Analysis Of Clinical Characteristics, Treatment Strategy And Prognostic Facters Of 352 Patients With Nasopharyngeal Carcinoma

Objective: The study was aimed to explore prognostic factors of patients with nasopharyngeal carcinoma after analyzing the clinical characteristics and treatment strategy.Materials and Methods: From January 1st 2002 to December 31st 2002, 352 patients with histology-proven NPC and treated for the first time were admitted into our hospital. Prognostic factors such as gender, age, family history, histological type, clinical stage and treatment factors (radiotherapy and chemotherapy) were performed by univariate and multivariate survival analyses using SPSS version 13.Results: 1)In our study 169 patients died before January 1st 2008. The median follow-up for the whole group was 48 months (range, 1 to 72 months). 90.9% patients had a complete follow-up. The 1-year, 3-year, and 5-year overall survival rate in this group were 89%, 62% and 51%respectively. From stage I to IV the 5-year overall survival rate in this group were 91%, 72%, 47% and 31% respectively. 2) Univariate analysis showed that age, clinical stage, T stage, N stage, M stage, RT dose to the primary tumor, RT dose to the neck, receiving brachytherapy or not, and receiving chemotherapy or not were prognostic factors (P<0.05) . Multivariate analysis showed that age, clinical stage, N stage, M stage, and RT dose to the primary tumor is the independent prognostic factors for overall survival (P<0.05) .3) 197 patients of stage III-IVA were treated with radical radiotherapy, and 130 patients were treated with chemoradiotherapy among them. There was no significant difference in OS between the chemoradiotherapy group and the radiotherapy alone (RT group). 4) There were 52 patients treated with neoadjuvant chemotherapy plus radiotherapy, 58 patients treated with concurrent chemoradiotherapy(CRT), 1 patient treated with adjuvant chemotherapy plus radiotherapy, and 3 patients treated with CRT plus adjuvant chemotherapy among the chemoradiotherapy group. And there was no significant difference in OS between the CRT group and the RT group. 5) There were 34 patients treated with platinum-based chemotherapy and 24 patients treated with Hcpt chemotherapy among the CRT group. And there was no significant difference in OS between the two groups and the RT group respectively. 6) Among the CRT group there were 2 patients equal to the least DDP total dose which was reported in phase III study of CRT, no patient above 75% of the dose, 21 patients in the 50%-75% of the dose, and 11 less than 50% the dose. 7) Among the CRT group there were 8 patients started chemotherapy before RT, 5 patients CT and RT started in the same day, 21 patients CT after RT.Conclusion: Our study showed that the young had longer survival time than the old. The later clinical stage, N stage, M stage had shorter survival time. Survival can benefit from the radical radiotherapy. Our study failed to demonstrate any significant survival benefit with the addition of irregular chemotherapy for patients with locoregionally advanced NPC.