Establishment of prognostic factors in recurrent nasopharyngeal carcinoma patients who received salvage intensity-modulated radiotherapy: A meta-analysis

被引:27
作者
Yue, Qiuyuan
Zhang, Mingwei [2 ]
Chen, Yunbin
Zheng, Dechun
Chen, Ying [1 ]
Feng, Meimei
机构
[1] Fujian Canc Hosp, Dept Radiol, Fuma Rd 420, Fuzhou 350014, Fujian, Peoples R China
[2] Fujian Med Univ, Affiliated Hosp 1, Dept Radiat Oncol, Fuzhou 350005, Fujian, Peoples R China
关键词
Recurrent; Nasopharyngeal carcinoma; Prognostic factors; Overall survival; Salvage intensity-modulated radiotherapy; Meta-analysis; LONG-TERM OUTCOMES; RADIATION-THERAPY; TUMOR OXYGENATION; LOCAL FAILURES; REIRRADIATION; SURVIVAL; NECROSIS; PHASE-2; MODEL; SIZE;
D O I
10.1016/j.oraloncology.2018.04.017
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Local recurrence remains a major cause of therapeutic failure in patients with nasopharyngeal carcinoma (NPC) and the effective treatment of recurrent NPC (r-NPC) is still a challenge. Intensity-modulated radiotherapy (IMRT) is considered as a favorable technique in the management of r-NPC, especially for extensive lesions. However, local r-NPC is a highly heterogeneous disease and the survival outcome following salvage IMRT varies. Furthermore, due to varied samples and therapeutic protocols, no consensus has been reached in the establishment of prognostic values. Hence, we used Medline and Embase electronic databases to conducted a meta-analysis to generate the best estimation of the prognostic factors in local r-NPC following salvage IMRT. Finally, a total of 783 patients in seven studies were enrolled. Overall, the pooled HR for OS of recurrent T stage and recurrent tumor volume was 1.77 (95% CI = 1.15-2.39) and 2.12 (95% CI = 1.42-2.82), without any heterogeneity. In addition, despite a significant association was observed in the pooled HR of significant compliance for OS, however, significant heterogeneity was also observed (I-2 = 76.6%, p = 0.039). Furthermore, no significant association was observed among the pooled HRs for OS in terms of age, gender, recurrent time interval, synchronous nodal recurrence, chemotherapy and total re-irradiation dose. Therefore, the present meta-analysis demonstrated that recurrent T stage and tumor volume may serve as the prognostic factors for OS in patients with r-NPC who received salvage IMRT. The other factors such as age, gender, and optimal re-irradiation dose warranted further investigation.
引用
收藏
页码:81 / 88
页数:8
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