鼻咽癌伴脑转移的临床特征和预后因素。

Clinical features and prognostic factors of nasopharyngeal carcinoma with brain metastases.

机构信息

Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.

出版信息

Oral Oncol. 2024 Apr;151:106738. doi: 10.1016/j.oraloncology.2024.106738. Epub 2024 Mar 7.

DOI:10.1016/j.oraloncology.2024.106738

PMID:38458037

Abstract

BACKGROUND

Brain metastasis in nasopharyngeal carcinoma is a rare occurrence, and the characteristics of patients in this subgroup remain poorly defined. This study aims to delineate the clinical features, treatment modalities, prognostic factors, and survival of nasopharyngeal carcinoma patients with brain metastasis.

METHODOLOGY

A retrospective analysis was conducted on patients diagnosed with nasopharyngeal carcinoma who developed brain metastasis and were treated at the Sun Yat-sen University Cancer Center between July 2000 and July 2023. Clinical data from patients were collected and used to assess their survival after brain metastases and prognostic factors.

RESULTS

Among 82,434 nasopharyngeal carcinoma patients, 40 (0.06 %) developed Brain metastasis with a median follow-up of 5.1 years. The predominant histological subtype was non-keratinizing squamous cell carcinoma (85 %). The median post-BM survival was 25 months. The age, the Eastern Cooperative Oncology Group (ECOG), and the procedural treatment of BM were prognostic factors. Notably, patients receiving local treatments had significantly prolonged post-BM survival compared to those receiving systemic therapy alone (median, 47.00 vs. 11.00 months; p = 0.011).

CONCLUSIONS

This is the largest cohort of brain metastasis in nasopharyngeal carcinoma to date. Local therapeutic measures after brain metastasis can significantly enhance the prognosis of these patients, particularly when radiotherapy is applied.

摘要

背景

鼻咽癌脑转移较为罕见，该亚组患者的特征仍未明确。本研究旨在阐述鼻咽癌脑转移患者的临床特征、治疗方式、预后因素和生存情况。

方法

回顾性分析中山大学肿瘤防治中心 2000 年 7 月至 2023 年 7 月期间诊断为鼻咽癌且发生脑转移的患者的临床资料。收集患者的临床数据，评估其脑转移后的生存情况和预后因素。

结果

在 82434 例鼻咽癌患者中，有 40 例（0.06%）发生脑转移，中位随访时间为 5.1 年。主要组织学类型是非角化性鳞状细胞癌（85%）。脑转移后的中位生存时间为 25 个月。年龄、东部肿瘤协作组（ECOG）体能状态和脑转移的治疗方法是预后因素。值得注意的是，与单纯全身治疗相比，接受局部治疗的患者脑转移后生存时间显著延长（中位，47.00 个月 vs. 11.00 个月；p=0.011）。