Liu Yang, Han Yaqian, Feng Mei, Zhang Ye, Wang Kai, Qu Yuan, Chen Xuesong, Zhang Jianghu, Luo Jingwei, Wu Runye, Li Ye-Xiong, Huang Xiaodong, Chen Qiuyan, Wang Jingbo, Yi Junlin
Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
Department of Radiation Oncology Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University Changsha China.
MedComm (2020). 2025 Mar 20;6(4):e70143. doi: 10.1002/mco2.70143. eCollection 2025 Apr.
Currently, there is little evidence supporting the use of early endpoints to assess primary treatment outcomes in nasopharyngeal carcinoma (NPC). We aim to explore the relationship between 24-month progression-free survival (PFS24) and subsequent overall survival (sOS) as well as loss of lifetime (LoL) in NPC patients. sOS is defined as survival from the 24-month point or progression within 24 months leading to mortality. LoL represents the reduction in life expectancy due to NPC, compared to the general population matched by age, sex, and calendar year. The standardized mortality ratio (SMR) is defined as the ratio of observed mortality to expected mortality. The study included 6315 patients from nonendemic and endemic regions of China. Among them, 5301 patients (83.9%) achieved PFS24, with a 5-year sOS of 90.2% and an SMR of 1.0. Over a 10-year period following treatment, the mean LoL was only 0.01 months/year. For most subgroups, patients achieving PFS24 exhibited comparable sOS and LoL with the general population. However, patients failing to achieve PFS24 showed significantly worse outcomes, with 5-year sOS of 21.9%, SMR of 23.7, and LoL of 6.48 months/year. These notable outcome disparities highlight the importance of PFS24 in NPC risk stratification, patient monitoring, and study design.
目前，几乎没有证据支持使用早期终点来评估鼻咽癌（NPC）的主要治疗结果。我们旨在探讨NPC患者24个月无进展生存期（PFS24）与后续总生存期（sOS）以及寿命损失（LoL）之间的关系。sOS定义为从24个月时开始的生存期或24个月内进展导致死亡。LoL表示与按年龄、性别和日历年匹配的一般人群相比，因NPC导致的预期寿命缩短。标准化死亡率（SMR）定义为观察到的死亡率与预期死亡率之比。该研究纳入了来自中国非流行区和流行区的6315例患者。其中，5301例患者（83.9%）实现了PFS24，5年sOS为90.2%，SMR为1.0。在治疗后的10年期间，平均LoL仅为0.01个月/年。对于大多数亚组，实现PFS24的患者表现出与一般人群相当的sOS和LoL。然而，未实现PFS24的患者显示出明显更差的结果，5年sOS为21.9%，SMR为23.7，LoL为6.48个月/年。这些显著的结果差异凸显了PFS24在NPC风险分层、患者监测和研究设计中的重要性。
