Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma
Abstract Background The study aims to evaluate the outcomes of metastasis‐directed stereotactic body radiation therapy (SBRT) in metastatic nasopharyngeal carcinoma (mNPC). Methods We reviewed all SBRT conducted in patients with mNPC in our institution between 2013 and 2022. Systemic therapy was per...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6764 |
| _version_ | 1797277174840950784 |
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| author | Jiangping Yang Wenjun Liao Shitong Su Ni Zeng Shichuan Zhang Jinlan He Nianyong Chen |
| author_facet | Jiangping Yang Wenjun Liao Shitong Su Ni Zeng Shichuan Zhang Jinlan He Nianyong Chen |
| author_sort | Jiangping Yang |
| collection | DOAJ |
| description | Abstract Background The study aims to evaluate the outcomes of metastasis‐directed stereotactic body radiation therapy (SBRT) in metastatic nasopharyngeal carcinoma (mNPC). Methods We reviewed all SBRT conducted in patients with mNPC in our institution between 2013 and 2022. Systemic therapy was performed with chemotherapy with or without anti‐programmed death‐1 (PD‐1) therapy. Local treatment delivered with ablative purpose in stereotactic setting with dose/fraction ≥5 Gy was evaluated. Kaplan–Meier analyses were used to determine the rates of local control (LC), progression‐free survival (PFS), and overall survival (OS). Univariate and multivariate analyses were performed by Cox regression. Results A total of 54 patients with 76 metastatic sites receiving SBRT were analyzed. Median follow‐up was 49 months. The 3‐year LC, PFS, and OS rates were 89.1%, 29.4%, and 57.9%, respectively. Adding a PD‐1 inhibitor to SBRT tended to prolong median OS (50.1 vs. 32.2 months, p = 0.068). Patients receiving a biological effective dose (BED, α/β = 10) ≥ 80 Gy had a significantly longer median OS compared to those who received a lower dose (not reached vs. 29.5 months, p = 0.004). Patients with oligometastases (1–5 metastases) had a better median OS (not reached vs. 29.5 months, p < 0.001) and PFS (34.3 vs. 4.6 months, p < 0.001). Pretreatment EBV‐DNA and maintenance therapy were also significant predictors for OS. Conclusions Metastatic NPC patients could benefit from metastases‐directed SBRT in combination with systemic therapy. |
| first_indexed | 2024-03-07T15:43:51Z |
| format | Article |
| id | doaj.art-aec8bd418cb84d0fbf396e2972d43f8e |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-07T15:43:51Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-aec8bd418cb84d0fbf396e2972d43f8e2024-03-05T06:22:52ZengWileyCancer Medicine2045-76342024-01-01131n/an/a10.1002/cam4.6764Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinomaJiangping Yang0Wenjun Liao1Shitong Su2Ni Zeng3Shichuan Zhang4Jinlan He5Nianyong Chen6Department of Head and Neck Oncology and Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu ChinaDepartment of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu ChinaDepartment of Head and Neck Oncology and Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu ChinaDepartment of Head and Neck Oncology and Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu ChinaDepartment of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu ChinaDepartment of Head and Neck Oncology and Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu ChinaDepartment of Head and Neck Oncology and Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital Sichuan University Chengdu ChinaAbstract Background The study aims to evaluate the outcomes of metastasis‐directed stereotactic body radiation therapy (SBRT) in metastatic nasopharyngeal carcinoma (mNPC). Methods We reviewed all SBRT conducted in patients with mNPC in our institution between 2013 and 2022. Systemic therapy was performed with chemotherapy with or without anti‐programmed death‐1 (PD‐1) therapy. Local treatment delivered with ablative purpose in stereotactic setting with dose/fraction ≥5 Gy was evaluated. Kaplan–Meier analyses were used to determine the rates of local control (LC), progression‐free survival (PFS), and overall survival (OS). Univariate and multivariate analyses were performed by Cox regression. Results A total of 54 patients with 76 metastatic sites receiving SBRT were analyzed. Median follow‐up was 49 months. The 3‐year LC, PFS, and OS rates were 89.1%, 29.4%, and 57.9%, respectively. Adding a PD‐1 inhibitor to SBRT tended to prolong median OS (50.1 vs. 32.2 months, p = 0.068). Patients receiving a biological effective dose (BED, α/β = 10) ≥ 80 Gy had a significantly longer median OS compared to those who received a lower dose (not reached vs. 29.5 months, p = 0.004). Patients with oligometastases (1–5 metastases) had a better median OS (not reached vs. 29.5 months, p < 0.001) and PFS (34.3 vs. 4.6 months, p < 0.001). Pretreatment EBV‐DNA and maintenance therapy were also significant predictors for OS. Conclusions Metastatic NPC patients could benefit from metastases‐directed SBRT in combination with systemic therapy.https://doi.org/10.1002/cam4.6764distant metastasisnasopharyngeal carcinomaPD‐1 inhibitorsstereotactic body radiation therapysurvival |
| spellingShingle | Jiangping Yang Wenjun Liao Shitong Su Ni Zeng Shichuan Zhang Jinlan He Nianyong Chen Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma Cancer Medicine distant metastasis nasopharyngeal carcinoma PD‐1 inhibitors stereotactic body radiation therapy survival |
| title | Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma |
| title_full | Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma |
| title_fullStr | Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma |
| title_full_unstemmed | Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma |
| title_short | Long‐term outcomes of metastasis‐directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma |
| title_sort | long term outcomes of metastasis directed stereotactic body radiation therapy in metastatic nasopharyngeal carcinoma |
| topic | distant metastasis nasopharyngeal carcinoma PD‐1 inhibitors stereotactic body radiation therapy survival |
| url | https://doi.org/10.1002/cam4.6764 |
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