State Key Laboratory of Oncology in South China and Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, China.
J Cancer Res Clin Oncol. 2011 Oct;137(10):1545-51. doi: 10.1007/s00432-011-1027-8. Epub 2011 Aug 13.
Bone is the most common site of metastases from nasopharyngeal carcinoma (NPC). Zoledronic acid (ZA) used to prevent skeletal-related events (SREs) of bone metastases has shown anti-tumor effects; yet, no report has been found on the survival benefit of ZA in NPC. This study aimed to evaluate whether ZA can bring survival benefits to patients with bone metastases from NPC.
A total of 307 patients with of NPC who had bone metastases were analyzed retrospectively. The differences of survival between patients treated with chemotherapy combined with ZA and those with chemotherapy alone were evaluated by the log-rank test. The Cox multivariate analyses of clinical features and different treatment methods of the 307 patients were conducted.
The prevalence of SREs in the combined approach group was lower than that with chemotherapy alone (34% vs. 48%, X (2) = 7.003, P = 0.008). The combined approach group had better progression-free survival (PFS) (11.5 vs. 5.5 months, P < 0.001) and overall survival (OS) (23.5 vs. 17.5 months, P < 0.001) than chemotherapy alone group. Cox multivariate analysis identified the following independent prognostic factors: ZA treatment, bone metastatic sites, baseline serum alkaline phosphatase (ALP) level, SREs and cycles of chemotherapy.
ZA treatment combined with chemotherapy could reduce SREs and improve PFS and OS for NPC patients with bone metastases.
骨骼是鼻咽癌(NPC)转移最常见的部位。唑来膦酸(ZA)用于预防骨转移的骨骼相关事件(SREs)已显示出抗肿瘤作用;然而,尚未发现 ZA 对 NPC 患者生存获益的报道。本研究旨在评估 ZA 是否能为 NPC 伴骨转移患者带来生存获益。
回顾性分析了 307 例 NPC 伴骨转移患者。采用对数秩检验比较化疗联合 ZA 治疗与单纯化疗患者的生存差异。对 307 例患者的临床特征和不同治疗方法进行 Cox 多因素分析。
联合治疗组 SRE 发生率低于单纯化疗组(34% vs. 48%,X (2) = 7.003,P = 0.008)。联合治疗组无进展生存期(PFS)(11.5 个月 vs. 5.5 个月,P < 0.001)和总生存期(OS)(23.5 个月 vs. 17.5 个月,P < 0.001)均优于单纯化疗组。Cox 多因素分析确定了以下独立预后因素:ZA 治疗、骨转移部位、基线血清碱性磷酸酶(ALP)水平、SREs 和化疗周期。
ZA 联合化疗治疗可减少 NPC 伴骨转移患者的 SREs,改善 PFS 和 OS。