Search

Brain metastasis predicts a worse clinical outcome in cancer patients. Emerging observational evidence suggests that statin use has a protective role in overall cancer prevention. Whether statin use could also be a supplementary treatment for advanced-stage cancers remains under researched and controversial. Data for cancer patients with brain metastasis were selected from the linked electronic medical care records of the West China Hospital between October 2010 and July 2019. Fisher's exact chi-square test was used to compare the differences between cohorts. Multivariate Cox analysis was conducted to adjust the potential confounders in evaluating the role of statin use in the overall survival (OS) of cancer patients with brain metastasis. There were 4510 brain metastatic patients included in this retrospective study. The overall statin use rate in our patients was 5.28% (219 cases/4510 cases). Compared with the non-statin use cohort, patients who received statin therapy showed a decreased Karnofsky performance score (KPS, p < 0.001) and lower high-density lipoprotein (HDL, p = 0.020) but higher body mass index (BMI, p = 0.002) and triglyceride (TG, p < 0.001) at admission. There was no association between statin use and the OS of the cancer patients with brain metastasis (Hazard ratio (HR) = 0.90, 95% confidence interval (CI): 0.73–1.07, p = 0.213) during the univariate analysis. However, after adjusting for baseline patient characteristics, metabolism indicators, and cancer-specific factors, statin use was shown to have a significant protective role, aiding the survival of the cancer patients with brain metastasis (adjustHR = 0.82, 95%CI: 0.69–0.99, p = 0.034). Our results highlight that statin use shows significant survival benefits in cancer patients with brain metastasis. However, future research is needed to validate our findings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the prognostic factors of penile cancer and establish a comprehensive predictive model for clinical application. Methods: A total of 581 patients from the Surveillance, Epidemiology, and End Results (SEER) program (2000–2018) were used to develop the prognostic model. The multivariate Cox proportional hazards regression was performed to identify independent prognostic factors to develop the nomogram. The performance of this model was validated internally by a cohort with 143 patients from the SEER database and validated externally by a cohort with 70 patients from the West China Hospital, Sichuan University (2010–2020). Results: Age, marital status, size of the primary lesion, primary tumor (T), regional lymph nodes status, distant metastasis (M), and the surgery of regional lymph node (LND) were the independent prognostic factors for overall survival (OS) and were incorporated in the prognostic model. The prognostic nomogram showed a good risk stratification ability for OS in the development cohort, internal validation cohort, and external validation cohort. Conclusion: This study incorporates the clinical, pathological, and therapeutic features comprehensively to develop a novel and clinically effective prognostic model for patients with penile cancer. [ABSTRACT FROM AUTHOR]

Background: To evaluate the efficiency of local radiotherapy to metastatic lesions in patients with metastatic nasopharyngeal carcinoma (mNPC). Methods: The overall survival was observed and compared for mNPC patients who received local radiotherapy versus nonradiotherapy to metastatic lesions by using the Kaplan–Meier method and Cox analysis. Results: One hundred and nine patients with NPC were involved in this study, with 61 (56.0%) received radiotherapy to metastatic sites and 48 (44.0%) did not receive radiotherapy to metastatic sites. The 2‐ and 5‐year OS for patients who received local radiotherapy to metastatic lesions were 65.8% and 35.7%, and for patients who did not receive radiotherapy to metastatic lesions were 45.3% and 26.2%. The multivariable adjusted hazard radios for local radiotherapy versus nonradiotherapy to metastatic lesions were 0.482 (95% confidence interval is 0.278–0.834, p = 0.009). Conclusions: Local radiotherapy to metastatic lesions might be a protective factor for patients with mNPC. [ABSTRACT FROM AUTHOR]

Objectives: The optimal treatment strategy of combining systemic chemotherapy and radiotherapy for nasopharyngeal carcinoma (NPC) is controversial. This study aimed to compare the efficacy and toxicities of induction chemotherapy followed by intensity‐modulated radiotherapy (IC‐RT) versus concurrent chemoradiotherapy (CCRT) in NPC. Methods: Of 448 stage II‐IVb NPC patients treated with IC‐RT or CCRT were retrospectively analysed. The primary outcome was overall survival, which was analysed by using Kaplan‐Meier curves and log‐rank (Mantel‐Cox) test. Results: The median follow‐up was 66 months (interquartile range, 46‐84 months). There was no statistically significant difference in the estimated 5‐year overall survival (OS), progression‐free survival (PFS), distance metastasis‐free survival (DMFS) and locoregional relapse‐free survival (LRFS) between IC‐RT group and CCRT group (OS: 89.5% vs 91.7%, P =.568; PFS: 85.2% vs 87.5%, P =.615; DMFS: 90.9% vs 91.7%, P =.847; LRFS: 92.0% vs 96.9%, P =.104). In the multivariate analysis, the treatment group (IC‐RT vs CCRT) was not an independent prognostic factor for OS, PFS, DMFS and LRFS. Less advanced tumour stage and lymph node stage were predictive of higher OS. EBV‐DNA level was an independent prognostic factor that was only significantly associated with LRFS. Conclusions: IC‐RT achieves similar survival outcomes and treatment‐related toxicities as CCRT in OS, PFS, DMFS and LRFS for patients with NPC. We need multicentre randomised controlled trials to reconfirm our data. [ABSTRACT FROM AUTHOR]

Background: A Bayesian network meta‐analysis was performed to compare the efficacy and toxicities among different induction chemotherapy regimens in locally advanced nasopharyngeal carcinoma (LA‐NPC). Methods: Electronic databases were searched for literature up to September 16, 2019. Two researchers independently selected the articles, evaluated the quality of the literature, and extracted and analyzed the data. Results: There were no significant differences in survival outcomes, mucositis, or gastrointestinal adverse events among the four regimens. The probability of GP being the best induction scheme to improve OS was 43.7%. The completion rate of concurrent chemotherapy with the GP regimen was significantly reduced than the other three regimens. Conclusions: The survival outcomes of the four regimens in LA‐NPC were comparable. Considering only OS, GP showed the highest probability of improving the survival of LA‐NPC, while it also affected the completion of concurrent chemotherapy. [ABSTRACT FROM AUTHOR]