Positive effect of high RKIP expression on reduced distant metastasis by chemotherapy when combined with radiotherapy in locoregionally advanced nasopharyngeal carcinoma: a prospective study

被引:0
作者
Si Wei Li
Hua Wang
Mei lian Liu
Hai Bo Zhang
Yan Qun Xiang
Xing Lv
Wei Xiong Xia
Mu Sheng Zeng
Hai Qiang Mai
Ming Huang Hong
Xiang Guo
机构
[1] the Affiliated Hospital of Guilin Medical College,Department of Radiation Oncology
[2] Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in Southern China, Department of Nasopharyngeal Carcinoma
[3] The Tumor Hospital of Yichang City,State Key Laboratory of Oncology in Southern China, Department of Hematologic Oncology
[4] Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in Southern China
[5] Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in Southern China, Department of GCP
[6] Sun Yat-sen University Cancer Center,undefined
来源
Medical Oncology | 2013年 / 30卷
关键词
Prospective study; Nasopharyngeal carcinoma; Prognosis; Metastasis; RKIP; Chemoradiotherapy;
D O I
暂无
中图分类号
学科分类号
摘要
The purpose of this prospective study is to investigate the predictive and prognostic significance of the Raf kinase inhibitory protein (RKIP) in locoregionally advanced nasopharyngeal carcinoma (NPC). Immunohistochemical assays were performed to detect the RKIP protein expression of samples from 212 patients with locoregionally advanced NPC. All patients were assigned randomly into the inductive chemotherapy plus radiation therapy (IC + RT) group, the concurrent chemoradiotherapy (CCRT) group, the inductive chemotherapy plus concurrent chemoradiotherapy (IC + CCRT) group, and the radiation therapy alone (RT) group. The patients in the IC + RT group were treated with IC using 2–3 cycles of cisplatin (80 mg/m2) and fluorouracil (500 mg/m2), repeated every 3 weeks, followed by radiotherapy. Those in the CCRT group were treated with weekly cisplatin (40 mg/m2) for 6–7 cycles during radiotherapy. In the IC + CCRT group, the chemotherapy prior to radiation was similar to the cisplatin–fluorouracil regimen in the IC + RT group, whereas it cisplatin regimen was identical to that in the CCRT group. The results show that RKIP is an independent prognostic factor for 5-year distant metastasis–free survival (DMFS), overall survival (OS), and progression-free survival (PFS). Patients with high RKIP expression benefited more from reduced metastasis in the IC + RT and the IC + CCRT group, with improved OS and PFS in each treatment group compared with that among patients with low RKIP expression. In the high RKIP expression subgroup, chemotherapy combined with radiotherapy improved the DMFS when compared with the RT group, but this effect was not observed in the low RKIP expression subgroup. RKIP was predictive of distant metastasis with good sensitivity and specificity. Clinically, high RKIP expression inhibited distant metastasis in advanced NPC, and its detection might be used to predict distant metastasis with good sensitivity and specificity. The effect of chemotherapy on distant metastasis in combined chemoradiotherapy might be related to the RKIP expression level. Patients with high RKIP expression showed more improved OS and PFS than their low RKIP expression counterparts. Higher RKIP expression improves the DMFS of patients who receive inductive high-dose cisplatin-based chemoradiotherapy, with or without concurrent cisplatin. Low RKIP expression is also a predictive marker for cancer progression and metastasis, which could be used to stratify patients with high risk of metastasis and death.
引用
收藏
相关论文
共 107 条
[1]  
Chen L(2012)Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial Lancet Oncol 13 163-171
[2]  
Hu CS(2006)Elevated plasma big ET-1 is associated with distant failure in patients with advanced-stage nasopharyngeal carcinoma Cancer 106 1548-1553
[3]  
Chen XZ(2009)Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma J Clin Oncol 27 242-249
[4]  
Mai HQ(2008)Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of china Int J Radiat Oncol Biol Phys 71 1356-1364
[5]  
Zeng ZY(2010)Prognostic factors of 305 nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy Chin J Cancer 29 145-150
[6]  
Zhang CQ(2004)Prognostic value of epidermal growth factor receptor expression in patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy and radiotherapy Int J Radiat Oncol Biol Phys 59 11-20
[7]  
Hui EP(2011)RAF kinase inhibitory protein (RKIP) modulates cell cycle kinetics and motility Mol BioSyst 7 928-941
[8]  
Ma BB(2003)Effects of Raf kinase inhibitor protein expression on suppression of prostate cancer metastasis J Natl Cancer Inst 95 878-889
[9]  
Leung SF(2005)Reduction of Raf-1 kinase inhibitor protein expression correlates with breast cancer metastasis Clin Cancer Res 11 7392-7397
[10]  
Chen Y(2009)Effects of raf kinase inhibitor protein expression on metastasis and progression of human breast cancer Mol Cancer Res 7 832-840