus radiotherapy (IC+RT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC).Patients and MethodsOne thousand three hundred twenty four patients with newly-diagnosed NPC treated with IC+CCRT or IC+RT were enrolled. Progression-free survival (PFS), distant metastasis-free survival (DMFS), overall survival (OS), locoregional relapse-free survival (LRFS), and acute toxicities during radiotherapy were compared using propensity score matching (PSM). A nomogram was developed to predict the 3- and 5-year PFS with or without concurrent chemotherapy (CC).ResultsPSM assigned 387 patients to the IC+CCRT group and IC+RT group, respectively. After 3 years, no significant difference in PFS (84.7 vs. 87.5%, P = 0.080), OS (95.5 vs. 97.6%, P = 0.123), DMFS (89.7 vs. 92.8%, P = 0.134), or LRFS (94.0 vs. 94.1%, P = 0.557) was noted between the groups. Subgroup analysis indicated comparable survival outcomes in low-risk NPC patients (II–III with EBV DNA
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- 2020
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18. Longitudinal Trend of Health-Related Quality of Life During Concurrent Chemoradiotherapy and Survival in Patients With Stage II–IVb Nasopharyngeal Carcinoma
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Ji-Bin Li, Shan-Shan Guo, Lin-Quan Tang, Ling Guo, Hao-Yuan Mo, Qiu-Yan Chen, and Hai-Qiang Mai
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longitudinal trend ,health-related quality of life ,cheomotherapy ,nasopharyngeal carcinoma ,radiotherapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background and Aims: To investigate the longitudinal trend of health-related quality of life (HRQOL) from the start to the end of concurrent chemoradiotherapy and survival in patients with advanced nasopharyngeal carcinoma (NPC).Methods: A total of 145 patients with stage II–IVb NPC, who were a subsample of a randomized phase III clinical trial, were recruited in this study. HRQOL was measured weekly for a total of 6 weeks during concurrent chemoradiotherapy by the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30. Longitudinal trends of HRQOL domains over time were analyzed using mixed models. Survival rates were estimated using Kaplan-Meier method.Results: During a median follow-up of 45 months, the 3-year progression-free survival rate, overall survival rate, and distant metastasis-free survival rate were highly at 86.8% (95% CI: 80.1%, 91.4%), 95.1% (95% CI: 90.1%, 97.6%), and 91.0% (95% CI: 84.9%, 94.6%), respectively. The average weekly declines of five functioning domains were 1.83–3.52 points during the treatment period, with role functioning having the largest decline rate (−2.52 points per week, 95% CI: −4.50, −2.55; p < 0.001). Loss of appetite is the most affected symptom, with severe appetite loss ranging from 35.9 to 61.1%. The average increases of symptoms were 0.63–5.16 points per week during treatment period (all p-values for time
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- 2020
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19. Optimizing the Treatment Pattern for De Novo Metastatic Nasopharyngeal Carcinoma Patients: A Large-Scale Retrospective Cohort Study
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Xue-Song Sun, Yu-Jing Liang, Qiu-Yan Chen, Shan-Shan Guo, Li-Ting Liu, Rui Sun, Dong-Hua Luo, Lin-Quan Tang, and Hai-Qiang Mai
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metastatic nasopharyngeal carcinoma ,palliative chemotherapy ,locoregional radiotherapy ,concurrent chemotherapy ,overall survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
ObjectivesTo investigate the optimal treatment pattern in patients with de novo metastatic nasopharyngeal carcinoma (NPC).MethodsWe assessed 502 consecutive and unselected de novo metastatic NPC patients in Sun Yat-sen University Cancer Center (SYSUCC) from November 2006 to October 2016 in our study. All patients were treated with palliative chemotherapy (PCT) and 308 patients received locoregional radiotherapy (LRRT) subsequently. Our primary study endpoint was overall survival (OS).ResultsThe patients treated with LRRT were associated with improved survival on univariate analysis (3-year OS rate 63.7% vs. 31.8%, P < 0.001) and multivariate analysis (HR 0.52, 95%CI 0.40–0.68, P < 0.001). The overall survival benefit of more than 4 PCT cycles was significant in female (HR 0.45, 95% CI 0.24–0.86, P = 0.016) and patients with multiple metastatic sites (HR 0.42, 95% CI 0.26–0.66, P < 0.001). The application of concurrent chemotherapy (CCT) was not associated with better survival among patients receiving LRRT (HR 1.31, 95% CI 0.92–1.86, P = 0.141).ConclusionLRRT prolonged survival in de novo metastatic NPC. For patients treated with multiple metastatic sites, more than 4 cycles of PCT is necessary. CCT does not improve survival in de novo metastatic NPC patients.
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- 2020
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20. Autocrine INSL5 promotes tumor progression and glycolysis via activation of STAT5 signaling
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Shi‐Bing Li, Yan‐Yan Liu, Li Yuan, Ming‐Fang Ji, Ao Zhang, Hui‐Yu Li, Lin‐Quan Tang, Shuo‐Gui Fang, Hua Zhang, Shan Xing, Man‐Zhi Li, Qian Zhong, Shao‐Jun Lin, Wan‐Li Liu, Peng Huang, Yi‐Xin Zeng, Yu‐Ming Zheng, Zhi‐Qiang Ling, Jian‐Hua Sui, and Mu‐Sheng Zeng
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diagnosis ,glycolysis ,INSL5 ,nasopharyngeal carcinoma ,STAT5 ,Medicine (General) ,R5-920 ,Genetics ,QH426-470 - Abstract
Abstract Metabolic reprogramming plays important roles in development and progression of nasopharyngeal carcinoma (NPC), but the underlying mechanism has not been completely defined. In this work, we found INSL5 was elevated in NPC tumor tissue and the plasma of NPC patients. Plasma INSL5 could serve as a novel diagnostic marker for NPC, especially for serum VCA‐IgA‐negative patients. Moreover, higher plasma INSL5 level was associated with poor disease outcome. Functionally, INSL5 overexpression increased, whereas knockdown of its receptor GPCR142 or inhibition of INSL5 reduced cell proliferation, colony formation, and cell invasion in vitro and tumorigenicity in vivo. Mechanistically, INSL5 enhanced phosphorylation and nuclear translocation of STAT5 and promoted glycolytic gene expression, leading to induced glycolysis in cancer cells. Pharmaceutical inhibition of glycolysis by 2‐DG or blockade of INSL5 by a neutralizing antibody reversed INSL5‐induced proliferation and invasion, indicating that INSL5 can be a potential therapeutic target in NPC. In conclusion, INSL5 enhances NPC progression by regulating cancer cell metabolic reprogramming and is a potential diagnostic and prognostic marker as well as a therapeutic target for NPC.
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- 2020
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21. Development and validation of the immune signature to predict distant metastasis in patients with nasopharyngeal carcinoma
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Sai-Lan Liu, Li-Juan Bian, Qiu-Yan Chen, Xue-Song Sun, Dong-Hua Luo, Xiao-Yun Li, Bei-Bei Xiao, Jin-Jie Yan, Zi-Jian Lu, Lin-Quan Tang, and Hai-Qiang Mai
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundThe tumor immune microenvironment has clinicopathological significance in predicting prognosis and therapeutic efficacy. We aimed to develop an immune signature to predict distant metastasis in patients with nasopharyngeal carcinoma (NPC).MethodsUsing multiplexed quantitative fluorescence, we detected 17 immune biomarkers in a primary screening cohort of 54 NPC tissues presenting with/without distant metastasis following radical therapy. The LASSO (least absolute shrinkage and selection operator) logistic regression model used statistically significant survival markers in the training cohort (n=194) to build an immune signature. The prognostic and predictive accuracy of it was validated in an external independent group of 304 patients.ResultsEight statistically significant markers were identified in the screening cohort. The immune signature consisting of four immune markers (PD-L1+ CD163+, CXCR5, CD117) in intratumor was adopted to classify patients into high and low risk in the training cohort and it showed a high level of reproducibility between different batches of samples (r=0.988 for intratumor; p
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- 2020
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22. Stratification of Candidates for Induction Chemotherapy in Stage III-IV Nasopharyngeal Carcinoma: A Large Cohort Study Based on a Comprehensive Prognostic Model
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Xue-Song Sun, Bei-Bei Xiao, Zi-Jian Lu, Sai-Lan Liu, Qiu-Yan Chen, Li Yuan, Lin-Quan Tang, and Hai-Qiang Mai
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nasopharyngeal carcinoma ,Epstein–Barr virus DNA ,induction chemotherapy ,radiotherapy ,survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Objective: To establish a prognostic index (PI) for patients with stage III-IV nasopharyngeal carcinoma (NPC) patients to personalize recommendations for induction chemotherapy (IC) before intensity-modulated radiotherapy (IMRT).Patients and Methods: Patients received concurrent chemoradiotherapy (CCRT) with or without IC. Factors used to construct the PI were selected by a multivariate analysis of progression-free survival (PFS), which was the primary endpoint (P < 0.05). Five variables were selected based on a backward procedure in a Cox proportional hazards model: gender, T stage, N stage, lactate dehydrogenase (LDH), and Epstein–Barr virus (EBV) DNA. The cutoff value for the PI was determined by the receiver operating characteristic curve analysis.Results: The present study involved 3,586 patients diagnosed with stage III-IV NPC. The cutoff value for PI was 0.8. The high-risk subgroup showed worse outcomes than did the low-risk subgroup on all endpoints: PFS, overall survival (OS), locoregional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). In the low-risk subgroup (PI 0.8), the addition of IC significantly improved PFS, OS, and DMFS, but not LRFS. In multivariate analyses, IC was a protective factor for PFS, OS, and DMFS in the high-risk subgroup, while it had no significant benefit in the low-risk subgroup.Conclusion: The proposed prognostic model effectively stratifies patients with stage III-IV NPC. High-risk patients are candidates for IC before CCRT, while low-risk patients are unlikely to benefit from it.
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- 2020
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23. Pretreatment quality of life as a predictor of survival for patients with nasopharyngeal carcinoma treated with IMRT
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Shan-Shan Guo, Wen Hu, Qiu-Yan Chen, Jian-Mei Li, Shi-Heng Zhu, Yan He, Jia-Wen Li, Le Xia, Lu Ji, Cui-Ying Lin, Li-Ting Liu, Lin-Quan Tang, Ling Guo, Hao-Yuan Mo, Chong Zhao, Xiang Guo, Ka-Jia Cao, Chao-Nan Qian, Mu-Sheng Zeng, Ming-Huang Hong, Jian-Yong Shao, Ying Sun, Jun Ma, Yu-Ying Fan, and Hai-Qiang Mai
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Nasopharyngeal carcinoma ,Quality of life ,EBV DNA ,Survival ,Prognostic factor ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background To evaluate the prognostic significance of pretreatment quality of life for patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Methods We performed a prospective, longitudinal study on 554 newly diagnosed patients with NPC from April 2011 to January 2015. A total of 501 consecutive NPC patients were included. Patients were asked to complete the EORTC QLQ-C30 (version 3.0) and QLQ-H&N35 questionnaires before treatment. Results Global health status among QLQ-C30 correlates with EBV DNA(P = 0.019). In addition, pretreatment appetite loss was significantly correlated with EBV DNA(P = 0.02). Pretreatment teeth, opening mouth, feeding tube was significantly correlated with EBV DNA, with P value of 0.003,
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- 2018
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24. Deep learning for the precise detection of recurrence in nasopharyngeal carcinoma from time-series medical imaging
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Xing Lv, Ying-Ying Huang, Yishu Deng, Yang Liu, Wenze Qiu, Meng-yun Qiang, Wei-Xiong Xia, Bingzhong Jing, Chen-Yang Feng, Haohua Chen, Xun Cao, Jia-Yu Zhou, Hao-yang Huang, Ze-Jiang Zhan, Ying Deng, Lin-Quan Tang, Hai-Qiang Mai, Ying Sun, Chuanmiao Xie, Xiang Guo, Liang-Ru Ke, and Chaofeng Li
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Precise detection of recurrence in patients with treated nasopharyngeal carcinoma (NPC) facilitates timely intervention and prolongs survival. However, there is no compelling tool realizing real-time precise recurrence detection as scale hitherto. Here we present a deep learning-based sequential scan model called RAIN, harnessing 10,212 time-series follow-up head and neck magnetic resonance (MR) scans of 1,808 patients with treated NPC in a multicenter observational study (Blinded ID). The RAIN yields larger area under the receiver operating curve (AUC) values than single scan model (internal: 0.916 vs 0.855, p = 0.004; external: 0.900 vs 0.709, p
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- 2023
25. Supplementary Data from A Randomized Controlled Trial Comparing Two Different Schedules for Cisplatin Treatment in Patients with Locoregionally Advanced Nasopharyngeal Cancer
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Yan-Qun Xiang, Xiang Guo, Hai-Qiang Mai, Chao-Nan Qian, Lin-Quan Tang, Yi-Jun Hua, Qiu-Yan Chen, Pei-Yu Huang, Chong Zhao, Lin Wang, Ka-Jia Cao, Ming-Yuan Chen, Ling Guo, Jing-Jing Miao, Zhuo-Chen Cai, Shu-Hui Lv, Wang-Zhong Li, Xin-Jun Huang, Kui-Yuan Liu, Ya-Hui Yu, Wen-Ze Qiu, Meng-Yun Qiang, Liang-Ru Ke, Jing Yang, Yan-Fang Ye, Meng-Yun Shi, Qing Liu, Dong-Hua Luo, Fei Han, Hao-Yuan Mo, Si-Wei Li, Qi Zeng, Rui Sun, Guo-Ying Liu, Hu Liang, Xing Lv, and Wei-Xiong Xia
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Supplementary Data
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- 2023
26. Data from A Randomized Controlled Trial Comparing Two Different Schedules for Cisplatin Treatment in Patients with Locoregionally Advanced Nasopharyngeal Cancer
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Yan-Qun Xiang, Xiang Guo, Hai-Qiang Mai, Chao-Nan Qian, Lin-Quan Tang, Yi-Jun Hua, Qiu-Yan Chen, Pei-Yu Huang, Chong Zhao, Lin Wang, Ka-Jia Cao, Ming-Yuan Chen, Ling Guo, Jing-Jing Miao, Zhuo-Chen Cai, Shu-Hui Lv, Wang-Zhong Li, Xin-Jun Huang, Kui-Yuan Liu, Ya-Hui Yu, Wen-Ze Qiu, Meng-Yun Qiang, Liang-Ru Ke, Jing Yang, Yan-Fang Ye, Meng-Yun Shi, Qing Liu, Dong-Hua Luo, Fei Han, Hao-Yuan Mo, Si-Wei Li, Qi Zeng, Rui Sun, Guo-Ying Liu, Hu Liang, Xing Lv, and Wei-Xiong Xia
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Purpose:Previous studies suggest that a cumulative cisplatin dose of 200 mg/m2 might be adequate in the intensity-modulated radiation therapy (IMRT) era for locoregionally advanced nasopharyngeal carcinoma (LANPC). However, two cycles of once-every-3-weeks cisplatin at 100 mg/m2 has never been prospectively compared with standard once-a-week cisplatin regimen.Patients and Methods:This trial was conducted at three hospitals from 2011 to 2016. Patients who met the eligibility criteria were recruited (ChiCTR-TRC-12001979) and randomly assigned (1:1) via a computer-generated sequence to receive once-every-3-weeks cisplatin at 100 mg/m2 for two cycles or once-a-week cisplatin at 40 mg/m2 for six cycles concurrently with IMRT. Primary endpoint was failure-free survival and between-group absolute difference of 10% as the noninferiority margin.Results:A total of 510 patients were enrolled. Median follow-up time was 58.3 months with 85.4% of 3-year failure-free survival in the once-every-3-weeks group and 85.6% in the once-a-week group. An absolute difference of −0.2% (95% confidence interval, −6.3 to 5.9; Pnoninferiority = 0.0016). Acute toxicities of grade 3 or higher occurred in 55.8% in the once-every-3-weeks group and 66.3% in the once-a-week group (P = 0.015). The most common acute toxicities were hematologic abnormalities, including leukopenia (16% vs. 27%; P = 0.0022) and thrombocytopenia (1% vs. 5%; P = 0.015). The late grade 3–4 auditory loss rate was significantly lower in the once-every-3-weeks group than the once-a-week group (6% vs. 13%; P = 0.0039).Conclusions:Once-every-3-weeks cisplatin as concurrent chemoradiotherapy is noninferior to once-a-week cisplatin in the treatment efficacy in the LANPC. Although both regimens are well tolerated, severe acute toxicities and late-onset auditory loss are higher in the once-a-week group.
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- 2023
27. FigureS2 from A Randomized Controlled Trial Comparing Two Different Schedules for Cisplatin Treatment in Patients with Locoregionally Advanced Nasopharyngeal Cancer
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Yan-Qun Xiang, Xiang Guo, Hai-Qiang Mai, Chao-Nan Qian, Lin-Quan Tang, Yi-Jun Hua, Qiu-Yan Chen, Pei-Yu Huang, Chong Zhao, Lin Wang, Ka-Jia Cao, Ming-Yuan Chen, Ling Guo, Jing-Jing Miao, Zhuo-Chen Cai, Shu-Hui Lv, Wang-Zhong Li, Xin-Jun Huang, Kui-Yuan Liu, Ya-Hui Yu, Wen-Ze Qiu, Meng-Yun Qiang, Liang-Ru Ke, Jing Yang, Yan-Fang Ye, Meng-Yun Shi, Qing Liu, Dong-Hua Luo, Fei Han, Hao-Yuan Mo, Si-Wei Li, Qi Zeng, Rui Sun, Guo-Ying Liu, Hu Liang, Xing Lv, and Wei-Xiong Xia
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FigureS2
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- 2023
28. Combination of MRI-based temporal tumor response and Epstein-Barr DNA level changes after radiotherapy leads to improved prognostic stratification of patients with nasopharyngeal carcinoma treated with concurrent chemoradiotherapy
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Zi-Jian Lu, Li-Ting Liu, Xiao-Yun Li, Xue-Song Sun, Sai-Lan Liu, Qi Yang, Shan-Shan Guo, Chao Lin, Hui-Zhi Qiu, Huan-Xin Lin, Hai-Qiang Mai, Lin-Quan Tang, and Ling Guo
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Objectives To investigated the prognostic value of temporal tumor response (TR) and plasma Epstein-Barr virus (EBV) DNA level changes at the end of radiotherapy (pRT0) and 3 months after radiotherapy (pRT3) in nasopharyngeal carcinoma (NPC) patients. Methods A total of 651 patients with biopsy-proven NPC, treated with concurrent chemo-radiotherapy, were retrospectively enrolled. TR and plasma EBV DNA levels were evaluated at pRT0 and pRT3. Progression-free survival (PFS) was the primary endpoint. Results Temporal change of tumor response (TRC) indicated that the refractory-disease group (where TR remained a non-complete response [non-CR] at pRT0 and pRT3) and slow-response group (where TR changed from non-CR to CR at pRT3) had a higher risk than the rapid-response group (where TR remained a CR at pRT0 and pRT3) in the 5-year locoregional relapse-free survival (LRRFS, P P
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- 2023
29. Low value of whole-body dual-modality [18f]fluorodeoxyglucose positron emission tomography/computed tomography in primary staging of stage I–II nasopharyngeal carcinoma: a nest case-control study
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Xu Zhang, Li-Ting Liu, Xiaofei Lv, Lujun Han, Xue-Song Sun, Qiu-Yan Chen, Sai-Lan Liu, Bei-Bei Xiao, Dong-Hua Luo, Jibin Li, Chao Lin, Lin-Quan Tang, Yue-Feng Wen, Xiao-Yun Li, Wei Fan, Li Yuan, Hai-Qiang Mai, Ling Guo, Yu-Jing Liang, Shan-Shan Guo, Qing-Nan Tang, Rui Sun, and Da-Feng Lin
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0301 basic medicine ,medicine.medical_specialty ,PET/CT ,03 medical and health sciences ,0302 clinical medicine ,Retropharyngeal lymph nodes ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Lymph node ,Neuroradiology ,PET-CT ,Nasopharyngeal Carcinoma ,medicine.diagnostic_test ,business.industry ,Nasopharyngeal Neoplasms ,General Medicine ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Bone scintigraphy ,Nasopharyngeal carcinoma ,Case-Control Studies ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Neoplasm staging ,Lymph Nodes ,Radiology ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,Tomography, X-Ray Computed ,business ,Chest radiograph ,Head and Neck ,MRI - Abstract
Objectives The value of using PET/CT for staging of stage I–II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy. Methods A total of 1003 patients with pathologically confirmed NPC of stages I–II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node metastasis was defined by the change of size according to follow-up MRI. The diagnostic efficacies were compared in 218 patients who underwent both PET/CT and CWU. After covariate adjustment using propensity scoring, a cohort of 872 patients (218 with and 654 without pre-treatment PET/CT) was included. The primary outcome was overall survival based on intention to treat. Results Retropharyngeal lymph nodes were metastatic based on follow-up MRI in 79 cases. PET/CT was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions (72.2% [62.3–82.1] vs. 91.1% [84.8–97.4], p = 0.004). Neck lymph nodes were metastatic in 89 cases and PET/CT was more sensitive than MRI (96.6% [92.8–100.0] vs. 76.4% [67.6–85.2], p < 0.001). In the survival analyses, there was no association between pre-treatment PET/CT use and improved overall survival, progression-free survival, local relapse-free survival, regional relapse-free survival, and distant metastasis-free survival. Conclusions This study showed PET/CT is of little value for staging of stage I–II NPC patients at initial imaging. Key Points • PET/CT was more sensitive than MRI in detecting neck lymph node lesions whereas it was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions. • No association existed between pre-treatment PET/CT use and improved survival in stage I–II NPC patients.
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- 2021
30. Prognostic significance of AKR1C4 and the advantage of combining EBV DNA to stratify patients at high risk of locoregional recurrence of nasopharyngeal carcinoma
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Shan-Shan Guo, Yan-Zhou Chen, Li-Ting Liu, Rong-Ping Liu, Yu-Jing Liang, Dong-Xiang Wen, Jing Jin, Lin-Quan Tang, Hai-Qiang Mai, and Qiu-Yan Chen
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Cancer Research ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Nasopharyngeal Carcinoma ,Oncology ,DNA, Viral ,Genetics ,Aldo-Keto Reductases ,Humans ,Nasopharyngeal Neoplasms ,Neoplasm Recurrence, Local ,Prognosis - Abstract
Background Distinguishing patients at a greater risk of recurrence is essential for treating locoregional advanced nasopharyngeal carcinoma (NPC). This study aimed to explore the potential of aldo–keto reductase 1C4 (AKR1C4) in stratifying patients at high risk of locoregional relapse. Methods A total of 179 patients with locoregionally advanced NPC were grouped by different strategies; they were: (a) divided into two groups according to AKR1C4 expression level, and (b) classified into three clusters by integrating AKR1C4 and Epstein-Barr virus (EBV) DNA. The Kaplan–Meier method was used to calculate locoregional relapse-free survival (LRFS), overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). The Cox proportional hazards model was used to determine potential prognostic factors, and a nomogram was generated to predict 3-year and 5-year LRFS. Results A significant difference in the 5-year LRFS was observed between the high and low AKR1C4 expression groups (83.3% vs. 92.7%, respectively; p = 0.009). After integrating AKR1C4 expression and EBV DNA, the LRFS (84.7%, 84.5%, 96.9%, p = 0.014) of high-, intermediate-, and low- AKR1C4 and EBV DNA was also significant. Multivariate analysis indicated that AKR1C4 expression (p = 0.006) was an independent prognostic factor for LRFS. The prognostic factors incorporated into the nomogram were AKR1C4 expression, T stage, and EBV DNA, and the concordance index of the nomogram for locoregional relapse was 0.718. Conclusions In conclusion, high AKR1C4 expression was associated with a high possibility of relapse in NPC patients, and integrating EBV DNA and AKR1C4 can stratify high-risk patients with locoregional recurrence.
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- 2022
31. M1 stage subdivisions based on
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Hui-Zhi, Qiu, Xu, Zhang, Sai-Lan, Liu, Xue-Song, Sun, Yi-Wen, Mo, Huan-Xin, Lin, Zi-Jian, Lu, Jia, Guo, Lin-Quan, Tang, Hai-Qiang, Mai, Li-Ting, Liu, and Ling, Guo
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To establish a risk classification of de novo metastatic nasopharyngeal carcinoma (mNPC) patients based onIn all, 586 de novo mNPC patients who underwentMultivariate Cox regression analyses revealed that total lesion glycolysis of locoregional lesions (LRL-TLG), the number of bone metastases (BMs), metabolic tumor volume of distant soft tissue metastases (DSTM-MTV), pretreatment Epstein-Barr virus DNA (EBV DNA), and liver involvement were independent prognosticators for OS. The number of BMs, LRL-TLG, and DSTM-MTV were incorporated as the PPS. Eligible patients were divided into three stages by the RPA-risk stratification model: M1a (low risk, PPSThe PPS-based RPA stratification model could identify suitable candidates for LRRT. Patients with stage M1a disease could benefit from LRRT.
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- 2022
32. Identifying optimal candidates for induction chemotherapy among stage II–IVa nasopharyngeal carcinoma based on pretreatment Epstein–Barr virus DNA and nodal maximal standard uptake values of [ 18 F]‐fluorodeoxyglucose positron emission tomography
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Li-Ting Liu, Rui Sun, Xue-Song Sun, Hao-Jun Xie, Qiu-Yan Chen, Shan-Shan Guo, Lin-Quan Tang, Hai-Qiang Mai, Guo-Dong Jia, Yi-Fei Yu, Sai-Lan Liu, and Dong-Hua Luo
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0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.diagnostic_test ,Proportional hazards model ,business.industry ,Hazard ratio ,Induction chemotherapy ,medicine.disease ,Confidence interval ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Nasopharyngeal carcinoma ,Positron emission tomography ,030220 oncology & carcinogenesis ,Internal medicine ,Clinical endpoint ,medicine ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,business - Abstract
OBJECTIVE This study aimed to select optimal candidates benefiting from the addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) in stage II-IVa nasopharyngeal carcinoma (NPC) based on Epstein-Barr virus (EBV) DNA and nodal maximal standardized uptake values (SUVmax-N) of [18 F]-fluorodeoxyglucose positron emission tomography. PATIENTS AND MATERIALS A total of 679 patients diagnosed with stage II-IVa (except N0) NPC were retrospectively included in this study. Overall survival was the primary endpoint. Survival differences between different groups were compared using the log-rank test. The hazard ratio (HR) and 95% confidence interval (CI) were calculated using a multivariable Cox proportional hazards model. RESULTS Both high levels of EBV DNA (>1500 copies/mL) and SUVmax-N (>12.3) indicated worse survival conditions. All patients were divided into low- and high-risk groups based on these two biomarkers. The risk group was an independent prognostic factor in OS, progression-free survival (PFS), and distant metastasis-free survival (DMFS) (all p-values
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- 2020
33. Single-cell transcriptomic analysis defines the interplay between tumor cells, viral infection, and the microenvironment in nasopharyngeal carcinoma
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Shanzhao Jin, Yi-Ling Luo, Shang-Xin Liu, Mu Sheng Zeng, Jiang-Ping Li, Jing-Yun Peng, Ruoyan Li, Yan-Min Liu, Guan-Nan Wang, Jianwei Wang, Bo Zhao, Lin-Quan Tang, Ming-Yuan Chen, Tian-Liang Xia, Yi-Na Liu, Rui You, Feng Han, Chao Yu, Jiang Li, Fan Bai, Hai-Qiang Mai, Qiu-Yan Chen, Lawrence S. Young, Y Y Zhao, Qi Liu, Li Zhang, Yu Zhang, Qian Zhong, and Benjamin E. Gewurz
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Stromal cell ,T-Lymphocytes ,Mice, Nude ,Cell Communication ,Biology ,Ligands ,medicine.disease_cause ,Article ,Immunomodulation ,03 medical and health sciences ,Lymphocytes, Tumor-Infiltrating ,0302 clinical medicine ,Immune system ,Interferon ,Tumor Microenvironment ,medicine ,Animals ,Humans ,Myeloid Cells ,Molecular Biology ,Cell Aggregation ,030304 developmental biology ,Mice, Inbred BALB C ,Stochastic Processes ,0303 health sciences ,Tumor microenvironment ,Gene Expression Profiling ,Nasopharyngeal Neoplasms ,Cell Biology ,Fibroblasts ,medicine.disease ,Cell aggregation ,Gene Expression Regulation, Neoplastic ,Nasopharyngeal carcinoma ,Virus Diseases ,Cancer research ,Female ,Interferons ,Single-Cell Analysis ,Stromal Cells ,Carcinogenesis ,030217 neurology & neurosurgery ,CD8 ,medicine.drug - Abstract
Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV)-associated malignancy with a complex tumor ecosystem. How the interplay between tumor cells, EBV, and the microenvironment contributes to NPC progression and immune evasion remains unclear. Here we performed single-cell RNA sequencing on ~104,000 cells from 19 EBV(+) NPCs and 7 nonmalignant nasopharyngeal biopsies, simultaneously profiling the transcriptomes of malignant cells, EBV, stromal and immune cells. Overall, we identified global upregulation of interferon responses in the multicellular ecosystem of NPC. Notably, an epithelial–immune dual feature of malignant cells was discovered and associated with poor prognosis. Functional experiments revealed that tumor cells with this dual feature exhibited a higher capacity for tumorigenesis. Further characterization of the cellular components of the tumor microenvironment (TME) and their interactions with tumor cells revealed that the dual feature of tumor cells was positively correlated with the expression of co-inhibitory receptors on CD8(+) tumor-infiltrating T cells. In addition, tumor cells with the dual feature were found to repress IFN-γ production by T cells, demonstrating their capacity for immune suppression. Our results provide new insights into the multicellular ecosystem of NPC and offer important clinical implications.
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- 2020
34. Establishment and Validation of a Nomogram for Nasopharyngeal Carcinoma Patients Concerning the Prognostic Effect of Parotid Lymph Node Metastases
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Chao Lin, Ling Guo, Xin-Ling Li, Sai-Lan Liu, Xue-Song Sun, Nian Lu, Lin-Quan Tang, and Xiao-Yun Li
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Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Nomogram ,Metastasis ,Internal medicine ,medicine ,Clinical endpoint ,Overall survival ,Humans ,Retrospective Studies ,Nasopharyngeal Carcinoma ,Radiotherapy ,business.industry ,Parotid lymph node ,Nasopharyngeal Neoplasms ,Middle Aged ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Parotid Neoplasms ,Radiation therapy ,Survival Rate ,Nomograms ,Nasopharyngeal carcinoma ,Lymphatic Metastasis ,Parotid lymph node metastasis ,Original Article ,Female ,Lymph Nodes ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Purpose The prognosis of nasopharyngeal carcinoma (NPC) patients with parotid lymph node (PLN) metastasis remains unclear. This study was performed to investigate the prognostic significance and optimal staging category of PLN metastasis and develop a nomogram for estimating individual risk.Materials and MethodsClinical data of 7,084 non-metastatic NPC patients were retrospectively reviewed. Overall survival (OS) was the primary endpoint. A nomogram was established based on the Cox proportional hazards regression model. The accuracy and calibration ability of this nomogram was evaluated by C-index and calibration curves with bootstrap validation.ResultTotally, 164/7,084 NPC patients (2.3%) presented with PLNs. Multivariate analyses showed that PLN metastasis was a negative prognostic factor for OS, progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS). Patients with PLN metastasis had a worse prognosis than N3 disease. Five independent prognostic factors were included in the nomogram, which showed a C-index of 0.743. The calibration curves for probability of 3- and 5-year OS indicated satisfactory agreement between nomogram-based prediction and actual observation. All results were confirmed in the validation cohort.ConclusionNPC patient with PLN metastasis had poorer survival outcome (OS, PFS, DMFS, and LRFS) than N3 disease. We developed a nomogram to provide individual prediction of OS for patients with PLN metastasis.
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- 2020
35. Comparing three induction chemotherapy regimens for patients with locoregionally advanced nasopharyngeal carcinoma based on TNM stage and plasma Epstein–Barr virus DNA level
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Yu Jing Liang, Xiao Yun Li, Lin Quan Tang, Shan Shan Guo, Ling Guo, Xue Song Sun, Sai Lan Liu, Li Ting Liu, Hu Liang, Jin Jie Yan, Zhen Chong Yang, Hao Jun Xie, Huan Xin Lin, Qiu Yan Chen, Hai Qiang Mai, Yu Yun Du, Qing Nan Tang, and Chao Lin
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Male ,0301 basic medicine ,Oncology ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Cancer Research ,Kaplan-Meier Estimate ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,Stage (cooking) ,Child ,Middle Aged ,Prognosis ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Treatment Outcome ,030220 oncology & carcinogenesis ,Induction chemotherapy ,Female ,Taxoids ,Fluorouracil ,Research Article ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Plasma Epstein–Barr virus ,lcsh:RC254-282 ,Disease-Free Survival ,Young Adult ,03 medical and health sciences ,Internal medicine ,TPF Regimen ,Genetics ,medicine ,Nasopharyngeal carcinoma ,Humans ,Progression-free survival ,Aged ,Retrospective Studies ,Cisplatin ,Proportional hazards model ,business.industry ,Nasopharyngeal Neoplasms ,Retrospective cohort study ,medicine.disease ,030104 developmental biology ,DNA, Viral ,Multivariate Analysis ,business - Abstract
Background We compared the efficacy and toxicity of three IC regimens (TPF: taxanes, cisplatin, and 5-fluorouracil; TP: taxanes and cisplatin; and PF: cisplatin and 5-fluorouracil) followed by CCRT in locoregionally advanced NPC. Methods The retrospective study involved 1354 patients with newly diagnosed stage III-IVA NPC treated with IC and CCRT. The median follow-up time in our cohort was 50 months. Based on EBV DNA level, all the patients with stage IV were divided into low- (pre-EBV DNA Results A multivariate analysis revealed TPF to be more effective than TP. Among stage III patients, no significant difference in clinical outcome between the different IC regimens was showed, while TPF was associated with significantly better survival conditions in the stage IV patients. A further subgroup analysis revealed that only patients with pre-EBV DNA ≥ 1500 copies could benefit from the application of TPF among stage IV NPC. In terms of acute toxicities, PF was associated with fewer grade 3/4 acute toxicities. Conclusions In low-risk NPC patients, PF-based IC showed similar efficacy as TPF and TP but was associated with fewer grade 3/4 acute toxicities. In high-risk patients, however, the TPF regimen was superior to PF and TP, although grade 3/4 toxicities were more common with the TPF regimen.
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- 2020
36. Establishment of a prognostic scoring model for regional recurrent nasopharyngeal carcinoma after neck dissection
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Qiu-Yan Chen, Chao Lin, Xiao-Yun Li, Ling Guo, Jin-Jie Yan, Hao-Jun Xie, Li-Ting Liu, Yu-Jing Liang, Shan-Shan Guo, Sai-Lan Liu, Qing-Nan Tang, Xiang Guo, Xuekui Liu, Hai-Qiang Mai, Xue-Song Sun, Lin-Quan Tang, and Hao Li
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0301 basic medicine ,Oncology ,Male ,Cancer Research ,Multivariate analysis ,medicine.medical_treatment ,0302 clinical medicine ,lymphatic metastasis ,education.field_of_study ,Hazard ratio ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Progression-Free Survival ,030220 oncology & carcinogenesis ,Cohort ,Disease Progression ,Neck Dissection ,Female ,Original Article ,Adult ,medicine.medical_specialty ,recurrence ,Adolescent ,Population ,Risk Assessment ,lcsh:RC254-282 ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,education ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Proportional hazards model ,nasopharyngeal carcinoma ,Neck dissection ,Nasopharyngeal Neoplasms ,medicine.disease ,Confidence interval ,operation ,Nomograms ,030104 developmental biology ,Nasopharyngeal carcinoma ,prognosis ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Objective: The main aim of this study was to establish a scoring model to predict risk of progression and survival in patients with regionally recurrent nasopharyngeal carcinoma (NPC). Methods: Three hundred and forty-eight patients subjected to neck dissection from 2003 to 2017 were included for study. Clinicopathologic information for each patient was analyzed. Independent prognostic factors were selected using the Cox proportional hazards model and incorporated into the scoring model. Concordance index (C-index) and calibration curves were used to verify discrimination and calibration, respectively and the results validated using bootstrap resampling. Results: Microscopic positive lymph node > 2 [hazard ratio (HR), 2.19; 95% confidence interval (CI), 1.30-3.68; P = 0.003], extranodal extension (HR, 2.75; 95% CI, 1.69-4.47; P < 0.001), and lower neck involvement (HR, 1.78; 95% CI, 1.04-3.04; P = 0.034) were identified from multivariate analysis as independent factors for overall survival (OS). A qualitative 4-point scale was generated to stratify patients into 4 risk groups for predicting OS and progression-free survival (PFS). The novel scoring model demonstrated enhanced discrimination (C-index = 0.69; 95% CI, 0.62-0.76) relative to the original recurrent tumor-node-metastasis (rTNM) staging system (C-index = 0.56; 95% CI, 0.50-0.62), and was internally validated with a bootstrap-adjusted C-index of 0.70. The calibration curve showed good agreement between predicted probabilities and actual observations. Conclusions: The scoring system established in this study based on a large regionally recurrent NPC cohort fills a gap regarding assessment of risk and prediction of survival outcomes after neck dissection in this population and could be further applied to identify high-risk patients who may benefit from more aggressive intervention.
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- 2020
37. Combining pretreatment plasma Epstein‐Barr virus DNA level and cervical node necrosis improves prognostic stratification in patients with nasopharyngeal carcinoma: A cohort study
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Dong Hua Luo, Hai Qiang Mai, Xue Song Sun, Wan Ru Zhang, Jing Hua Zhong, Lin Quan Tang, Hao Yuan Mo, Dong Mei Mai, Wen Hui Chen, Qiu Yan Chen, and Yu Yun Du
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0301 basic medicine ,Oncology ,Male ,Cancer Research ,Herpesvirus 4, Human ,Multivariate analysis ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Cohort Studies ,0302 clinical medicine ,Clinical endpoint ,Original Research ,Chemoradiotherapy ,cohort ,Middle Aged ,Prognosis ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Neoadjuvant Therapy ,cervical node necrosis ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Cohort ,Female ,Sentinel Lymph Node ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Antineoplastic Agents ,lcsh:RC254-282 ,Virus ,03 medical and health sciences ,Necrosis ,Young Adult ,EBV ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Chemotherapy ,business.industry ,nasopharyngeal carcinoma ,Clinical Cancer Research ,Nasopharyngeal Neoplasms ,medicine.disease ,Radiation therapy ,030104 developmental biology ,Nasopharyngeal carcinoma ,DNA, Viral ,Cisplatin ,business - Abstract
This study aimed to evaluate the prognostic value of combining pretreatment Epstein‐Barr virus (EBV) DNA level and cervical node necrosis (CNN) for patients with nasopharyngeal carcinoma (NPC) receiving intensity‐modulated radiotherapy (IMRT). A total of 607 incident nonmetastatic NPC patients treated with IMRT ± chemotherapy were reviewed. Patients were divided into four groups based on EBV DNA level and CNN status. The primary endpoint was progression‐free survival (PFS). Kaplan‐Meier curves with log‐rank test were applied to compare survival outcomes and the Cox proportional model was used to identify independent prognostic factors. Pretreatment EBV DNA level and CNN status were independent prognostic factors. Patients in the low‐level EBV DNA group or non‐CNN group had significantly better 5‐year PFS. Multivariate analyses demonstrated that CNN was an independent prognostic factor for overall survival (OS) (HR = 1.927, 95% CI: 1.129‐3.290, P = .016), PFS (HR = 1.492, 95% CI: 1.005‐2.214, P = .047), distant metastasis‐free survival (DMFS) (HR = 1.661, 95% CI: 1.044‐2.644, P = .032), but not locoregional relapse‐free survival. EBV DNA levels correlated significantly with CNN with a correlation coefficient of .324 (P, It is the first retrospective study that combined pretreatment plasma EBV DNA level and cervical node necrosis (CNN) status to assess the prognosis of nasopharyngeal carcinoma patients. We observed a significant association between plasma EBV DNA level and CNN status in the IMRT era. Compared with the low‐level EBV DNA and non‐CNN group, the high‐level EBV DNA and CNN group had poorer OS, progression‐free survival, and distant metastasis‐free survival. The Kaplan–Meier survival curves showed a significant difference in survival between the different risk groups according to the optimal cut‐off.
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- 2019
38. Identifying optimal candidates for postoperative adjuvant therapy among regional persistent/recurrent nasopharyngeal carcinoma patients after neck dissection
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Sai-Lan Liu, Xiao-Yun Li, Xue-Song Sun, Jing-Yun Peng, Chao Lin, Jin-Jie Yan, Qiu-Yan Chen, Lin-Quan Tang, Shan-Shan Guo, Ling Guo, Li-Ting Liu, and Hai-Qiang Mai
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Cancer Research ,Herpesvirus 4, Human ,Epstein-Barr Virus Infections ,Nasopharyngeal Carcinoma ,Oncology ,DNA, Viral ,Genetics ,Humans ,Neck Dissection ,Nasopharyngeal Neoplasms ,Neoplasm Recurrence, Local ,Prognosis ,Retrospective Studies - Abstract
Purpose To analyze the clinical outcomes of patients with regional persistent/recurrent nasopharyngeal carcinoma (NPC) who received neck dissection, and to evaluate the clinical benefit of postoperative adjuvant therapy (PAT) based on patients’ positive lymph node counts (PLNs), extracapsular spread (ECS) and preoperative plasma EBV DNA levels. Methods From 2003 to 2017, 342 patients with regional persistent/recurrent NPC were included in this study. All patients were treated with neck dissection and 76 patients received PAT. Progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS) and locoregional relapse-free survival (LRFS) were compared between groups using propensity score matching (PSM). Results 152 patients without PAT treatment and 76 patients with PAT treatment were selected by the PSM. There was no significant difference in 2-year PFS (52.4% vs. 61.3%, P = 0.371), 2-year OS (91.9% vs. 90.5%, P = 0.097) or 2-year LRFS (66.3% vs. 67.9%, P = 0.872) between the two groups. However, the application of PAT brought survival benefits to patients in terms of 2-year DMFS (76.5% vs. 84.7%, P = 0.020). PLN, ECS and preoperative EBV DNA level remained independent risk factors for poorer PFS. Accordingly, patients were divided into low-risk and high-risk groups using receiver operating characteristic (ROC) curve; the 2-year PFS rates for two risk groups were 73.4% and 59.1% (P P = 0.023). Conclusions PLNs, ECS and preoperative EBV DNA level are associated with the prognosis of patients with regional persistent/recurrent NPC. High-risk patients identified by PLNs, ECS and preoperative EBV DNA level may benefit from the addition of PAT after neck dissection.
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- 2021
39. Alpha-fetoprotein–producing recurrent nasopharyngeal carcinoma: A case report
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Mu-Yan Cai, Mei-Juan Luo, Yu-Jing Liang, Qiu-Yan Chen, Li-Li Liu, Hai-Qiang Mai, Zhen-Chong Yang, and Lin-Quan Tang
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Pathology ,medicine.medical_specialty ,Medicine (General) ,medicine.diagnostic_test ,business.industry ,Bone metastasis ,Case Report ,General Medicine ,medicine.disease ,Virus ,digestive system diseases ,Metastasis ,Staining ,alpha-fetoprotein ,Fine-needle aspiration ,R5-920 ,Nasopharyngeal carcinoma ,medicine ,Carcinoma ,Alpha-fetoprotein ,business ,bone metastasis - Abstract
Alpha-fetoprotein hardly increased due to nasopharyngeal cancer. In this article, we reported a 57-year-old male nasopharyngeal carcinoma patient who had posttreatment subscapular metastasis with high serum alpha-fetoprotein but negative plasma Epstein–Barr virus DNA. Pathology results indicated that the scapular mass was undifferentiated non-keratinizing carcinoma originated in the nasopharynx. Moreover, no liver lesion was detected by imaging examination. In view of the positive alpha-fetoprotein and alpha-fetoprotein messenger RNA staining result in the right scapular mass fine needle aspiration biopsy sample, we considered the diagnosis of alpha-fetoprotein-producing nasopharyngeal carcinoma that had never been reported before.
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- 2021
40. Correction to: FMNL1 mediates nasopharyngeal carcinoma cell aggressiveness by epigenetically upregulating MTA1
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Jia-Xing Zhang, Chen-Yuan Wang, Ling Guo, Dan Xie, Yi-Ji Liao, Feng-Wei Wang, Lin-Quan Tang, Wen-Hui Chen, Hai-Qiang Mai, Xiao-Han Jin, Mu Sheng Zeng, Cai-Ping Ren, Mu-Yan Cai, Chao-Nan Qian, Yiguo Jiang, and Hsiang-Fu Kung
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Cancer Research ,medicine.anatomical_structure ,Nasopharyngeal carcinoma ,Cell ,Genetics ,medicine ,Cancer research ,Biology ,medicine.disease ,Molecular Biology - Published
- 2021
41. Utility of Epstein-Barr Virus DNA in Nasopharynx Swabs as a Reflex Test to Triage Seropositive Individuals in Nasopharyngeal Carcinoma Screening Programs
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Geng Hang Chen, Zhiwei Liu, Kelly J Yu, Anna E Coghill, Xiao Xia Chen, Shang Hang Xie, Dong Feng Lin, Qi Hong Huang, Yu Qiang Lu, Wei Ling, Chu Yang Lin, Zi Jian Lu, Yu Ying Fan, Lin Quan Tang, Joshua N Sampson, Hui Li, Ann D King, Jaap M Middeldorp, Allan Hildesheim, Su Mei Cao, Pathology, AII - Infectious diseases, and CCA - Cancer biology and immunology
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Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Nasopharyngeal Carcinoma ,Biochemistry (medical) ,Clinical Biochemistry ,Nasopharyngeal Neoplasms ,DNA ,Antibodies, Viral ,Immunoglobulin A ,Nasopharynx ,DNA, Viral ,Reflex ,otorhinolaryngologic diseases ,Humans ,Triage - Abstract
Background Epstein–Barr virus (EBV) DNA detection in the nasopharynx is considered a biomarker for nasopharyngeal carcinoma (NPC). We evaluated its performance as a reflex test to triage EBV seropositives within an NPC screening program in China. Methods The study population was embedded within an ongoing NPC screening trial and included 1111 participants who screened positive for anti-EBV VCA (antibodies against EBV capsid antigens)/EBNA1 (EBV nuclear antigen1)-IgA antibodies (of 18 237 screened). Nasopharynx swabs were collected/tested for EBNA1 gene EBV DNA load. We evaluated performance of EBV DNA in the nasopharynx swab as a reflex test to triage EBV serological high-risk (those referred to endoscopy/MRI) and medium-risk (those referred to accelerated screening) individuals. Results By the end of 2019, we detected 20 NPC cases from 317 serological high-risk individuals and 4 NPC cases from 794 medium-risk individuals. When used to triage serological high-risk individuals, nasopharynx swab EBV DNA was detected in 19/20 cases (positivity rate among cases: 95.0%; 95% CI, 75.1%–99.9%), with a referral rate of 63.4% (201/317, 95% CI, 57.8%–68.7%) and NPC detection rate among positives of 9.5% (19/201, 95% CI, 5.8%–14.4%). The performance of an algorithm that combined serology with triage of serology high-risk individuals using EBV DNA testing yielded a sensitivity of 72.4% (95% CI, 3.0%-81.4%) and specificity of 97.6% (95% CI, 97.2%-97.9%). When used to triage EBV serological medium-risk individuals, the positivity rate among cases was 75.0% (95% CI, 19.4%-99.4%), with a referral rate of 61.8% (95% CI, 58.4%-65.2%) and NPC detection rate among positives of 0.6% (95% CI, 0.1%-1.8%). Conclusions Nasopharynx swab EBV DNA showed promise as a reflex test to triage serology high-risk individuals, reducing referral by ca. 40% with little reduction in sensitivity compared to a serology-only screening program.
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- 2021
42. Different prognostic values of plasma Epstein-Barr virus DNA and maximal standardized uptake value of 18F-FDG PET/CT for nasopharyngeal carcinoma patients with recurrence.
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Ting Shen, Lin-Quan Tang, Dong-Hua Luo, Qiu-Yan Chen, Pei-Jing Li, Dong-Mei Mai, Shan-Shan Guo, Li-Ting Liu, Chao-Nan Qian, Xiang Guo, Mu-Sheng Zeng, Hao-Yuan Mo, and Hai-Qiang Mai
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Medicine ,Science - Abstract
PURPOSE:To evaluate and compare the prognostic value of Epstein-Barr virus (EBV) DNA and maximal standard uptake values (SUVmax ) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) in subgroups of nasopharyngeal carcinoma (NPC) patients with locoregional or distant recurrence. PATIENTS AND METHODS:A total of 194 patients with recurrent NPC (locoregional recurrence: 107, distant recurrence: 87) were enrolled. Patients took evidence of recurrence performed with 18F-FDG-PET and an EBV DNA test before salvage treatment. Clinical parameters, the status of EBV DNA and the value of SUVmax were used for survival analysis using the Kaplan-Meier method and the Cox proportional hazards regression model. RESULTS:In the subgroup of patients with locoregional recurrence, patients with SUVmax
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- 2015
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43. Divergent effects of irradiation on brain cortical morphology in patients with nasopharyngeal carcinoma: one-year follow-up study using structural magnetic resonance imaging
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Xiaoshan Lin, Yingwei Qiu, Zheng Guo, Lin-Quan Tang, Jing Li, Zhipeng Li, Xiaofei Lv, Hai-Qiang Mai, and Lujun Han
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Fusiform gyrus ,business.industry ,Middle temporal gyrus ,Encephalopathy ,Brain morphometry ,Anatomy ,medicine.disease ,03 medical and health sciences ,Superior temporal gyrus ,Basal (phylogenetics) ,0302 clinical medicine ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Medicine ,Middle frontal gyrus ,Radiology, Nuclear Medicine and imaging ,Original Article ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Increasing evidence indicates that radiotherapy (RT)-induced brain cortical deficits may play a critical role in developing radiation encephalopathy in patients with nasopharyngeal carcinoma (NPC). However, the evolutional processes of RT-induced cortical injury have not been sufficiently investigated. This study investigates RT-induced effects on cortical morphology using longitudinal structural magnetic resonance imaging (MRI) in NPC patients. METHODS: Using MRI-based morphometry with surface-based measures, we evaluated the longitudinal alterations of cortical volume (CV), cortical thickness (CT), and cortical surface area (CSA) in 104 NPC patients at pre-RT (n=104), within 3 months post-RT (n=92), 6 months post-RT (n=71), and 9–12 months post-RT (n=52). Twenty healthy controls were also evaluated in parallel. Linear mixed models were used to investigate the trajectories of RT-related changes in cortical brain morphology and its association with irradiation dose, with healthy controls data being used to construct a normal age-related benchmark. The level of statistical significance was set at P
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- 2021
44. Subdivision of de-novo metastatic nasopharyngeal carcinoma based on tumor burden and pretreatment EBV DNA for therapeutic guidance of locoregional radiotherapy
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Xue-Song Sun, Jia-dong Liang, Bei-Bei Xiao, Qiu-Yan Chen, Guo-Dong Jia, Lin-Quan Tang, Li-Ting Liu, Hai-Qiang Mai, Jin-Hao Yang, and Shan-Shan Guo
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Adult ,Male ,Oncology ,Herpesvirus 4, Human ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,Risk stratifications ,medicine.medical_treatment ,Tumor burden ,EBV DNA ,Malignancy ,Virus ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,Nasopharyngeal carcinoma ,Genetics ,Humans ,Medicine ,030212 general & internal medicine ,RC254-282 ,Aged ,Retrospective Studies ,business.industry ,Research ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Nasopharyngeal Neoplasms ,Middle Aged ,Prognosis ,medicine.disease ,Head and neck squamous-cell carcinoma ,Tumor Burden ,Radiation therapy ,030220 oncology & carcinogenesis ,DNA, Viral ,Distant metastasis ,Female ,business ,Locoregional radiotherapy - Abstract
Background Nasopharyngeal carcinoma (NPC) is a malignancy predominantly associated with infection by the Epstein-Barr virus (EBV). Approximately 12,900 new cases of NPC occur each year, with more than 70% of cases occurring in the east and southeast Asia. NPC is different from ordinary head and neck squamous cell carcinoma due to its particular biological properties and it is highly sensitive to radiotherapy. With the development of RT technology, the 3-year local control rate and survival rates of non-metastatic NPC reached 80–90% in the intensity-modulated RT (IMRT) era. However, whether distant metastatic NPC (de novo mNPC, dmNPC) should receive locoregional RT (LRRT) needs to be clarified. Results Multivariate analysis identified three independent prognostic factors: Epstein-Barr virus (EBV) DNA, number of metastatic lesions, and number of metastatic organs. Through these factors, all patients were successfully divided into 3 subgroups: low-risk (single metastatic organ, EBV DNA ≤ 25,000 copies/ml, and ≤ 5 metastatic lesions), intermediate-risk (single metastatic organ, EBV DNA > 25,000 copies/ml, and ≤ 5 metastatic lesions), and high-risk (multiple metastatic organs or > 5 metastatic lesions or both). By comparing LRRT and non-LRRT groups, statistical differences were found in OS in the low-risk and intermediate-risk subgroups (p = 0.039 and p = 0.010, respectively) but no significant difference was found in OS in the high-risk subgroup (p = 0.076). Further multivariate analysis of different risk stratifications revealed that LRRT can improve OS of low- and intermediate-risk subgroups. Conclusions The risk stratification of dmNPC may be used as a new prognostic factor to help clinicians organize individualized LRRT treatment to improve the survival outcomes of dmNPC patients.
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- 2021
45. Maximal standard uptake values of 18F-fluoro-2-deoxy-D-glucose positron emission tomography compared with Epstein-Barr virus DNA as prognostic indicators in de novo metastatic nasopharyngeal carcinoma patients
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Sai Lan Liu, Qing Nan Tang, Hai Qiang Mai, Xiao Yun Li, Lin Quan Tang, Xue Song Sun, Shan Shan Guo, Hao Jun Xie, Jin Jie Yan, Yu Jing Liang, Qiu Yan Chen, Yue Feng Wen, and Li Ting Liu
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0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Survival ,medicine.medical_treatment ,EBV DNA ,lcsh:RC254-282 ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,Genetics ,medicine ,Nasopharyngeal carcinoma ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,SUVmax ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Primary tumor ,Radiation therapy ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,Cervical lymph nodes ,Positron emission tomography ,030220 oncology & carcinogenesis ,business ,2-Deoxy-D-glucose - Abstract
Background This study aimed to evaluate the prognostic value of maximal standard uptake values (SUVmax) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (PET) comparing with Epstein-Barr virus (EBV) DNA levels in de novo metastatic nasopharyngeal carcinoma (NPC) patients. Methods From December 2006 to December 2016, 253 de novo metastatic NPC patients assessed by PET/ computed tomography were involved in current study. SUVmax-T, SUVmax-N, and SUVmax-M referred to the SUVmax at the primary tumor, cervical lymph nodes, and metastatic lesions respectively. Overall survival (OS) was the primary endpoint. Result Patients who died during the follow-up had significantly higher SUVmax-N, SUVmax-M, and EBV DNA level than those in the patients who were alive. SUVmax-N and SUVmax-M were positively correlated with EBV DNA level. The cut-off values of SUVmax-T, SUVmax-N, SUVmax-M, and EBV DNA were 17.0, 12.7, and 6.9, and 13,800 copies/mL respectively, which were determined by receiver operating characteristic (ROC) curve analysis. Patients with elevated SUVmax-N, SUVmax-M, and EBV DNA levels had a lower 3-year OS rate. In multivariate analysis, the independent prognostic factors of OS included EBV DNA, metastatic site, and locoregional radiotherapy application, while SUVmax was not an independent prognostic factor. Conclusion In de novo metastatic NPC patients, higher SUVmax-N and SUVmax-M were associated with worse prognosis. However, the predictive ability of SUVmax-N and SUVmax-M was poorer than that of EBV DNA.
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- 2019
46. Palliative chemotherapy with or without anti-EGFR therapy for de novo metastatic nasopharyngeal carcinoma: a propensity score-matching study
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Yu Jing Liang, Hai Qiang Mai, Qiu Yan Chen, Xiao Yun Li, Xue Song Sun, Sai Lan Liu, and Lin Quan Tang
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Pharmaceutical Science ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,parasitic diseases ,Drug Discovery ,medicine ,Clinical endpoint ,Mucositis ,Nimotuzumab ,Pharmacology ,Chemotherapy ,Cetuximab ,Proportional hazards model ,business.industry ,bacterial infections and mycoses ,medicine.disease ,030104 developmental biology ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Propensity score matching ,business ,medicine.drug - Abstract
Objective We aimed to investigate the efficacy and safety of cetuximab (CTX) or nimotuzumab (NTZ) on the addition of palliative chemotherapy (PCT) in patients with de novo metastatic nasopharyngeal carcinoma (NPC). Materials and methods From 2007 to 2016, 451 eligible patients with de novo metastatic NPC were enrolled in the study. With propensity score matching technique, we created a well-balanced cohort by matching patients who received CTX/NTZ plus PCT (62 patients) with those receiving PCT alone (248 patients) in a ratio of 1:4. The primary endpoint was overall survival (OS). All potential prognostic factors were involved in the multivariate analysis with the Cox regression hazards model. Kaplan-Meier curves were used to compare the survival status, and log-rank test to measure the significance. Results The median follow-up time was 27.7 months (range, 1-126 months). No significant difference in survival was observed between the CTX/NTZ plus PCT group and PCT group. (3-year OS: 63.0% vs 58.1%; P=0.485). The administration of CTX/NTZ was not found to be an independent prognostic factor in multivariate analysis. With regard to toxicity, the development of a G3-4 skin reaction and mucositis was more common in patients receiving CTX plus PCT. Interaction effects analysis did not show any significant interaction effects on OS between the treatment regimen and prognostic factors (P>0.05). Conclusion The efficacy of CTX/NTZ and PCT is comparable to single PCT treatment in terms of survival outcomes among de novo metastatic NPC patients. Moreover, the application of CTX exacerbated skin reactions and mucositis.
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- 2019
47. Individualized concurrent chemotherapy by pretreatment plasma Epstein‐Barr viral DNA in II‐III stage nasopharyngeal carcinoma: A propensity score matching analysis using a large cohort
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Qing Nan Tang, Yu Jing Liang, Sai Lan Liu, Hai Qiang Mai, Shan Shan Guo, Jin Jie Yan, Xiao Yun Li, Lin Quan Tang, Hao Jun Xie, Xue Song Sun, Wen Hui Chen, Qiu Yan Chen, Yue Feng Wen, and Li Ting Liu
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0301 basic medicine ,Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,medicine.medical_treatment ,overall survival ,Epstein‐Barr virus ,medicine.disease_cause ,chemotherapy ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,Drug Therapy ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Radiology, Nuclear Medicine and imaging ,Progression-free survival ,Stage (cooking) ,Precision Medicine ,Propensity Score ,Neoplasm Staging ,Retrospective Studies ,Original Research ,Chemotherapy ,business.industry ,nasopharyngeal carcinoma ,Clinical Cancer Research ,Nasopharyngeal Neoplasms ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Epstein–Barr virus ,Survival Analysis ,Radiation therapy ,030104 developmental biology ,Treatment Outcome ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Propensity score matching ,DNA, Viral ,Female ,Radiotherapy, Intensity-Modulated ,business - Abstract
Object To ascertain the treatment effect of concurrent chemotherapy (CCT) in stage II‐III nasopharyngeal carcinoma (NPC) patients with different Epstein‐Barr virus (EBV) DNA level in intensity‐modulated radiotherapy (IMRT) era. Methods A total of 2742 patients diagnosed with stage II‐III NPC were involved in this study. Patients received IMRT with/without CCT. Overall survival (OS) was the primary endpoint. Receiver operating characteristics curve was used to determine the cut‐off value of pre‐DNA based on OS. After propensity score matching, the role of CCT was explored in patients with different EBV DNA level. Results In our cohort, the cut‐off value of pre EBV DNA was 1460 copies/mL (area under curve [AUC], 0.695‐0.769; sensitivity, 0.766; specificity, 0.599). Patients with high EBV DNA level showed poor survival in OS, progression free survival (PFS), locoregional relapse‐free survival (LRFS) and distant metastasis‐free survival (DMFS). In patients with EBV DNA level >1460 copies/mL, the concurrent chemoradiotherapy (CCRT) group achieved higher 3‐year OS compared with IMRT groups. However, the CCRT and IMRT groups showed comparable OS in patients with EBV DNA ≤1460 copies/mL. In multivariate analyses, CCT was a protective factor for OS, PFS, and LRFS in high‐risk patients (EBV DNA level >1460 copies/mL), while not an independent prognostic factor among the low‐risk patients (EBV DNA level ≤1460 copies/mL). Conclusion Pre‐EBV DNA could be a useful tool to guide individualized treatment for stage II‐III NPC patients. Additional CCT to IMRT improved the survival for patients with high pre‐EBV DNA, while those with low pre‐EBV DNA could not.
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- 2019
48. The development of a nomogram to predict post-radiation necrosis in nasopharyngeal carcinoma patients: a large-scale cohort study
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Xiao Yun Li, Xue Song Sun, Jin Jie Yan, Qing Nan Tang, Ling Guo, Sai Lan Liu, Hao Jun Xie, Lin Quan Tang, Li Ting Liu, Hai Qiang Mai, Qiu Yan Chen, Shan Shan Guo, and Yu Jing Liang
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,education.field_of_study ,Receiver operating characteristic ,business.industry ,medicine.medical_treatment ,Population ,Nomogram ,medicine.disease ,Radiation therapy ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,T-stage ,education ,business ,Adverse effect ,Cohort study - Abstract
Objective: This study aimed to establish a nomogram to predict the risk of post-radiation necrosis in nasopharyngeal carcinoma (NPC) patients. Background: This study was performed to identify influencing factors for developing post-radiation necrosis, and to establish an effective nomogram model to predict individual risks in NPC patients. Methods: 7144 NPC patients receiving radical radiotherapy from 2007 to 2012 were involved in the study, and 207 of them developed nasopharyngeal necrosis (NPN). The clinical characteristics and baseline laboratory results were collected and analyzed. Independent predictive factors were selected using the Cox proportional model and incorporated into the nomogram. The receiver operating characteristic curve and the calibration curve were used to verify discrimination and calibration. Results: The experience of re-irradiation contributed most to the occurrence of NPN (HR, 15.56, 95% CI 10.84-22.35, p
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- 2019
49. Relationship of circulating tumor cells and Epstein–Barr virus DNA to progression‐free survival and overall survival in metastatic nasopharyngeal carcinoma patients
- Author
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Ming Huang Hong, Hai Qiang Mai, Ming Yuan Chen, Ting Kang, Rui You, Wan Li Liu, Xiong Zou, Yi Nuan Zhang, Pei Yu Huang, Wei Bang Guo, Ai Hua Lin, Ke Ming Zhao, Li Zhi Liu, Mei Lin, Mu Sheng Zeng, You Ping Liu, Lin Quan Tang, and Yi Pan
- Subjects
Adult ,Male ,Oncology ,Herpesvirus 4, Human ,Cancer Research ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Virus ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Circulating tumor cell ,Predictive Value of Tests ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,medicine ,Overall survival ,Humans ,Prospective Studies ,Progression-free survival ,Aged ,Chemotherapy ,Nasopharyngeal Carcinoma ,business.industry ,Epstein-Barr virus DNA ,Nasopharyngeal Neoplasms ,Middle Aged ,Neoplastic Cells, Circulating ,Prognosis ,medicine.disease ,Progression-Free Survival ,Nasopharyngeal carcinoma ,chemistry ,030220 oncology & carcinogenesis ,DNA, Viral ,Female ,business ,DNA - Abstract
We analyzed the number of circulating tumor cells (CTCs) and Epstein-Barr virus DNA (EBV DNA) for diagnosis, monitoring and prognosis of patients with metastatic nasopharyngeal carcinoma (mNPC). The levels of CTCs and EBV DNA were measured at baseline and after first-line chemotherapy in 148 mNPC patients prospectively enrolled between December 2014 and August 2016. We also collected 122 non-mNPC cases within the same time frame for examining CTCs and EBV DNA at baseline. In 270 NPC patients, we observed improved specificity (86.0% vs. 41.0%) and inferior sensitivity (42.3% vs. 81.3%) of CTCs as compared to EBV DNA for diagnosis of distant metastasis. mNPC patients were stratified into unfavorable and favorable prognostic groups, respectively, based on CTC of 12 at baseline and 1 after first-line chemotherapy and EBV DNA of 10,000 at baseline and 4,000 after first-line chemotherapy. Conversion of baseline unfavorable CTCs and EBV DNA to favorable after first-line chemotherapy was associated with significantly longer progression-free survival (PFS) and overall survival (OS) compared to patients with unfavorable CTCs and EBV DNA at both time points. Among patients with a complete/partial response as per imaging evaluation, favorable CTCs and EBV DNA levels after first-line chemotherapy were associated with significantly longer PFS and OS. In conclusion, our data demonstrated the number of CTCs and EBV DNA before, after and during first-line chemotherapy were strong predictive markers for mNPC patients. When utilized in conjunction with imaging studies, CTCs and EBV DNA could provide additional prognostic information.
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- 2019
50. Neoadjuvant or Adjuvant Chemotherapy Plus Concurrent CRT Versus Concurrent CRT Alone in the Treatment of Nasopharyngeal Carcinoma: A Study Based on EBV DNA
- Author
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Shan Shan Guo, Chong Zhao, Qing Nan Tang, Chao Nan Qian, Jian Yong Shao, Lin Quan Tang, Yu Jing Liang, Xiang Guo, Ying Sun, Li Ting Liu, Jun Ma, Hai Qiang Mai, Jin Xin Bei, Xue Song Sun, Ming Huang Hong, Ling Guo, Qiu Yan Chen, Mu Sheng Zeng, Yang Li, and Hao Yuan Mo
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Chemotherapy ,business.industry ,Adjuvant chemotherapy ,medicine.medical_treatment ,Hazard ratio ,Retrospective cohort study ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Progression-free survival ,Young adult ,Stage (cooking) ,business - Abstract
Background: The goal of this study was to explore the value of adding neoadjuvant chemotherapy (NACT) or adjuvant chemotherapy (ACT) to concurrent chemoradiotherapy (CCRT) in patients with nasopharyngeal carcinoma (NPC) with different risks of treatment failure. Patients and Methods: A total of 2,263 eligible patients with stage III–IVb NPC treated with CCRT ± NACT or ACT were included in this retrospective study. Distant metastasis–free survival (DMFS), overall survival, and progression-free survival were calculated using the Kaplan-Meier method and differences were compared using the log-rank test. Results: Patients in the low-risk group (stage N0–1 disease and Epstein-Barr virus [EBV] DNA P= .008). Multivariate analyses also demonstrated that additional NACT was the only independent prognostic factor for DMFS (hazard ratio, 0.42; 95% CI, 0.22–0.80; P=.009). In both the intermediate-risk group (stage N0–1 disease and EBV DNA ≥4,000 copies/mL and stage N2–3 disease and EBV DNA Conclusions: The addition of NACT to CCRT could reduce distant failure in patients with low risk of treatment failure.
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- 2019
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