title: Prognostic implications of dynamic serum lactate dehydrogenase assessments in nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy.
abstract: The prognostic value of dynamic serum lactate dehydrogenase (LDH) levels in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) hasn't been explored. We retrospectively analyzed 1,428 cases of NPC treated with IMRT with or without chemotherapy. Elevated pre- and/or post-treatment LDH levels were found to be associated with unfavorable overall survival (OS), disease-free survival (DFS) and distant metastasis-free survival (DMFS), but not with local relapse-free survival (LRFS). The dynamic variations in LDH levels were prognostic factors for OS, DFS and DMFS, but not for LRFS. Multivariate analysis revealed that the N category, T category, post-treatment serum LDH level and age were independent prognostic factors for OS. Our results demonstrated that dynamic variations in LDH levels were associated with risk of distant failure and death, which may shed light on the dynamics of the disease and the response to therapy. We consider that LDH measurements will be of great clinical importance in the management of NPC, especially, when considering "decision points" in treatment algorithms. Therefore, we strongly recommend that LDH levels should be determined before and after treatment in NPC patients and the results integrated into decisions regarding treatment strategies.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Guan-Qun
authors.initials: GQ
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Xian-Yue
authors.initials: XY
authors.lastname: Ren
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Mao
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Sun
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Li-Zhi
authors.initials: LZ
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Lin
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Nasopharyngeal Cancer, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Hai-Qiang
authors.initials: HQ
authors.lastname: Mai
authors.affiliation: State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002277:Carcinoma; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000532:radiotherapy; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase