Increased pretreatment levels of serum LDH and ALP as poor prognostic factors for nasopharyngeal carcinoma

Serum enzymes that play potential roles in tumor growth have recently been reported to have prognostic relevance in a diverse array of tumors.However,prognosis-related serum enzymes are rarely reported for nasopharyngeal carcinoma(NPC).To clarify whether the level of serum enzymes is linked to the prognosis of NPC,we reviewed the pretreatment data of lactate dehydrogenase(LDH),alkaline phosphatase (ALP),and glutamyl transferase (GGT) in 533 newly diagnosed NPC patients who underwent radical radiotherapy between May 2002 and October 2003 at Sun Yat-sen University Cancer Center.Patients were grouped according to the upper limit of normal values of LDH,ALP,and GGT.The Kaplan-Meier method and log-rank test were used for selecting prognostic factors from clinical characteristics and serum enzymes,and the chi-square test was applied to analyze the relationships of clinical characteristics and serum enzymes.Finally,a Cox proportional hazards model was used to identify the independent prognostic factors.We found that increased levels of LDH had poor effects on both overall survival and distant metastasis-free survival(P=0.009 and 0.035,respectively),and increased pretreatment level of serum ALP had poor effects on both overall survival and local recurrence-free survival(P=0.037 and 0.039,respectively).In multivariate analysis,increased LDH level was identified as an independent prognostic factor for overall survival.Therefore,we conclude that increased pretreatment serum LDH and ALP levels are poor prognostic factors for NPC.

Forty-six cases of nasopharyngeal carcinoma treated with 50 Gy radiotherapy plus hematoporphyrin derivative:20 years of follow-up and outcomes from the Sun Yat-sen University Cancer Center

Background:With the improved overall survival(OS) of nasopharyngeal carcinoma(NPC) patients,the importance of quality of life(Qo L) is increasingly being recognized.For some radiosensitive NPC patients,whether low?dose radio?therapy can improve the Qo L without affecting clinical efficacy is unknown.This study aimed to assess the survival rates and Qo L of NPC patients treated with 50 Gy radiotherapy plus hematoporphyrin derivative(HPD).Methods:Forty?six newly diagnosed NPC patients treated with 50 Gy radiotherapy plus HPD between June 1988 and July 1992 were analyzed.All patients were restaged according to the 7th edition of the American Joint Commit?tee on Cancer staging system.The radiotherapy plan was designed on the basis of pretreatment computed tomog?raphy.The OS,local recurrence?free survival(LRFS),distant metastasis?free survival(DMFS),and disease?free survival(DFS) rates were estimated using the Kaplan–Meier method.Qo L was assessed using the Late Radiation Morbidity Scoring Criteria of the Radiation Therapy Oncology Group.Results:The 5?year OS,LRFS,DMFS,and DFS rates were 74.3%,72.6%,82.1%,and 61.2%,respectively.The corre?sponding 10?year rates were 38.4%,62.9%,78.5%,and 49.8%,respectively,and the 20?year rates were 27.7%,51.4%,78.5%,and 40.7%,respectively.None of the patients developed severe radiation?related complications,such as radiation?induced temporal lobe necrosis,hearing loss,trismus,and dysphagia.Conclusion:Some NPC patients were sensitive to 50 Gy radiotherapy plus HPD,and this sensitivity was characterized by long?term survival without significant late treatment morbidities.