Zhu Yi, Song Xinmao, Li Ruichen, Quan Huatao, Yan Li
Department of Radiation, Eye and ENT Hospital, Fudan University, Shanghai, China.
Front Oncol. 2019 Nov 6;9:1179. doi: 10.3389/fonc.2019.01179. eCollection 2019.
This study assessed the prognosis of young patients with nasopharyngeal cancer (NPC), both domestic and foreign, using data from the Surveillance, Epidemiology and End Results (SEER) database, a population-based database, and departmental records. Patients diagnosed with NPC from 2004 to 2016 in the SEER database were reviewed. Young patients aged ≤30 years when diagnosed, were compared with older patients. The medical records of patients with NPC aged ≤30 years in our own department were also reviewed. The prognostic effects of different variables, including age, sex, race, tumor stage, pathology, radiation, and chemotherapy were assessed by Kaplan-Meier and Cox analyses. A total of 212 foreign and 257 domestic patients, with mean ages of 21.5 and 22.9 years and median ages of 22 and 24 years, respectively, were included. In SEER database, younger NPC patients had a more advanced tumor stage (74.5% stage III/IV vs. 63.1% in older patients) and a worse pathological differentiation, but a better prognosis ( < 0.0001). Interestingly, the younger the patient, the better the prognosis. Younger patients received a higher proportion of chemotherapy. M stage, overall stage and radiation were the primary prognostic factors. Similar and more comprehensive results were found in our center. Patients with distant metastases, at a primary visit, had worse diagnoses. Intensity-modulated radiotherapy and three-dimensional conventional radiotherapy had minimal effects on survival in young patients in our center. Most patients from our department received chemotherapy, and different induction chemotherapy regimens resulted in similar survival prognoses. Young patients with NPC usually present at an advanced stage, but have a better overall prognosis. How to treat patients with metastasis is critical for improving prognoses in young NPC patients.
本研究利用基于人群的监测、流行病学和最终结果(SEER)数据库的数据以及科室记录,评估了国内外年轻鼻咽癌(NPC)患者的预后。对2004年至2016年SEER数据库中诊断为NPC的患者进行了回顾。将诊断时年龄≤30岁的年轻患者与老年患者进行比较。还回顾了本科室年龄≤30岁的NPC患者的病历。通过Kaplan-Meier和Cox分析评估了年龄、性别、种族、肿瘤分期、病理、放疗和化疗等不同变量的预后影响。共纳入212例国外患者和257例国内患者,平均年龄分别为21.5岁和22.9岁,中位年龄分别为22岁和24岁。在SEER数据库中,年轻的NPC患者肿瘤分期更晚(74.5%为III/IV期,而老年患者为63.1%),病理分化更差,但预后更好(<0.0001)。有趣的是,患者越年轻,预后越好。年轻患者接受化疗的比例更高。M分期、总分期和放疗是主要的预后因素。在我们中心也发现了类似且更全面的结果。初诊时伴有远处转移的患者诊断更差。调强放疗和三维常规放疗对我们中心年轻患者的生存影响最小。我们科室的大多数患者接受了化疗,不同的诱导化疗方案导致相似的生存预后。年轻的NPC患者通常就诊时处于晚期,但总体预后较好。如何治疗转移患者对于改善年轻NPC患者的预后至关重要。