243 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. Role of chemotherapy in patients with nasopharynx carcinoma treated with radiotherapy (MAC-NPC): an updated individual patient data network meta-analysis
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Claire Petit, Anne Lee, Jun Ma, Benjamin Lacas, Wai Tong Ng, Anthony T C Chan, Ruey-Long Hong, Ming-Yuan Chen, Lei Chen, Wen-Fei Li, Pei-Yu Huang, Terence Tan, Roger K C Ngan, Guopei Zhu, Hai-Qiang Mai, Edwin P Hui, George Fountzilas, Li Zhang, Alexandra Carmel, Dora L W Kwong, James Moon, Jean Bourhis, Anne Auperin, Jean-Pierre Pignon, Pierre Blanchard, Anne Aupérin, Ellen Benhamou, Somvilai Chakrabandhu, Anthony TC Chan, Qiu-Yan Chen, Yong Chen, Richard J Chappell, Horace Choi, Daniel TT Chua, Melvien Lee Kiang Chua, Julian Higgins, Ming Huang Hong, Edwin Pun Hui, Chin-Fu Hsiao, Michael Kam, Georgia Angeliki Koliou, Shu-Chuan Lai, Ka On Lam, Michael L LeBlanc, Anne WM Lee, Ho Fun Victor Lee, Wen Fei Li, Yoke Lim, Brigette Ma, Frankie Mo, Roger Ngan, Camille Ollivier, Brian O'Sullivan, Sharon X Poh, Gerta Rücker, Jonathan Sham, Yoke Lim Soong, Ying Sun, Lin-Quan Tang, Yuk Tung, Joseph Wee, Xuang Wu, Tingting Xu, and Yuan Zhang
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Oncology - Published
- 2023
17. 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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18. 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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19. 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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20. 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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21. 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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22. 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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23. 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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24. 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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25. 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
26. 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
27. 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
28. 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
- Abstract
FigureS2
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- 2023
29. Deintensified Chemoradiotherapy for Pretreatment Epstein-Barr Virus DNA-Selected Low-Risk Locoregionally Advanced Nasopharyngeal Carcinoma: A Phase II Randomized Noninferiority Trial
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Xiao-Yun Li, Dong-Hua Luo, Ling Guo, Hao-Yuan Mo, Rui Sun, Shan-Shan Guo, Li-Ting Liu, Zhen-Chong Yang, Jin-Hao Yang, Fang Qiu, Xue-Song Sun, Pan Wang, Qing Liu, Ji-Bin Li, Qing-Nan Tang, Chao Lin, Qi Yang, Sai-Lan Liu, Yu-Jing Liang, Guo-Dong Jia, Dong-Xiang Wen, Chun-Yan Guo, Jin-Jie Yan, Chong Zhao, Qiu-Yan Chen, Lin-Quan Tang, and Hai-Qiang Mai
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Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Cancer Research ,Nasopharyngeal Carcinoma ,Nasopharyngeal Neoplasms ,Chemoradiotherapy ,DNA ,Oncology ,Antineoplastic Combined Chemotherapy Protocols ,Quality of Life ,Humans ,Cisplatin ,Neoplasm Recurrence, Local ,Retrospective Studies - Abstract
PURPOSE Cumulative doses of 200 mg/m2 for concurrent cisplatin (DDP) were indicated by retrospective studies as sufficient in conferring survival benefit for locoregionally advanced nasopharyngeal carcinoma (LA-NPC). We performed an open-label, phase II, randomized, controlled trial to test the noninferiority of a two-cycle 100 mg/m2 concurrent DDP regimen over three-cycle in patients with low-risk LA-NPC with pretreatment Epstein-Barr virus DNA levels < 4,000 copies/mL. PATIENTS AND METHODS Eligible patients were randomly assigned 1:1 to receive two cycles or three cycles concurrent DDP-based chemoradiotherapy. The primary end point was 3-year progression-free survival (PFS). The secondary end points included overall survival, distant metastasis-free survival, locoregional relapse-free survival, etc. RESULTS Between September 2016 and October 2018, 332 patients were enrolled, with 166 in each arm. After a median follow-up of 37.7 months, the estimated 3-year PFS rates were 88.0% in the two-cycle group and 90.4% in the three-cycle group, with a difference of 2.4% (95% CI, –4.3 to 9.1, Pnoninferiority = .014). No differences were observed between groups in terms of PFS, overall survival, and the cumulative incidences of locoregional relapse and distant metastasis. Patients in the three-cycle group developed significantly more grade 3-4 mucositis (41 [24.8%] v 25 [15.1%]), hyponatremia (26 [15.8%] v 14 [8.4%]), and dermatitis (9 [5.5%] v 2 [1.2%]). The overall all-grade and grade 3-4 toxicity burdens were heavier in three-cycle group (T-scores, 12.33 v 10.57, P < .001 for all grades; 1.76 v 1.44, P = .05 for grade 3-4). Patients in the three-cycle group also showed more all-grade hearing impairment, dry mouth and skin fibrosis, and impaired long-term quality of life. CONCLUSION Intensity-modulated radiotherapy plus two cycles of concurrent 100 mg/m2 DDP could be an alternative treatment option for patients with low-risk LA-NPC.
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- 2022
30. Development and validation of a transcriptomics-based gene signature to predict distant metastasis and guide induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma
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Sai-Lan Liu, Xue-Song Sun, Qiu-Yan Chen, Ze-Xian Liu, Li-Juan Bian, Li Yuan, Bei-Bei Xiao, Zi-Jian Lu, Xiao-Yun Li, Jin-Jie Yan, Shu-Mei Yan, Jian-Ming Li, Jin-Xin Bei, Hai-Qiang Mai, and Lin-Quan Tang
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Cancer Research ,Nasopharyngeal Carcinoma ,Oncology ,Humans ,Nasopharyngeal Neoplasms ,Chemoradiotherapy ,Induction Chemotherapy ,Transcriptome - Abstract
Metastasis is the primary cause of treatment failure in nasopharyngeal carcinoma (NPC); however, the current tumour-node-metastasis staging system has limitations in predicting distant metastasis and guiding induction chemotherapy (IC) application. Here, we established a transcriptomics-based gene signature to assess the risk of distant metastasis and guide IC in locoregionally advanced NPC.Transcriptome sequencing was performed on NPC biopsy samples from 12 pairs of patients with different metastasis risks. Bioinformatics and qPCR were used to identify differentially expressed genes (DEGs), while univariate and multivariate analyses were used to select prognostic indicators for the gene signature. A signature-based nomogram was established in a training cohort (n = 191) and validated in an external cohort (n = 263).Eleven DEGs were identified between metastatic and non-metastatic NPC. Four of these (AK4, CPAMD8, DDAH1 and CRTR1) were used to create a gene signature that effectively categorised patients into low- and high-risk metastasis groups (training: 91.1 versus 70.4%, p 0.0001, C-index = 0.752; validation: 88.4 versus 73.9%, p = 0.00057, C-index = 0.741). IC with concurrent chemoradiotherapy (CCRT) improved distant metastasis-free survival in low-risk patients (94.4 versus 85.0%, p = 0.043), whereas patients in the high-risk group did not benefit from IC (72.6 versus 74.9%, p = 0.946).Our transcriptomics-based gene signature was able to reliably predict metastasis in locoregionally advanced NPC and could be used to identify candidates that could benefit from IC + CCRT.
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- 2022
31. 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
- Abstract
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
32. Concurrent Chemoradiotherapy Followed by Adjuvant Cisplatin-Gemcitabine Versus Cisplatin-5-Fluorouracil Chemotherapy for N2-3 Nasopharyngeal Carcinoma: A Multicentre, Open-Label, Randomised, Controlled, Phase 3 Trial
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Li-Ting Liu, Huai Liu, Ying Huang, Jin-Hao Yang, Si-Yi Xie, Yuan-Yuan Li, Shan-Shan Guo, Bin Qi, Xiao-Yun Li, Dongping Chen, Jin Feng, Xue-Song Sun, Zhen-Chong Yang, Sai-Lan Liu, Dong-Hua Luo, Jin-Bin Li, Qing Liu, Pan Wang, Ling Guo, Hao-Yuan Mo, Fang Qiu, Qi Yang, Yu-Jing Liang, Guo-Dong Jia, Dong-Xiang Wen, Jin-Jie Yan, Chong Zhao, Qiu-Yan Chen, Rui Sun, Lin-Quan Tang, and Hai-Qiang Mai
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- 2023
33. Management of suboptimal response to induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma: Re-induction therapy or direct to Radiotherapy?
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Sai-Lan Liu, Li-Ting Liu, Xiao-Yun Li, Mei-Juan Luo, Qiu-Yan Chen, Bo-Wen Shen, Ting Liu, Yu-Jing Liang, Shan-Shan Guo, Jie-Yi Lin, Lin-Quan Tang, Hai-Qiang Mai, and Xue-Song Sun
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Oncology ,medicine.medical_specialty ,Anemia ,medicine.medical_treatment ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies ,Chemotherapy ,Nasopharyngeal Carcinoma ,business.industry ,Induction chemotherapy ,Nasopharyngeal Neoplasms ,Chemoradiotherapy ,Induction Chemotherapy ,Hematology ,Guideline ,medicine.disease ,Radiation therapy ,Regimen ,Nasopharyngeal carcinoma ,Propensity score matching ,Cisplatin ,Neoplasm Recurrence, Local ,business - Abstract
Background Unsatisfactory tumor response to induction chemotherapy (IC) is an adverse prognostic factor of locoregionally advanced nasopharyngeal carcinoma (LANPC). A re-induction strategy which applies additional cycles of an alternative IC regimen prior to radiotherapy (RT) has been adopted. Methods A total of 419 LANPC patients who attained suboptimal response (stable disease or disease progression) according to the Response Evaluation in Solid Tumors (RECIST) guideline after initial IC were retrospectively included. They were divided into those who received additional cycles of re-induction regimen prior to RT (re-induction group, n = 87) and those who had no additional chemotherapy (direct to RT group, n = 332). Propensity score matching (PSM) was used to adjust for potential confounders. Tumor response and long-term survival were compared between two groups. Results After receiving a second IC regimen, 39.1% of the patients in re-induction group attained partial response; however, the tumor control of subsequent RT was not significantly improved when compared with direct to RT group (patients attaining complete response after RT 55.2% vs. 52.5%, P = 0.757). Patients who received re-induction therapy showed worse locoregional relapse-free survival (LRFS) and progression-free survival (PFS) than those proceeded directly to RT (3-year LRFS 75.7% vs. 83.1%, P = 0.005; 3-year PFS 62.4% vs. 68.3%, P = 0.037). The increased hematological toxicities were observed in re-induction group that included grade 3–4 anemia, thrombocytopenia and liver enzyme increase. Conclusion Re-induction therapy decreased LRFS and PFS and increased toxicities among patients who attain suboptimal response to initial IC regimen, as compared with direct to RT strategy.
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- 2021
34. Efficacy of Transnasal Endoscopic Fine‐Needle Aspiration Biopsy in Diagnosing Submucosal Nasopharyngeal Carcinoma
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Jin-Jie Yan, Hao-Jun Xie, Yue-Feng Wen, Jin-Hao Yang, Xiao-Yun Li, Sai-Lan Liu, Qing-Nan Tang, Shan-Shan Guo, Jibin Li, Guo-Ping Ou, Zi-Jian Lu, Xue-Song Sun, Hai-Qiang Mai, Lin-Quan Tang, Dong-Xiang Wen, Li-Ting Liu, and Qiu-Yan Chen
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Adult ,Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Diagnostic methods ,Biopsy, Fine-Needle ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Nasopharynx ,Aspiration biopsy ,Biopsy ,Mucositis ,medicine ,Humans ,Aged ,Aged, 80 and over ,Nasopharyngeal Carcinoma ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Endoscopy ,Nasopharyngeal Neoplasms ,Middle Aged ,medicine.disease ,Predictive value ,Nasal Mucosa ,Fine-needle aspiration ,ROC Curve ,Otorhinolaryngology ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
OBJECTIVES/HYPOTHESIS The routine practices of examining submucosal lesions are not suitable for deep lesions. Therefore, we evaluated the efficacy of non-real-time image-guided transnasal endoscopic fine-needle aspiration biopsy (FNAB) in diagnosing nasopharyngeal carcinoma (NPC) with submucosal lesions. STUDY DESIGN The effectiveness evaluation of diagnostic methods. METHODS Fifty suspected NPC patients who failed in conventional biopsies were enrolled in this study. The efficacy, maneuverability, and safety of FNAB in diagnosing these intractable cases were evaluated. RESULTS The definitive diagnostic results of these 50 patients were NPC (34/50, 68.0%), nasopharyngeal necrosis (1/50, 2.0%), nasopharyngeal mucositis (12/50, 24.0%), and other cancers (3/50, 6.0%), respectively. The results of the diagnostic efficacy of FNAB were sensitivity, 89.2%; specificity, 100.0%; positive predictive value, 100.0%; negative predictive value, 76.5%; and accuracy, 92.0%, respectively. The area under the receiver operating characteristic curves was 0.946 (95% confidence interval = 0.884-1.00, P
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- 2021
35. Retraction notice to 'Endogenous production of C–C motif chemokine ligand 2 by nasopharyngeal carcinoma cells drives radioresistance-associated metastasis' [Canc. Lett. 468 (2020) 27–40]
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Shan-Shan Guo, Rui Liu, Yue-Feng Wen, Li-Ting Liu, Li Yuan, Yan-Xian Li, Yang Lie, Wen-Wen Hao, Jing-Yun Peng, Dan-Ni Chen, Qing-Nan Tang, Xue-Song Sun, Ling Guo, Hao-Yuan Mo, Chao-Nan Qian, Mu-Sheng Zeng, Jin-Xin Bei, Shu-Yang Sun, Qiu-Yan Chen, Lin-Quan Tang, and Hai-Qiang Mai
- Subjects
Cancer Research ,Oncology - Published
- 2023
36. A new prognostic model for predicting outcomes of patients with recurrent or metastatic nasopharyngeal carcinoma receiving subsequent line (≥2 lines) anti-programmed death-1 monotherapy
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Su-Chen Li, Shen-Wen Deng, Xue-Song Sun, Kai-Qi Lan, Chun-Yan Guo, Da-Feng Lin, Li-Ting Liu, Sai-Lan Liu, Hai-Qiang Mai, and Lin-Quan Tang
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Cancer Research ,Oncology ,Oral Surgery - Published
- 2023
37. 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.
- Published
- 2021
38. Nomogram for the prediction of primary distant metastasis of nasopharyngeal carcinoma to guide individualized application of FDG PET/CT
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Jibin Li, Yue-Feng Wen, Xiao-Yun Li, Da-Feng Lin, Ling Guo, Li-Ting Liu, Bei-Bei Xiao, Qiu-Yan Chen, Rui Sun, Yu-Jing Liang, Sai-Lan Liu, Shan-Shan Guo, Wei Fan, Hai-Qiang Mai, Qing-Nan Tang, Dong-Hua Luo, Lujun Han, Xue-Song Sun, Lin-Quan Tang, Xu Zhang, Li Yuan, and Xiaofei Lv
- Subjects
Oncology ,medicine.medical_specialty ,Multivariate statistics ,Logistic regression ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,Internal medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Neoplasm Staging ,PET-CT ,Nasopharyngeal Carcinoma ,business.industry ,Distant metastasis ,Nasopharyngeal Neoplasms ,General Medicine ,Nomogram ,Prognosis ,medicine.disease ,Net reclassification improvement ,Nomograms ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Fdg pet ct ,business - Abstract
This study aimed to establish an effective nomogram to predict primary distant metastasis (DM) in patients with nasopharyngeal carcinoma (NPC) to guide the application of PET/CT. In total, 3591 patients with pathologically confirmed NPC were consecutively enrolled. The nomogram was constructed based on 1922 patients treated between 2007 and 2014. Multivariate logistical regression was applied to identify the independent risk factors of DM. The predictive value of the nomogram was evaluated using the concordance index (C-index), calibration curve, probability density functions (PDFs), and clinical utility curve (CUC). The results were validated in 1669 patients enrolled from 2015 to 2016. Net reclassification improvement (NRI) was applied to compare performances of the nomogram with other clinical factors. The best cut-off value of the nomogram chosen for clinical application was analyzed. A total of 355 patients showed primary DM among 3591 patients, yielding an incidence rate of 9.9%. Sex, N stage, EBV DNA level, lactate dehydrogenase level, and hemoglobin level were independent predictive factors for primary DM. C-indices in the training and validation cohort were 0.796 (95% CI, 0.76–0.83) and 0.779 (95% CI, 0.74–0.81), respectively. The NRI indices demonstrated that this model had better predictive performance than plasma EBV DNA level and N stage. We advocate for a threshold probability of 3.5% for guiding the application of PET/CT depending on the clinical utility analyses. This nomogram is a useful tool to predict primary DM of NPC and guide the clinical application of PET/CT individually at the initial staging.
- Published
- 2021
39. 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
- Subjects
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.
- Published
- 2022
40. M1 stage subdivisions based on
- Author
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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
- Abstract
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.
- Published
- 2022
41. 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
- Author
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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
- Subjects
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
- Published
- 2020
42. 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
- Subjects
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.
- Published
- 2020
43. 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
- Subjects
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.
- Published
- 2020
44. 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
- Subjects
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
45. 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
- Subjects
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
46. RETRACTED: Endogenous production of C–C motif chemokine ligand 2 by nasopharyngeal carcinoma cells drives radioresistance-associated metastasis
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Lin Quan Tang, Xue Song Sun, Li Ting Liu, Ling Guo, Wen Wen Hao, Jin Xin Bei, Chao Nan Qian, Hai Qiang Mai, Yan Xian Li, Qing Nan Tang, Mu Sheng Zeng, Dan Ni Chen, Yang Li, Rui Liu, Qiu Yan Chen, Hao Yuan Mo, Jing Yun Peng, Shan Shan Guo, Li Yuan, Yue Feng Wen, and Shu Yang Sun
- Subjects
Adult ,Male ,0301 basic medicine ,Cancer Research ,Chemokine ,Epithelial-Mesenchymal Transition ,Organoplatinum Compounds ,CCL2 ,Radiation Tolerance ,Disease-Free Survival ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Cell Line, Tumor ,Radioresistance ,otorhinolaryngologic diseases ,medicine ,Humans ,Epithelial–mesenchymal transition ,Progression-free survival ,Autocrine signalling ,Chemokine CCL2 ,Nasopharyngeal Carcinoma ,biology ,business.industry ,Nasopharyngeal Neoplasms ,Chemoradiotherapy ,Middle Aged ,Prognosis ,medicine.disease ,Xenograft Model Antitumor Assays ,Progression-Free Survival ,Gene Expression Regulation, Neoplastic ,Autocrine Communication ,stomatognathic diseases ,030104 developmental biology ,Oncology ,Nasopharyngeal carcinoma ,030220 oncology & carcinogenesis ,Cancer research ,biology.protein ,Female ,Cisplatin ,Neoplasm Recurrence, Local ,Tumor Suppressor Protein p53 ,business ,Signal Transduction - Abstract
Patients with recurrent nasopharyngeal carcinoma (NPC) have more co-existing distant metastasis than those of no-recurrence and are more likely to suffer distant metastasis after re-irradiation than patients with newly diagnosed NPC. However, the relationship between radioresistance and distant metastasis and the mechanisms involved in radioresistance-associated metastasis are still unclear. In this study, we proved that C-C motif chemokine ligand 2 (CCL2) expression was significantly elevated in HONE1-IR cells and recurrent NPC tumour. Inhibition of CCL2 enhanced sensitivity to radiotherapy in NPC cells. Moreover, autocrine CCL2 promoted NPC cell adaptive radioresistance, metastasis and epithelial-mesenchymal transition. Additionally, p53 activated CCL2 transcription. High CCL2 expression was highly associated with poorer locoregional recurrence free survival, progression free survival and overall survival in patients with newly diagnosed NPC. Notably, high CCL2 expression was an independent prognostic factor for distant metastasis free survival in recurrent NPC patients. Our results provide insights into the autocrine signalling mechanisms of CCL2 and suggest that inhibition of autocrine CCL2 may be a candidate treatment strategy for management of radioresistant NPC.
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- 2020
47. Deep learning signatures reveal multiscale intratumor heterogeneity associated with biological functions and survival in recurrent nasopharyngeal carcinoma
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Xun Zhao, Yu-Jing Liang, Xu Zhang, Dong-Xiang Wen, Wei Fan, Lin-Quan Tang, Di Dong, Jie Tian, and Hai-Qiang Mai
- Subjects
Nomograms ,Deep Learning ,Nasopharyngeal Carcinoma ,Positron Emission Tomography Computed Tomography ,Humans ,Radiology, Nuclear Medicine and imaging ,Nasopharyngeal Neoplasms ,General Medicine ,Neoplasm Recurrence, Local ,Retrospective Studies - Abstract
How to discriminate different risks of recurrent nasopharyngeal carcinoma (rNPC) patients and guide individual treatment has become of great importance. This study aimed to explore the associations between deep learning signatures and biological functions as well as survival in (rNPC) patients.A total of 420 rNPC patients with PET/CT imaging and follow-up of overall survival (OS) were retrospectively enrolled. All patients were randomly divided into a training set (n = 269) and test set (n = 151) with a 6:4 ratio. We constructed multi-modality deep learning signatures from PET and CT images with a light-weighted deep convolutional neural network EfficienetNet-lite0 and survival loss DeepSurvLoss. An integrated nomogram was constructed incorporating clinical factors and deep learning signatures from PET/CT. Clinical nomogram and single-modality deep learning nomograms were also built for comparison. Furthermore, the association between biological functions and survival risks generated from an integrated nomogram was analyzed by RNA sequencing (RNA-seq).The C-index of the integrated nomogram incorporating age, rT-stage, and deep learning PET/CT signature was 0.741 (95% CI: 0.688-0.794) in the training set and 0.732 (95% CI: 0.679-0.785) in the test set. The nomogram stratified patients into two groups with high risk and low risk in both the training set and test set with hazard ratios (HR) of 4.56 (95% CI: 2.80-7.42, p 0.001) and 4.05 (95% CI: 2.21-7.43, p 0.001), respectively. The C-index of the integrated nomogram was significantly higher than the clinical nomogram and single-modality nomograms. When stratified by sex, N-stage, or EBV DNA, risk prediction of our integrated nomogram was valid in all patient subgroups. Further subgroup analysis showed that patients with a low-risk could benefit from surgery and re-irradiation, while there was no difference in survival rates between patients treated by chemotherapy in the high-risk and low-risk groups. RNA sequencing (RNA-seq) of data further explored the mechanism of high- and low-risk patients from the genetic and molecular level.Our study demonstrated that PET/CT-based deep learning signatures showed satisfactory prognostic predictive performance in rNPC patients. The nomogram incorporating deep learning signatures successfully divided patients into different risks and had great potential to guide individual treatment: patients with a low-risk were supposed to be treated with surgery and re-irradiation, while for high-risk patients, the application of palliative chemotherapy may be sufficient.
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- 2022
48. Comparison of induction chemotherapy combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in Lymph-Node-Stage III nasopharyngeal carcinoma based on propensity score-matching
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Zhi-Cheng, Liu, Ke-Hao, Zeng, Zhen-Bang, Gu, Run-Pu, Chen, Yi-Jing, Luo, Lin-Quan, Tang, Kai-Bin, Zhu, Yan, Liu, Xue-Song, Sun, and Lei, Zeng
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging ,Hematology - Abstract
To explore the role of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in patients diagnosed with N3 nasopharyngeal carcinoma (NPC).A total of 787 patients with newly diagnosed N3 NPC treated with IC + CCRT or CCRT alone were included. Progression-free survival (PFS) was the primary endpoint. We balanced variables using propensity score matching (PSM). Kaplan-Meier curves with log-rank tests were applied to evaluate the survival condition of each group. Independent prognostic factors were identified using the Cox regression analysis.PSM assigned 228 patients to IC + CCRT and CCRT alone groups. Survival analysis for the matched data set showed that IC + CCRT achieved better survival outcomes compared with CCRT alone, and significant difference was observed in 5-year PFS [74.8% (95%CI 69.2 ∼ 80.9%) vs 65.4% (95%CI 59.4 ∼ 72.0%), P = 0.008], 5-year OS [(77.4%(95%CI 71.9 ∼ 83.3%) vs66.3%(95%CI 60.3 ∼ 72.9%), P = 0.005)] and 5-year distant metastasis-free survival (DMFS)[(81.8%(95%CI 76.7 ∼ 87.2%) vs72.4%(95%CI 66.7 ∼ 78.7%), P = 0.007)] between the two treatment groups. In multivariate analysis, IC + CCRT remained an independent protective factor for PFS (adjusted HR, 0.603; 95% CI, 0.433-0.841; P = 0.003), OS (adjusted HR, 0.568; 95% CI, 0.406-0.793; P 0.001), and DMFS (adjusted HR, 0.541; 95% CI, 0.364-0.805; P = 0.002).More chemotherapy should be considered in patients with N3 NPC because of its ability to improve survival time. This could be from the use of IC or adjuvant metronomic chemotherapy.
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- 2023
49. 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
- Subjects
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.
- Published
- 2019
50. Identifying optimal candidates for postoperative adjuvant therapy among regional persistent/recurrent nasopharyngeal carcinoma patients after neck dissection
- Author
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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
- Subjects
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.
- Published
- 2021
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