Master Study Program of Biostatistics and Population, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.
Department of Biostatistics and Population Studies, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia,
Oncology. 2020;98(3):154-160. doi: 10.1159/000504449. Epub 2020 Jan 27.
Nasopharyngeal cancer (NPC) is a common malignancy in Southeast Asia with a high mortality rate. Previous studies have shown that the patient survival rate is <80% worldwide. At the Dharmais Cancer Hospital, NPC is the first of the top 10 diseases with the highest rate of stage III cancer progression.
This study aims to determine the 5-year survival rate of patients with NPC based on tumor response and their prognostic factors after receiving neoadjuvant chemotherapy, followed by chemoradiation.
The records of 261 patients between January 2009 and December 2013 were retrospectively analyzed. All patients with NPC who received neoadjuvant chemotherapy, followed by chemoradiation, at the Dharmais Cancer Hospital from 2009 to 2013 were identified. Patients with metastasis were excluded. The primary endpoint of this study was overall survival, which was defined as the time from the date of treatment to the date of death. The survival curve was analyzed using the Kaplan-Meier method. The Cox proportional hazard model was used for the multivariate analysis of prognostic factors.
The tumor response rates for patients with complete response (CR), partial response (PR), and progressive disease (PD) were 33.7, 45.2, and 21.2%, respectively. The 5-year overall survival rate was 38.6%. The 5-year survival rates based on tumor response among CR, PR, and PD patients were 71.0, 30.4, and 10.6%, respectively. The significant independent prognostic factors were tumor response, educational background, job, alcohol consumption, clinical stage, and prompt treatment.
The survival probability of patients with NPC receiving neoadjuvant chemotherapy, followed by chemoradiation, was higher in the CR group than in the PR and PD groups. This confirms that early detection can improve the patient's survival. Long-term follow-up is required to determine the factors influencing tumor response in NPC.
鼻咽癌（NPC）是东南亚地区常见的恶性肿瘤，死亡率较高。先前的研究表明，全球范围内的患者生存率<80%。在 Dharmais 癌症医院，NPC 是癌症进展至第三期比例最高的前 10 种疾病之首。
本研究旨在确定基于肿瘤反应以及接受新辅助化疗后接受放化疗的 NPC 患者的 5 年生存率，这些患者的肿瘤反应和预后因素。
回顾性分析了 2009 年 1 月至 2013 年 12 月间的 261 名患者的记录。所有在 2009 年至 2013 年期间在 Dharmais 癌症医院接受新辅助化疗后接受放化疗的 NPC 患者均被排除转移患者。本研究的主要终点是总生存率，定义为从治疗开始到死亡的时间。使用 Kaplan-Meier 方法分析生存曲线。使用 Cox 比例风险模型进行预后因素的多变量分析。
完全缓解（CR）、部分缓解（PR）和疾病进展（PD）患者的肿瘤反应率分别为 33.7%、45.2%和 21.2%。5 年总生存率为 38.6%。CR、PR 和 PD 患者的 5 年总生存率分别为 71.0%、30.4%和 10.6%。显著的独立预后因素是肿瘤反应、教育背景、职业、饮酒、临床分期和及时治疗。
接受新辅助化疗后接受放化疗的 NPC 患者的生存概率在 CR 组高于 PR 和 PD 组。这证实了早期检测可以提高患者的生存率。需要长期随访以确定影响 NPC 肿瘤反应的因素。
