본문 바로가기
KERD
논문KCI 등재

Neutropenia during the First Cycle of Induction Chemotherapy Is Prognostic for Poor Survival in Locoregionally Advanced Nasopharyngeal Carcinoma: A Real-World Study in an Endemic Area

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose The purpose of this study was to investigate the effect of neutropenia during the first cycle of induction chemotherapy (IC-1) on survival in locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods Eligible patients (n=545) with LANPC receiving IC+concurrent chemoradiotherapy were included. Based on nadir neutrophil after IC-1, all patients were categorized into three groups: no/grade 1-2/grade 3-4 neutropenia. Five-year overall survival (OS) and disease-free survival (DFS) were compared between groups and subgroups stratified by IC regimen. We also explored the occurrence of IC-1–induced myelosuppression events and the minimal value of post-treatment neutrophil-to-lymphocyte ratio (post-NLRmin). Univariate/multivariate analyses were performed to investigate the effect of IC-1–induced neutropenia, timing of neutropenia, number of myelosuppression events, and high post-NLRmin on OS/DFS. Results Grade 1-2/grade 3-4 neutropenia were associated with poorer OS/DFS than no neutropenia (all p < 0.05); OS/DFS were not significantly different between patients experiencing grade 1-2 vs. 3-4 neutropenia. Neutropenia had no significant effect on OS/DFS in patients receiving docetaxel–cisplatin–5-fluorouracil (TPF). Grade 1-2 (grade 3-4) neutropenia negatively influenced OS/DFS in patients receiving cisplatin–5-fluorouracil (PF) (PF and docetaxel– cisplatin [TP]; all p < 0.05). Neutropenia, two/three myelosuppression events, and high post-NLRmin ( 1.33) was most frequent on days 5-10, second and third week of IC-1, respectively. After adjustment for covariates, IC-1–induced neutropenia, two/three myelosuppression events, and post-NLRmin  1.33 were validated as negative predictors of OS/DFS (all p < 0.05); timing of neutropenia had no significant effect. Conclusion Occurrence of neutropenia, number of myelosuppression events, and high post-NLRmin during PF/TP IC-1 have prognostic value for poor survival in LANPC.

Abstract

Purpose The purpose of this study was to investigate the effect of neutropenia during the first cycle of induction chemotherapy (IC-1) on survival in locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods Eligible patients (n=545) with LANPC receiving IC+concurrent chemoradiotherapy were included. Based on nadir neutrophil after IC-1, all patients were categorized into three groups: no/grade 1-2/grade 3-4 neutropenia. Five-year overall survival (OS) and disease-free survival (DFS) were compared between groups and subgroups stratified by IC regimen. We also explored the occurrence of IC-1–induced myelosuppression events and the minimal value of post-treatment neutrophil-to-lymphocyte ratio (post-NLRmin). Univariate/multivariate analyses were performed to investigate the effect of IC-1–induced neutropenia, timing of neutropenia, number of myelosuppression events, and high post-NLRmin on OS/DFS. Results Grade 1-2/grade 3-4 neutropenia were associated with poorer OS/DFS than no neutropenia (all p < 0.05); OS/DFS were not significantly different between patients experiencing grade 1-2 vs. 3-4 neutropenia. Neutropenia had no significant effect on OS/DFS in patients receiving docetaxel–cisplatin–5-fluorouracil (TPF). Grade 1-2 (grade 3-4) neutropenia negatively influenced OS/DFS in patients receiving cisplatin–5-fluorouracil (PF) (PF and docetaxel– cisplatin [TP]; all p < 0.05). Neutropenia, two/three myelosuppression events, and high post-NLRmin ( 1.33) was most frequent on days 5-10, second and third week of IC-1, respectively. After adjustment for covariates, IC-1–induced neutropenia, two/three myelosuppression events, and post-NLRmin  1.33 were validated as negative predictors of OS/DFS (all p < 0.05); timing of neutropenia had no significant effect. Conclusion Occurrence of neutropenia, number of myelosuppression events, and high post-NLRmin during PF/TP IC-1 have prognostic value for poor survival in LANPC.

참고문헌 (30)

  1. Mao YP, "Re-evaluation of 6th edition of AJCC staging system for nasopharyngeal carcinoma and proposed improvement based on magnetic resonance imaging", Int J Radiat Oncol Biol Phys, 73, pp.1326~1334 (2009)[DOI]
  2. Sun Y, "Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial", Lancet Oncol, 17, pp.1509~1520 (2016)[DOI]
  3. Kuderer NM, "Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients", Cancer, 106, pp.2258~2266 (2006)[DOI]
  4. Lyman GH, "Predicting individual risk of neutropenic complications in patients receiving cancer chemotherapy", Cancer, 117, pp.1917~1927 (2011)[DOI]
  5. Chen Y, "Timing of chemotherapy-induced neutropenia predicts prognosis in metastatic colon cancer patients: a retrospective study in mFOLFOX6 -treated patients", BMC Cancer, 17, pp.242~ (2017)[DOI]
  6. Lee CY, "Early-onset neutropenia during perioperative chemotherapy is predictive of increased survival in patients with completely resected non-small cell lung cancer: a retrospective analysis", Anticancer Res, 33, pp.2755~2761 (2013)
  7. Kishida Y, "Chemotherapy-induced neutropenia as a prognostic factor in advanced non-small-cell lung cancer: results from Japan Multinational Trial Organization LC00-03", Br J Cancer, 101, pp.1537~1542 (2009)[DOI]
  8. Di Maio M, "Chemotherapy-induced neutropenia and treatment efficacy in advanced non-small-cell lung cancer: a pooled analysis of three randomised trials", Lancet Oncol, 6, pp.669~677 (2005)[DOI]
  9. Tewari KS, "Chemotherapy-induced neutropenia as a biomarker of survival in advanced ovarian carcinoma: an exploratory study of the Gynecologic Oncology Group", Gynecol Oncol, 133, pp.439~445 (2014)[DOI]
  10. Kim JJ, "Is chemotherapy-induced neutropenia a prognostic factor in patients with ovarian cancer?", Acta Obstet Gynecol Scand, 89, pp.623~628 (2010)[DOI]
  11. Kumpulainen EJ, "Neutropenia during adjuvant chemotherapy of breast cancer is not a predictor of outcome", Acta Oncol, 48, pp.1204~1206 (2009)[DOI]
  12. Bogani G, "Chemotherapy-related leukopenia as a biomarker predicting survival outcomes in locally advanced cervical cancer", Eur J Obstet Gynecol Reprod Biol, 208, pp.41~45 (2017)[DOI]
  13. Miyoshi N, "Myelotoxicity of preoperative chemoradiotherapy is a significant determinant of poor prognosis in patients with T4 esophageal cancer", J Surg Oncol, 99, pp.302~306 (2009)[DOI]
  14. Blay JY, "Early lymphopenia after cytotoxic chemotherapy as a risk factor for febrile neutropenia", J Clin Oncol, 14, pp.636~643 (1996)[DOI]
  15. Crawford J, "Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management", Cancer, 100, pp.228~237 (2004)[DOI]
  16. Wong G, "Cancers after renal transplantation", Transplant Rev (Orlando), 22, pp.141~149 (2008)[DOI]
  17. Xu C, "Establishing and applying nomograms based on the 8th edition of the UICC", AJCC staging system to select patients with nasopharyngeal carcinoma who benefit from induction chemotherapy plus concurrent chemoradiotherapy, 2017, pp.69, 99~107
  18. Diakos CI, "Cancerrelated inflammation and treatment effectiveness", Lancet Oncol, 15, pp.e493~e503 (2014)[DOI]
  19. Sherman RE, "Real-world evidence: what is it and what can it tell us?", N Engl J Med, 375, pp.2293~2297 (2016)[DOI]
  20. Kaplan EL, "Nonparametric estimation from incomplete observations", J Am Stat Assoc, 53, pp.457~481 (1958)[DOI]
  21. Neyeloff JL, "Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis", BMC Res Notes, 5, pp.52~ (2012)[DOI]
  22. Li XH, "An inflammatory biomarker-based nomogram to predict prognosis of patients with nasopharyngeal carcinoma: an analysis of a prospective study", Cancer Med, 6, pp.310~319 (2017)[DOI]
  23. Azab B, "The value of the pretreatment neutrophil lymphocyte ratio vs. platelet lymphocyte ratio in predicting the long-term survival in colorectal cancer", Cancer Biomark, 14, pp.303~312 (2014)[DOI]
  24. Ferrucci PF, "Baseline neutrophils and derived neutrophil-to-lymphocyte ratio: prognostic relevance in metastatic melanoma patients receiving ipilimumab", Ann Oncol, 27, pp.732~738 (2016)[DOI]
  25. Liang W, "Development and validation of a nomogram for predicting the survival of patients with non-metastatic nasopharyngeal carcinoma after curative treatment", Chin J Cancer, 35, pp.98~ (2016)[DOI]
  26. Peng H, "Prognostic value of the cumulative cisplatin dose during concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: a secondary analysis of a prospective phase III clinical trial", Oncologist, 21, pp.1369~1376 (2016)[DOI]
  27. Burdach S, "Allogeneic and autologous stem-cell transplantation in advanced Ewing tumors: an update after long-term followup from two centers of the European Intergroup study EICESS. Stem-Cell Transplant Programs at Dusseldorf University Medical Center, Germany and St. Anna Kinderspital, Vienna, Austria", Ann Oncol, 11, pp.1451~1462 (2000)[DOI]
  28. Li-Ting Liu, "The Prognostic Value of Treatment-Related Lymphopenia in Nasopharyngeal Carcinoma Patients", Cancer Research and Treatment, 50(1), pp.19~29 (2018), 대한암학회
  29. Sun W, "Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio", Head Neck, 38(Suppl 1), pp.E1332~E1340 (2016)[DOI]
  30. An X, "Elevated neutrophil to lymphocyte ratio predicts poor prognosis in nasopharyngeal carcinoma", Tumour Biol, 32, pp.317~324 (2011)[DOI]

관련 논문AI추천

The Prognostic Value of Treatment-Related Lymphopenia in Nasopharyngeal Carcinoma PatientsChao-Nan Qian, Chong Zhao, Hai-Qiang Mai, Hao-Yuan Mo, Jian-Yong Shao, Jing Tan, Jin-Xin Bei, Jun Ma, Ling Guo, Lin-Quan Tang, Li-Ting Liu, Ming-Huang Hong, Ming-Yuan Chen, Mu-Sheng Zeng, Qiu-Yan Chen, Shan-Shan Guo, Shuai Chen, Xiang Guo, Ying Sun대한암학회 · Cancer Research and Treatment2018 · 제50권 제1호Metronomic S1 Adjuvant Chemotherapy Improves Survival in Patients with Locoregionally Advanced Nasopharyngeal CarcinomaPeng Wu, Rui Zhuo, San-Gang Wu, Yi-Feng Yu대한암학회 · Cancer Research and Treatment2024 · 제56권 제4호Induction Chemotherapy Plus Concurrent Chemoradiotherapy versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma in Children and Adolescents: A Matched Cohort AnalysisChong Zhao, Hai-Qiang Mai, Jing Tan, Jin-Xin Bei, Jun Ma, Lin-Quan Tang, Li-Ting Liu, Qing-Nan Tang, Qiu-Yan Chen, Shan-Shan Guo, Shuai Chen, Xue-Song Sun, Yang Li, Yu-Jing Liang대한암학회 · Cancer Research and Treatment2018 · 제50권 제4호Long-term Survivals, Toxicities and the Role of Chemotherapy in Early-Stage Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy: A Retrospective Study with 15-Year Follow-upBoyu Chen, Chong Zhao, Fei Han, Huageng Huang, Jingjing Miao, Lin Wang, Manyi Zhu, Shaomin Huang, Weiwei Xiao, Weixiong Xia, Xiang Guo, Xiaowu Deng, Xiao Xiao, Xing Lv, Yanqun Xiang, Yinglin Peng, Yingshan Liang대한암학회 · Cancer Research and Treatment2022 · 제54권 제1호Individualized Concurrent Chemotherapy for Patients with Stage III–IVa Nasopharyngeal Carcinoma Receiving Neoadjuvant Chemotherapy Combined with Definitive Intensity-Modulated RadiotherapyCheng Lin, Jingfeng Zong, Pengjie Ji, Qiongjiao Lu, Shaojun Lin, Xiane Peng, Xiaoqiang Chen, Yuebing Chen, Zhiwei Chen대한암학회 · Cancer Research and Treatment2023 · 제55권 제4호The Role of Neoadjuvant Chemotherapy in the Treatment of Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Study (KROG 11-06) Using Propensity Score Matching Analysis계철승, 금기창, 김범석, 김연실, 김원택, 김지윤, 노재명, 문성호, 박효정, 송진호, 안용찬, 오동률, 오영택, 우홍균, 이창걸, 정웅기, 조관호, 조문준, 차지혜, 하정훈대한암학회 · Cancer Research and Treatment2016 · 제48권 제3호

이 간행물의 다른 논문 (39건)