title: Serum C-reactive protein predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
abstract: BACKGROUND
  We aimed to evaluate the association of serum C-reactive protein (crp) with prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
  
  
  METHODS
  We retrospectively reviewed 79 patients with locoregionally advanced nasopharyngeal carcinoma (cT3-4N0-3M0) treated with chemoradiotherapy. Chemoradiotherapy consisted of external-beam radiotherapy to the nasopharynx (70-80 Gy), the lymph node-positive area (60-70 Gy), and the lymph node-negative area (50-60 Gy) combined with 3 cycles of various platinum-based regimens delivered at 3-week intervals. Elevated crp was defined as more than 8 mg/L. The survival rate was calculated using the Kaplan-Meier method, and univariate and multivariate analyses (Cox proportional hazards model) were used to identify factors significantly associated with prognosis.
  
  
  RESULTS
  During the median follow-up of 3.9 years (range: 1-5.5 years), 23 patients died from nasopharyngeal cancer. The 5-year cancer-specific survival (css) rate was 62.90%. Before chemoradiotherapy, 18 patients had high serum crp; the css rate in that subgroup was significantly worse than the rate in the remaining patients (p = 0.0002). Multivariate analysis showed that crp was an independent prognostic indicator of css, with a hazard ratio of 3.04 (95% confidence interval: 1.22 to 7.55; p = 0.017). Among the 18 patients with elevated serum crp, 9 achieved normal serum crp after chemoradiotherapy, of whom 5 remained living with no evidence of recurrence or metastasis during follow-up. By contrast, the remaining 9 patients in whom serum crp did not normalize after chemoradiotherapy died within 4.2 years.
  
  
  CONCLUSIONS
  Elevated serum crp before treatment predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: Y C
authors: YC
authors: Zeng
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: R
authors: R
authors: Wu
authors: Cancer Insititute, No. 1 Hospital of China Medical University, Shenyang, PR China.
authors: Y P
authors: YP
authors: Xiao
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: F
authors: F
authors: Chi
authors: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: M
authors: M
authors: Xue
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: Z Y
authors: ZY
authors: Zhang
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: R
authors: R
authors: Xing
authors: Lung Cancer Research Institute and Cancer Center, Guangdong Provincial People's Hospital, Guangzhou, PR China.
authors: W Z
authors: WZ
authors: Zhong
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: S L
authors: SL
authors: Wang
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: X
authors: X
authors: Tian
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: W
authors: W
authors: Chen
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: J J
authors: JJ
authors: Chen
authors: Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.
authors: L N
authors: LN
authors: Wu
keywords: C-reactive protein; Nasopharyngeal carcinoma; cancer-specific survival; chemoradiotherapy