Oei Ronald Wihal, Ye Lulu, Kong Fangfang, Du Chengrun, Zhai Ruiping, Xu Tingting, Shen Chunying, Wang Xiaoshen, He Xiayun, Kong Lin, Hu Chaosu, Ying Hongmei
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China.
J Cancer. 2018 Jan 1;9(1):54-63. doi: 10.7150/jca.22190. eCollection 2018.
To analyze the prognostic value of pre-treatment serum lactate dehydrogenase (SLDH) level in patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT) with or without chemotherapy. From January 2010 to March 2013, 427 eligible patients were reviewed. Pre-treatment SLDH level was measured within 2 weeks prior to treatment. Receiver operating characteristic (ROC) curve analysis was performed to select the optimal cutoff point. The impact of pre-treatment SLDH on overall survival (OS), progression-free survival (PFS) and distant metastasis-free survival (DMFS) were analyzed using Kaplan-Meier method and Cox proportional hazards model. Further propensity score matching was carried out to adjust bias. The optimal cutoff point of 168.5 IU/L was selected based on ROC curve analysis. Multivariate analysis showed that high pre-treatment SLDH level was an independent prognostic factor for OS (P=0.001), PFS (P=0.004) and DMFS (P=0.001). After propensity score matching was performed, it remained to be significantly associated with poor OS (P=0.009), PFS (P=0.015) and DMFS (P=0.008) in the adjusted model. High pre-treatment SLDH level predicts poor survival in patients with NPC treated with IMRT-based therapy. As a routinely performed biomarker, pre-treatment SLDH can be utilized in combination with current Tumor-Node-Metastasis staging to predict survival and to plan a personalized treatment in these patients.
分析接受调强放疗（IMRT）联合或不联合化疗的鼻咽癌（NPC）患者治疗前血清乳酸脱氢酶（SLDH）水平的预后价值。回顾性分析2010年1月至2013年3月期间427例符合条件的患者。在治疗前2周内测量治疗前SLDH水平。采用受试者工作特征（ROC）曲线分析选择最佳截断点。采用Kaplan-Meier法和Cox比例风险模型分析治疗前SLDH对总生存期（OS）、无进展生存期（PFS）和无远处转移生存期（DMFS）的影响。进一步进行倾向评分匹配以调整偏倚。根据ROC曲线分析选择最佳截断点为168.5 IU/L。多因素分析显示，治疗前SLDH水平高是OS（P=0.001）、PFS（P=0.004）和DMFS（P=0.001）的独立预后因素。进行倾向评分匹配后，在调整模型中，其仍与较差的OS（P=0.009）、PFS（P=0.015）和DMFS（P=0.008）显著相关。治疗前SLDH水平高预示接受基于IMRT治疗的NPC患者生存较差。作为常规检测的生物标志物，治疗前SLDH可与目前的肿瘤-淋巴结-转移分期联合使用，以预测生存并为这些患者制定个性化治疗方案。
