Yin Z, et al. - This study was designed to determine the role of locoregional radiotherapy (RT) when used in combination with systemic chemotherapy, for patients with newly diagnosed metastatic nasopharyngeal carcinoma (NPC), in a non-endemic region of northern China. The addition of RT to systemic chemotherapy improved survival and disease control in patients with newly diagnosed metastatic NPCs compared with historical cohort. This was particularly evident with single-organ metastasis.

Methods

• Between June 2011 and June 2016, in total, 611 patients with NPCs were newly diagnosed.
• Of these, 32 patients presented with metastasis at initial diagnosis.
• Among these 32 patients, single-organ metastasis was evident in 29 and multiple-organ metastasis was evident in 3.
• RT was administered to all patients for the treatment of local and regional disease.

Results

• All patients were followed-up for a median period of 20 months (range 9–59 months).
• Median survival was not achieved (some patients had succumbed) at the time of the last follow-up.
• The 2-year and 3-year overall survival (OS) rates were 75.2% and 50.1%, respectively.
• Patients with single- and multiple-organ metastasis indicated significant difference regarding 2-year OS: 67.5% for single- vs 0% for multiple-organ metastasis (p=0.039).
• Intensity-modulated RT resulted in a better prognosis than treatment with conventional RT: 2-year OS was 76.6% for single- vs 44.4% for multiple-organ metastasis (no significant difference was found between the 2 groups, p=0.297).
• The median progression time was 8 months (6–22 months), and the median survival after disease progression was 6 months (2–14 months) for patients with progression (all were with distant disease progression).