Zhou Guan-Qun, Ren Xian-Yue, Mao Yan-Ping, Chen Lei, Sun Ying, Liu Li-Zhi, Li Li, Lin Ai-Hua, Mai Hai-Qiang, Ma Jun
State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
Sci Rep. 2016 Mar 1;6:22326. doi: 10.1038/srep22326.
The prognostic value of dynamic serum lactate dehydrogenase (LDH) levels in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) hasn't been explored. We retrospectively analyzed 1,428 cases of NPC treated with IMRT with or without chemotherapy. Elevated pre- and/or post-treatment LDH levels were found to be associated with unfavorable overall survival (OS), disease-free survival (DFS) and distant metastasis-free survival (DMFS), but not with local relapse-free survival (LRFS). The dynamic variations in LDH levels were prognostic factors for OS, DFS and DMFS, but not for LRFS. Multivariate analysis revealed that the N category, T category, post-treatment serum LDH level and age were independent prognostic factors for OS. Our results demonstrated that dynamic variations in LDH levels were associated with risk of distant failure and death, which may shed light on the dynamics of the disease and the response to therapy. We consider that LDH measurements will be of great clinical importance in the management of NPC, especially, when considering "decision points" in treatment algorithms. Therefore, we strongly recommend that LDH levels should be determined before and after treatment in NPC patients and the results integrated into decisions regarding treatment strategies.
调强放疗（IMRT）治疗的鼻咽癌（NPC）患者血清乳酸脱氢酶（LDH）水平动态变化的预后价值尚未得到研究。我们回顾性分析了1428例接受IMRT联合或不联合化疗的NPC患者。治疗前和/或治疗后LDH水平升高与总生存期（OS）、无病生存期（DFS）和无远处转移生存期（DMFS）不佳相关，但与无局部复发生存期（LRFS）无关。LDH水平的动态变化是OS、DFS和DMFS的预后因素，但不是LRFS的预后因素。多因素分析显示，N分期、T分期、治疗后血清LDH水平和年龄是OS的独立预后因素。我们的结果表明，LDH水平的动态变化与远处失败和死亡风险相关，这可能有助于了解疾病的动态变化和对治疗的反应。我们认为，LDH检测在NPC的管理中具有重要的临床意义，特别是在考虑治疗方案中的“决策点”时。因此，我们强烈建议在NPC患者治疗前后测定LDH水平，并将结果纳入治疗策略的决策中。
