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Patterns of failure in patients with nasopharyngeal cancer of Northeastern region of India: a retrospective observational study

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Abstract

Purpose

We aimed to analyze patterns of failure and disease volume-treatment outcomes in patients with Nasopharyngeal carcinoma (NPC) treated with definitive radiation with or without concurrent chemotherapy at a tertiary cancer centre in northeast India.

Methods

From February 2018 to February 2022, 99 histopathologically proved non-metastatic NPC patients treated with curative-intent RT with or without chemotherapy were retrospectively analyzed. Locally advanced patients received neoadjuvant or adjuvant chemotherapy. The Cox proportional hazards model was used to investigate the impact of various prognostic factors on locoregional free survival (LRFS), distant metastasis free survival (DMFS), progression free survival (PFS) and overall survival (OS). The log-rank test and Kaplan–Meir curves compared outcome variables based on ROC analysis-classified tumor volume.

Results

During a median follow up of 25.4 months (17.3–39.2), 35(35.4%) patients developed recurrence. Twenty-three patients developed locoregional failures, of which 11 were in-field; 12 patient showed an out-field failure. The 3-year LRFS, DMFS, PFS and OS was 71.10%, 70.90%, 64.10% and 74.10% respectively. There was statistically significant difference in LRFS according to T staging (p < 0.0001). Gross tumor volume (GTVp) and gross nodal volume (GTVn) were an independent prognostic factor for OS, PFS, LRFS and DMFS. The cut-off volumes for GTVp and GTVn for distant metastases and locoregional failure, respectively, were found to be 13 and 22.7 mL and 3.7 and 39.2 mL, respectively, by ROC curve analysis. Based on this, 99 patients were divided into three subgroups. OS demonstrated significant differences among patients in different volume subgroups for GTVp (p = 0.03) and GTVn (p = 0.00024).

Conclusions

For NPC patients who undergo curative IMRT, primary tumour and nodal volumes are independent prognostic indicators. GTVp and GTVn are highly predictive of local control, distant metastases, disease-free survival, and overall survival. This justifies their use as quantitative prognostic indicator for NPC.

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Data availability

All data generated or analyzed during this study are included in this article and further enquiries can be directed to the corresponding author.

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Authors and Affiliations

  1. Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India

    Mouchumee Bhattacharyya, Jyotiman Nath, Apurba Kumar Kalita & Yanpothung Yanthan

  2. Department of Radiation Oncology, All India Institute of Medical Sciences, Guwahati, Assam, India

    Partha Pratim Medhi

  3. Department of Radiation Oncology, Tata Memorial Hospital, Dr. E Borges Road, Parel, Mumbai, 400012, India

    Prashasti Sharma

  4. Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India

    Partha Sarathi Roy

  5. Department of Head and Neck Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India

    Tashnin Rahman

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  1. Mouchumee Bhattacharyya
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Bhattacharyya, M., Medhi, P.P., Sharma, P. et al. Patterns of failure in patients with nasopharyngeal cancer of Northeastern region of India: a retrospective observational study. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08624-x

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