title: The impact of baseline serum C-reactive protein and C-reactive protein kinetics on the prognosis of metastatic nasopharyngeal carcinoma patients treated with palliative chemotherapy.
abstract: BACKGROUND
  The aim of this study was to determine whether baseline C-reactive protein (CRP) levels and CRP kinetics predict the overall survival in metastatic nasopharyngeal carcinoma (mNPC) patients.
  
  
  METHODS
  A total of 116 mNPC patients from January 2006 to July 2011 were retrospectively reviewed. Serum CRP level was measured at baseline and thereafter at the start of each palliative chemotherapy cycle for all patients.
  
  
  RESULTS
  Patients with higher values of baseline CRP (≥ 3.4 mg/L) had significantly worse survival than those with lower baseline CRP values (< 3.4 mg/L). Patients were divided into four groups according to baseline CRP and CRP kinetics: (1) patients whose CRP < 3.4 mg/L and never elevated during treatment; (2) patients whose CRP < 3.4 mg/L and elevated at least one time during treatment; (3) patients whose CRP ≥ 3.4 mg/L and normalized at least one time during treatment; and (4) patients whose CRP ≥ 3.4 mg/L and never normalized during treatment. The patients were further assigned to non-elevated, elevated, normalized, and non-normalized CRP groups. Overall survival rates were significantly different among the four groups, with three-year survival rates of 68%, 41%, 33%, and 0.03% for non-elevated, elevated, normalized, and non-normalized CRP groups respectively. When compared with the non-elevated group, hazard ratios of death were 1.69, 2.57, and 10.34 in the normalized, elevated, and non-normalized groups (P < 0.001).
  
  
  CONCLUSIONS
  Baseline CRP and CRP kinetics may be useful to predict the prognosis of metastatic NPC patients treated with palliative chemotherapy and facilitate individualized treatment. A prospective study to validate this prognostic model is still needed however.
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China ; State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China.
authors.forename: Wei-Xiong
authors.initials: WX
authors.lastname: Xia
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Ye
authors.forename: Xing
authors.initials: X
authors.lastname: Lu
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Liang-Ru
authors.initials: LR
authors.lastname: Ke
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Zhang
authors.forename: Mark D
authors.initials: MD
authors.lastname: Roycik
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.forename: Jun-Li
authors.initials: JL
authors.lastname: Shi
authors.forename: Ka-Jia
authors.initials: KJ
authors.lastname: Cao
authors.forename: Xiang
authors.initials: X
authors.lastname: Guo
authors.forename: Yan-Qun
authors.initials: YQ
authors.lastname: Xiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D002277:Carcinoma; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009362:Neoplasm Metastasis; D010166:Palliative Care; D011379:Prognosis; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein