The goal of primary therapy in non-metastatic nasopharyngeal cancer should be radiological complete response

• Published in: The Egyptian journal of otolaryngology Vol. 38; no. 1; pp. 79 - 7
• Main Authors: Korkmaz, Mustafa, Eryılmaz, Melek Karakurt, Koçak, Mehmet Zahid, Demirkıran, Aykut, Karaağaç, Mustafa, Artaç, Mehmet
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2022; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Age; Cancer; Cancer therapies; Chemotherapy; Epstein-Barr virus; Gender; Lymphatic system; Medical prognosis; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Metastasis; Nasopharyngeal cancer; Non-metastatic nasopharyngeal cancer; Original Article; Predict; Radiation therapy; Radiological complete response; Surgery; Throat cancer; Tumors; United States > US; Predict; Non-metastatic nasopharyngeal cancer; Radiological complete response
• ISSN: 1012-5574; 2090-8539
• DOI: 10.1186/s43163-022-00267-1

Background
We aimed to investigate the effect of radiological complete response on survival outcomes in patients with non-metastatic nasopharyngeal cancer. This study is conducted as a retrospective cohort. Of the 185 patients screened, 60 were metastatic, 25 patients’ data was not available, and as a result, 92 patients were included in the study. Among the complete response (CR) and incomplete response (IR) groups, overall survival (OS), distant metastasis-free survival (DMFS), and locoregional failure-free survival (LRFFS) were evaluated.
Results
Of the 92 patients, 54 (58.6%) were CR and 38 (41.4%) were IR patients. Of the whole study group, the 5-year OS, DMFS, and LRFFS rates were 75%, 78%, and 95%, respectively. A significant difference was found between the 5-year OS (90% vs. 60%,
p
 = 0.001) and DMFS (87% vs. 65%,
p
 = 0.02) rates. However, there was no significant difference in the 5-year LRFFS rate (97% vs. 92%,
p
 = 0.16). Complete response were determined as an independent predictor for OS (HR: 0.13, 95% Cl: 0.045–0.36,
p
 < 0.001) and DMFS (HR: 0.26, 95% CI: 0.095–0.744,
p
 = 0.012).
Conclusion
As a result, the survival benefit in patients with CR after primary treatment is evident as shown in the above studies. Therefore, the aim of primary treatment should be to increase the CR rates. It is important to evaluate early tumor response to determine poor tumor regression.