Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China.
Medical Imaging Department, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China.
Radiother Oncol. 2024 Jul;196:110311. doi: 10.1016/j.radonc.2024.110311. Epub 2024 Apr 24.
We investigated the efficacy of metastatic lesion radiotherapy (MLRT) in patients with metastatic nasopharyngeal carcinoma (mNPC).
Patients with mNPC from three institutions were included in this study. Propensity score matching (PSM) was employed to ensure comparability between patient groups. Overall survival (OS) rates were assessed using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors were identified using univariate and multivariate Cox hazard analyses. Subgroup analyses were conducted to assess the effects of MLRT on specific patient populations.
We analyzed data from 1157 patients with mNPC. Patients who received MLRT had significantly better OS than those who did not, both in the original (28 vs. 21 months) and PSM cohorts (26 vs. 23 months). MLRT was identified as an independent favorable predictor of OS in multivariate analyses, with hazard ratios of 0.67. The subgroup analysis results indicated that radiotherapy effectively treated liver, lung, and bone metastatic lesions, particularly in patients with a limited tumor burden. Higher total radiation doses of MLRT (biologically effective dose (BED) ≥ 56 Gy) were associated with improved OS, while neither radiation technique nor dose fractionation independently influenced prognosis.
MLRT offers survival advantages to patients diagnosed with mNPC. Patients with limited metastatic burden derive the most benefit from MLRT, and the recommended regimen for MLRT is a minimum BED of 56 Gy for optimal outcomes.
我们研究了转移性病变放疗（MLRT）在转移性鼻咽癌（mNPC）患者中的疗效。
本研究纳入了来自三个机构的 mNPC 患者。采用倾向评分匹配（PSM）以确保患者组之间的可比性。使用 Kaplan-Meier 法评估总生存期（OS）率，并使用对数秩检验进行比较。使用单因素和多因素 Cox 风险分析确定预后因素。进行亚组分析以评估 MLRT 对特定患者人群的影响。
我们分析了 1157 例 mNPC 患者的数据。接受 MLRT 的患者的 OS 明显优于未接受 MLRT 的患者，原始队列（28 个月 vs. 21 个月）和 PSM 队列（26 个月 vs. 23 个月）均如此。多因素分析表明，MLRT 是 OS 的独立有利预测因素，风险比为 0.67。亚组分析结果表明，放疗可有效治疗肝、肺和骨转移病灶，尤其是在肿瘤负荷有限的患者中。MLRT 的总放疗剂量较高（生物有效剂量（BED）≥56Gy）与 OS 改善相关，而放疗技术和剂量分割均未独立影响预后。
MLRT 为诊断为 mNPC 的患者提供了生存优势。转移性负担有限的患者从 MLRT 中获益最多，MLRT 的推荐方案是最低 BED 为 56Gy，以获得最佳疗效。
