title: Prognostic factors of poorly-differentiated squamous cell carcinoma of the nasopharynx.
abstract: Retrospective analysis was performed with intent to evaluate prognostic factors in radiation therapy for 72 patients with histologically confirmed poorly-differentiated squamous cell carcinoma of the nasopharynx. The 10-year overall actuarial and cause specific survival rates were 36 and 40%, respectively. The median survival time was 43 months. Sixteen patients survived for more than 10 years (maximum 297 months). The five- and 10-year cause specific survival rates for Stages I, II, III and IV disease were 100 and 100%, 80 and 27%, 83 and 83%, and 38 and 31%, respectively. Two patients with Stage II disease died of a re-recurrent tumor more than seven years after their initial treatment. There was a significant difference between the survival curve for Stage I or III disease and that for Stage IV disease (P < 0.05). The patients with a T1-3 tumor had a statistically better survival rate than those with a T4 tumor (T1:T4, P < 0.001, T2 or T3:T4, P < 0.05). The patients with N0 had statistically better survival rates than those with N3 (P < 0.01). Twenty-eight patients developed loco-regional recurrence. Twenty-one patients developed distant bone metastases, most of which occurred within a year of the initiation of radiation therapy. The survival for the patients with loco-regional recurrence was nearly the same as that for the patients without loco-regional recurrence. The 10-year survival rates for patients with and without distant bone metastases were 0 and 48%, respectively (P < 0.001). Multivariate analysis revealed that the parameters influencing cause specific survival were stage categories of T and N, and adjuvant chemotherapy, whereas those influencing loco-regional recurrence were only stage categories of T and N. The only parameter to influence distant bone metastases was sex. We concluded the most important cause of failure for the patients with poorly-differentiated squamous cell carcinoma of the nasopharynx to be distant bone metastases.
authors.affiliation: Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi.
authors.forename: N
authors.initials: N
authors.lastname: Mitsuhashi
authors.forename: H
authors.initials: H
authors.lastname: Niibe
authors.forename: K
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Tamaki
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Yamakawa
authors.forename: I
authors.initials: I
authors.lastname: Hashida
authors.forename: T
authors.initials: T
authors.lastname: Akimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kiryu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate