A multicenter real-world study reviewing relevance between CCRT and CVA for NPC: In the IMRT era
PO-1227
Abstract
A multicenter real-world study reviewing relevance between CCRT and CVA for NPC: In the IMRT era
Authors: JENG-YOU WU1,2, Min-Huei Hsu3,4
1Wan Fang Hospital, Taipei Medical University, Department of Radiation Oncology , Taipei, Taiwan; 2Taipei Medical University, Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei, Taiwan; 3Taipei Medical University, Graduate Institute of Data Science, Taipei, Taiwan; 4Shuang Ho Hospital, Taipei Medical University, Department of Neurosurgery, Taipei, Taiwan
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Purpose or Objective
Research on cancer survivorship associated with nasopharyngeal carcinoma (NPC) is rare. The advance of radiotherapy technique diverse the long-term analytic variable related with treatment. We conducted a multicenter real-world study, focused on IMRT era technique, to evaluate the relevance between cerebrovascular accidents (CVA) and those who receive concurrent chemoradiotherapy in patient with nasopharyngeal carcinoma.
Material and Methods
There are 976 patients with nasopharyngeal carcinoma treated at Taipei Medical University Hospital, Shuang-Ho Hospital and Wan-Fang Hospital between 2002-2019. 504 patients are newly diagnosed with NPC and treated with concurrent chemoradiotherapy. Host factors include age, sex, body height, body weight, alcohol drinking, betel nut chewing, smoking, etc.; tumoral factors include clinical T, clinical N, clinical cStage, histology type and treatment related factors include radiotherapy dose, gap between simulation and treatment, radiotherapy treatment duration etc. are collected. Previous medical history with diabetes meatus, hyperlipidemia, hypertension or ischemic heart disease is also retrieved by reviewing the patient’s outpatient clinical record. Recurrence patten, date, survival status and cerebrovascular accident (CVA) are also collected as major outcome for survival analysis and event analysis.
Results
In this cohort, there are 504 patients are newly diagnosed with NPC. There are 67.26% male patient. The main age group is between 40-60, which account 51.2% of the cohort. Most of the patient are stage IV (40.7%) and stage III (25.8%.) The crude one year-overall survival is 93.2%, and five-year overall survival 68.9%.
There are 56 (11.1%) patients then develop cerebrovascular accidents after receiving concurrent chemoradiotherapy. The chi-square test shows clinicalN(p=0.0235), clinical TNM stage(p=0.0222), curative radiotherapy dose or not (p<0.0001) are statistically related with CVA. For COX proportional hazard model, age as continuous variable (HR 1.033, p<0.05), obesity (HE 1.938, p<0.05) show statically significant. And the CVA-event-free survival of cerebrovascular accident is related to age (p=0.0047), obesity or not (p=0.0496), curative radiotherapy or not (p=0.0418) in log-rank test.
Conclusion
This real-world study suggests that CVA is associated with age, obesity and radiation dose for NPC patients who receive concurrent chemoradiotherapy in TMRT era. Further prospective study and long-term follow-up are warranted to clarify the relevance between cerebrovascular accidents and concurrent chemoradiotherapy in nasopharyngeal carcinoma.