Clinical Research Papers:

Higher N stage and serum ferritin, but lower serum albumin levels are associated with distant metastasis and poor survival in patients with nasopharyngeal carcinoma following intensity-modulated radiotherapy

Xiaoqian Chen, Xianfeng Long, Zhongguo Liang, Hao Lei, Ling Li, Song Qu and Xiaodong Zhu _

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Oncotarget. 2017; 8:73177-73186. https://doi.org/10.18632/oncotarget.17418

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Xiaoqian Chen1, Xianfeng Long1, Zhongguo Liang1, Hao Lei2, Ling Li1, Song Qu1 and Xiaodong Zhu1

1Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning 530021, China

2Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan 430079, China

Correspondence to:

Xiaodong Zhu, email: [email protected]

Keywords: nasopharyngeal carcinoma, serum albumin, serum ferritin, distant metastasis, intensity-modulated radiotherapy

Received: January 21, 2017    Accepted: March 29, 2017    Published: April 25, 2017


Purpose: To evaluate the potential risk factors for distant metastasis of nasopharyngeal carcinoma in Chinese patients following standard intensity-modulated radiotherapy and chemotherapy.

Methods: The potential risk factors for distant metastasis in 622 patients with newly-diagnosed primary nasopharyngeal carcinoma following standard radiotherapy and chemotherapy were evaluated retrospectively by stratification, univariate and multivariate analyses. The 5-year overall survival, distant metastasis-free survival, local recurrence-free survival and progression-free survival rates were determined.

Results: Univariate and multivariate analyses indicated that N2-3 stage, serum ferritin > 300 μg/L and serum albumin < 42 g/L were independent risk factors for distant metastasis of nasopharyngeal carcinoma (P < 0.001, P = 0.013, P = 0.002, respectively). A risk prediction model was developed as follows: 1) low-risk group: 0-1 risk factor; and 2) high-risk group: 2-3 risk factors. Compared with low-risk group, the high-risk group had significantly lower 5-year distant metastasis-free survival (76.4% vs. 89.6%, P < 0.001), overall survival (76% vs. 85.9%,P < 0.001), local recurrence-free survival (88% vs. 92.4%, P = 0.029) and progression-free survival rates (68.2% vs. 83.7%, P < 0.001). In the high-risk group, patients with three risk factors had the lowest distant metastasis-free survival rate (P = 0.036).

Conclusions: Combination of higher N stage, serum ferritin and lower serum albumin levels may be valuable for predicting distant metastasis of nasopharyngeal carcinoma patients following standard intensity-modulated radiotherapy and chemotherapy.

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