Prognostic Analysis Of Patients With Distant Mtastasis From Nasopharyngeal Carcinoma After Radical Radiation Therapy

Objective: To study the prognostic factors of nasopharyngeal carcinoma patients who developed distant metastasis after radical radiation therapy, and further analyse the characteristics and survival relative factors of the long-term survivors who had undergone retreatment, which can be the basis of the individual and regulate therapeutic regimen.Methods: There was 184 distant metastatic nasopharyngeal carcinoma patients after radical radiotherapy enrolled in this retrospective research. Kaplan-Meier curve and log-rank test was used for the survival test, and Cox regression analysis was used for multivariate prognostic analysis. For the long-term survivors, characteristics and survival relative factors were evaluated and summarized. Results:The median survival was 12 months for the whole group, 1,2,3-year survival was 50.6% ,30.7% and 20.9%, respectively. Univariate analysis showed that the relative factors with the survival time of patients in distant metastatic nasopharyngeal carcinoma were included N staging, chemotherapy or not in the initial treatment and after distant metastasis , the cycle numbers of chemotherapy, whether or not alleviated radiotherapy was given after metastasis,the time interval between the end of radiotherapy and the occurrence of distant metastasis.Muhivariable analysis indicated that factors including N staging at initial diagonosis,site of metastatic lesions,whether or not chemotherapy was given,the time interval between the end of radiotherapy and the occurrence of distant metastasis had independent prognostic signiticance. For the long-term survivors ,we summarized their characteristics asfollows:①The median time from the end of radiotherapy to metastasis≥22 months.②metastatic site was single organ, single site, small metastasis or multiple bone metastases but localized.③Received chemotherapy and more than 4 cycles for the metastatic patients.④Received palliative radiotherapy for metastasis (single or multiple) .Conclusion: This study shows as follows:(1)The prognosis of patients with metastatic nasopharyngeal carcinoma is significant related with the time from the end of radiotherapy to distant metastasis,metastatic sites, the numbers of metastatic lesions, and treatment,etc.(2) Systemic chemotherapy and local palliative radiotherapy are main treatment in patients with metastatic nasopharyngeal carcinoma.