title: Zoledronic acid combined with chemotherapy bring survival benefits to patients with bone metastases from nasopharyngeal carcinoma.
abstract: OBJECTIVE
  Bone is the most common site of metastases from nasopharyngeal carcinoma (NPC). Zoledronic acid (ZA) used to prevent skeletal-related events (SREs) of bone metastases has shown anti-tumor effects; yet, no report has been found on the survival benefit of ZA in NPC. This study aimed to evaluate whether ZA can bring survival benefits to patients with bone metastases from NPC.
  
  
  METHODS
  A total of 307 patients with of NPC who had bone metastases were analyzed retrospectively. The differences of survival between patients treated with chemotherapy combined with ZA and those with chemotherapy alone were evaluated by the log-rank test. The Cox multivariate analyses of clinical features and different treatment methods of the 307 patients were conducted.
  
  
  RESULTS
  The prevalence of SREs in the combined approach group was lower than that with chemotherapy alone (34% vs. 48%, X (2) = 7.003, P = 0.008). The combined approach group had better progression-free survival (PFS) (11.5 vs. 5.5 months, P < 0.001) and overall survival (OS) (23.5 vs. 17.5 months, P < 0.001) than chemotherapy alone group. Cox multivariate analysis identified the following independent prognostic factors: ZA treatment, bone metastatic sites, baseline serum alkaline phosphatase (ALP) level, SREs and cycles of chemotherapy.
  
  
  CONCLUSIONS
  ZA treatment combined with chemotherapy could reduce SREs and improve PFS and OS for NPC patients with bone metastases.
authors.affiliation: State Key Laboratory of Oncology in South China and Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jin
authors.forename: Xin
authors.initials: X
authors.lastname: An
authors.forename: Yu Chen
authors.initials: YC
authors.lastname: Cai
authors.forename: Ye
authors.initials: Y
authors.lastname: Cao
authors.forename: Xiu Yu
authors.initials: XY
authors.lastname: Cai
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
authors.forename: Yu Ting
authors.initials: YT
authors.lastname: Tan
authors.forename: Wen Qi
authors.initials: WQ
authors.lastname: Jiang
authors.forename: Yan Xia
authors.initials: YX
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid