title: Baseline serum lactate dehydrogenase levels for patients treated with intensity-modulated radiotherapy for nasopharyngeal carcinoma: a predictor of poor prognosis and subsequent liver metastasis.
abstract: OBJECTIVE
  To evaluate the prognostic value of baseline serum lactate dehydrogenase (LDH) levels in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT).
  
  
  METHODS
  Cases of NPC (n = 465) that involved treatment with IMRT with or without chemotherapy were retrospectively analyzed.
  
  
  RESULTS
  The mean (±SD) and median baseline serum LDH levels for this cohort were 172.77 ± 2.28 and 164.00 IU/L, respectively. Levels of LDH were significantly elevated in patients with locoregionally advanced disease (p = 0.016). Elevated LDH levels were identified as a prognostic factor for rates of overall survival (OS), disease-free survival (DFS), and distant metastasis-free survival (DMFS), with p values <0.001 in the univariate analysis and p < 0.001, p = 0.004, and p = 0.003, respectively, in the multivariate analysis. Correspondingly, the prognostic impact of patient LDH levels was found to be statistically significant for rates of OS, DFS, and DMFS (p = 0.028, 0.024, and 0.020, respectively). For patients who experienced subsequent liver failure after treatment, markedly higher pretreatment serum LDH levels were detected compared with patients experiencing distant metastasis events at other sites (p = 0.032).
  
  
  CONCLUSIONS
  Elevated baseline LDH levels are associated with clinically advanced disease and are a poor prognosticator for OS, DFS, and DMFS for NPC patients. These results suggest that elevated serum levels of LDH should be considered when evaluating treatment options.
authors: Department of Radiation Oncology, Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors: Guan-Qun
authors: GQ
authors: Zhou
authors: Ling-Long
authors: LL
authors: Tang
authors: Yan-Ping
authors: YP
authors: Mao
authors: Lei
authors: L
authors: Chen
authors: Wen-Fei
authors: WF
authors: Li
authors: Ying
authors: Y
authors: Sun
authors: Li-Zhi
authors: LZ
authors: Liu
authors: Li
authors: L
authors: Li
authors: Ai-Hua
authors: AH
authors: Lin
authors: Jun
authors: J
authors: Ma
mesh_terms: D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary; D002681:China; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D007770:L-Lactate Dehydrogenase