<?xml version="1.0" encoding="UTF-8"?> <!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd"> <ArticleSet> <Article> <Journal> <PublisherName>jmedicalcasereports</PublisherName> <JournalTitle>Frontiers in Medical Case Reports</JournalTitle> <PISSN>I</PISSN> <EISSN>S</EISSN> <Volume-Issue>Volume 2; Issue 2, (Jul-Dec,2021)</Volume-Issue> <PartNumber/> <IssueTopic>Multidisciplinary</IssueTopic> <IssueLanguage>English</IssueLanguage> <Season>Cancer Case Reports</Season> <SpecialIssue>N</SpecialIssue> <SupplementaryIssue>N</SupplementaryIssue> <IssueOA>Y</IssueOA> <PubDate> <Year>-0001</Year> <Month>11</Month> <Day>30</Day> </PubDate> <ArticleType>Cancer Case Reports</ArticleType> <ArticleTitle>Role of Primary and Metastasis Directed Radiotherapy in Metastatic Nasopharyngeal Cancer</ArticleTitle> <SubTitle/> <ArticleLanguage>English</ArticleLanguage> <ArticleOA>Y</ArticleOA> <FirstPage>1</FirstPage> <LastPage>12</LastPage> <AuthorList> <Author> <FirstName>Ismail</FirstName> <LastName>Ghorbel</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>N</CorrespondingAuthor> <ORCID/> </Author> </AuthorList> <DOI/> <Abstract>Background: Role of primary and metastasis directed radiotherapy established for several cancer sites. While it is not yet clarified in metastatic nasopharyngeal cancer (mNPC). Material and Method: A research of relevant studies published in the literature through Pubmed between 2000 and 2020 in English language. The following key words used; metastatic nasopharyngeal cancer, role of radiotherapy in metastatic nasopharyngeal cancer, metastasis directed radiotherapy, primary treatment in metastatic nasopharyngeal cancer. Results: Fifteen retrospective studies, one meta-analysis and one randomized controlled trial (RCT) found. All retrospective studies showed a significant overall survival (OS) benefit of primary radiotherapy in addition to induction chemotherapy. This confirmed by RCT and the meta-analysis. Number of metastasis, response to chemotherapy and EBV DNA level could be part of a prognostic scoring system to indicate primary treatment. Conclusion: primary and metastasis directed radiotherapy has a role in metastatic nasopharyngeal cancer. Further RCT are necessary to establish this indication.</Abstract> <AbstractLanguage>English</AbstractLanguage> <Keywords>Local Treatment,Metastatic,Radiotherapy,Nasopharyngeal Carcinoma,Metastasis Directed Radiation Therapy</Keywords> <URLs> <Abstract>https://jmedicalcasereports.org/ubijournal-v1copy/journals/abstract.php?article_id=15146&title=Role of Primary and Metastasis Directed Radiotherapy in Metastatic Nasopharyngeal Cancer</Abstract> </URLs> <References> <ReferencesarticleTitle>References</ReferencesarticleTitle> <ReferencesfirstPage>16</ReferencesfirstPage> <ReferenceslastPage>19</ReferenceslastPage> <References>Badwe R, Hawaldar R, Nair N, Kaushik R, Parmar V, Siddique S, Budrukkar A, Mittra I, Gupta S. Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. Lancet Oncol 2015; 16: 1380-1388. Blanchard P, Lee A, Marguet S, Leclercq J, Ng WT, Ma J, Chan AT, Huang PY, Benhamou E, Zhu G, Chua DT, Chen Y, Mai HQ, Kwong DL, Cheah SL, Moon J, Tung Y, Chi KH, Fountzilas G, Zhang L, Hui EP, Lu TX, Bourhis J, Pignon JP; MAC-NPC Collaborative Group. Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol 2015; 16: 645-655. Bookman MA. Optimal primary therapy of ovarian cancer. Ann Oncol 2016; 27: i58-i62. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394–424. Chen MY, Jiang R, Guo L, Zou X, Liu Q, Sun R, Qiu F, Xia ZJ, Huang HQ, Zhang L, Hong MH, Mai HQ, Qian CN. Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis. Chin J Cancer 2013; 32: 604-613. Flanigan, R.C., Mickisch, G., Sylvester, R., Tangen, C., Van Poppel, H. and Crawford, E.D. (2004) Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171: 1071–1076. Hu J, Kong L, Gao J, Hu W, Guan X, Lu JJ. Use of Radiation Therapy in Metastatic Nasopharyngeal Cancer Improves Survival: A SEER Analysis. Sci Rep 2017; 7: 721. Hu SX, He XH, Dong M, Jia B, Zhou SY, Yang JL, Yang S, Zhang CG, Liu P, Qin Y, Gui L. Systemic chemotherapy followed by locoregional definitive intensity-modulated radiation therapy yields prolonged survival in nasopharyngeal carcinoma patients with distant metastasis at initial diagnosis. Med Oncol 2015; 32: 224. Huang T, Su N, Zhang X, Ma S, Zhong G, Tian X, Chen Q, Tang L, Lu L, Fang Y, Cai J, Cai Q. Systemic chemotherapy and sequential locoregional radiotherapy in initially metastatic nasopharyngeal carcinoma: Retrospective analysis with 821 cases. Head Neck 2020; 42: 1970-1980. Kaplan RN, Psaila B, Lyden D. Bone marrow cells in the ‘pre-metastatic niche’: within bone and beyond. Cancer Metastasis Rev 2006; 25: 521–529. Khanfir A, Frikha M, Ghorbel A, Drira MM, Daoud J. Prognostic factors in metastatic nasopharyngeal carcinoma. Cancer Radiother 2007; 11: 461-464. Kim MY, Oskarsson T, Acharyya S, Nguyen DX, Zhang XH, Norton L, Massaguand;eacute; J. Tumor self-seeding by circulating cancer cells. Cell 2009; 139: 1315-1326. Li WZ, Lv SH, Liu GY, Liang H, Guo X, Lv X, Liu KY, Qiang MY, Chen X, Gu SZ, Xie CQ, Xia WX, Xiang YQ. Development of a Prognostic Model to Identify the Suitable Definitive Radiation Therapy Candidates in de Novo Metastatic Nasopharyngeal Carcinoma: A Real-World Study. Int J Radiat Oncol Biol Phys 2021; 109: 120-130. Liao W, He J, Gou Q, Duan B, Liu L, Ai P, Li Y, Ren K, Chen N. Synchronous Metastatic Nasopharyngeal Carcinoma: Characteristics and Survival of Patients Adding Definitive Nasopharyngeal-Neck Radiotherapy to Systematic Chemotherapy. Cancer Manag Res 2020; 12: 10211-10219. Lin S, Tham IW, Pan J, Han L, Chen Q, Lu JJ. Combined high-dose radiation therapy and systemic chemotherapy improves survival in patients with newly diagnosed metastatic nasopharyngeal cancer. Am J Clin Oncol 2012; 35: 474-479. Palma DA, Olson R, Harrow S, Gaede S, Louie AV, Haasbeek C, Mulroy L, Lock M, Rodrigues GB, Yaremko BP, Schellenberg D, Ahmad B, Griffioen G, Senthi S, Swaminath A, Kopek N, Liu M, Moore K, Currie S, Bauman GS, Warner A, Senan S. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet 2019; 393: 2051-2058. Parker CC, James ND, Brawley CD, Clarke NW, Hoyle AP, Ali A, Ritchie AWS, Attard G, Chowdhury S, Cross W, Dearnaley DP, Gillessen S, Gilson C, Jones RJ, Langley RE, Malik ZI, Mason MD, Matheson D, Millman R, Russell JM, Thalmann GN, Amos CL, Alonzi R, Bahl A, Birtle A, Din O, Douis H, Eswar C, Gale J, Gannon MR, Jonnada S, Khaksar S, Lester JF, Oand;#39;Sullivan JM, Parikh OA, Pedley ID, Pudney DM, Sheehan DJ, Srihari NN, Tran ATH, Parmar MKB, Sydes MR; Systemic Therapy for Advanced or Metastatic Prostate cancer: Evaluation of Drug Efficacy (STAMPEDE) investigators. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet 2018; 392: 2353-2366. Powell IJ, Tangen CM, Miller GJ, Lowe BA, Haas G, Carroll PR, et al. Neoadjuvant therapy before radical prostatectomy for clinical T3/T4 carcinoma of the prostate: 5-year followup, Phase II Southwest Oncology Group Study 9109. J Urol 2002; 168: 2016–2019. Rusthoven CG, Lanning RM, Jones BL, Amini A, Koshy M, Sher DJ, Bowles DW, McDermott JD, Jimeno A, Karam SD. Metastatic nasopharyngeal carcinoma: Patterns of care and survival for patients receiving chemotherapy with and without local radiotherapy. Radiother Oncol 2017; 124: 139-146. Shuang H, Feng J, Caineng C, Qifeng J, Tin J, Yuanyuan C, Xiaozhong C. The value of radical radiotherapy in the primary tumor of newly diagnosed oligo-metastatic nasopharyngeal carcinoma patients. Clin Transl Oncol 2019; 21: 213-219. Sun XS, Liang YJ, Chen QY, Guo SS, Liu LT, Sun R, Luo DH, Tang LQ, Mai HQ. Optimizing the Treatment Pattern for De Novo Metastatic Nasopharyngeal Carcinoma Patients: A Large-Scale Retrospective Cohort Study. Front Oncol 2020; 10: 543-646. Sun XS, Liu LT, Liu SL, Guo SS, Wen YF, Xie HJ, Tang QN, Liang YJ, Li XY, Yan JJ, Ma J, Chen QY, Tang LQ, Mai HQ. Identifying optimal candidates for local treatment of the primary tumor among patients with de novo metastatic nasopharyngeal carcinoma: a retrospective cohort study based on Epstein-Barr virus DNA level and tumor response to palliative chemotherapy. BMC Cancer 2019; 19: 92. Tian YH, Zou WH, Xiao WW, Zeng L, Yuan X, Bai L, Lu T, Tian Y, Han F. Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: A subset with better overall survival. Head Neck 2016; 38: 1152-1157. Toumi N, Ennouri S, Charfeddine I, Daoud J, Khanfir A. Prognostic factors in metastatic nasopharyngeal carcinoma. Braz J Otorhinolaryngol 2020; 4: S1808-8694(20)30092-6. Tzelepi V, Efstathiou E, Wen S, Troncoso P, Karlou M, Pettaway CA, Pisters LL, Hoang A, Logothetis CJ, Pagliaro LC. Persistent, biologically meaningful prostate cancer after 1 year of androgen ablation and docetaxel treatment. J Clin Oncol 2011; 29: 2574–2581. Verma V, Allen PK, Simone CB 2nd, Gay HA, Lin SH. Addition of Definitive Radiotherapy to Chemotherapy in Patients With Newly Diagnosed Metastatic Nasopharyngeal Cancer. J Natl Compr Canc Netw 2017; 15: 1383-1391. Wang G and Shen L. The efficacy of locoregional radiotherapy plus chemotherapy vs. chemotherapy alone in metastatic nasopharyngeal carcinoma: a meta-analysis. Ann Palliat Med 2021; 20: 1561. Wang P, Zhang M, Ke C, Cai C. The efficacy and toxicity of induction chemotherapy plus concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99: e19360. Yin Z, Zhang X, Wang Y, Wang P, Yuan Z. The combination of systemic therapy and locoregional radiotherapy prolongs survival in newly diagnosed metastatic nasopharyngeal carcinoma patients. Onco Targets Ther 2017; 10: 5677-5683. You R, Liu YP, Huang PY, Zou X, Sun R, He YX, Wu YS, Shen GP, Zhang HD, Duan CY, Tan SH, Cao JY, Li JB, Xie YL, Zhang YN, Wang ZQ, Yang Q, Lin M, Jiang R, Zhang MX, Hua YJ, Tang LQ, Zhuang AH, Chen QY, Guo L, Mo HY, Chen Y, Mai HQ, Ling L, Liu Q, Chua MLK, Chen MY. Efficacy and Safety of Locoregional Radiotherapy with Chemotherapy vs Chemotherapy Alone in De Novo Metastatic Nasopharyngeal Carcinoma: A Multicenter Phase 3 Randomized Clinical Trial. JAMA Oncol 2020; 6: 1345-1352. Zeng L, Tian YM, Huang Y, Sun XM, Wang FH, Deng XW, Han F, Lu TX. Retrospective analysis of 234 nasopharyngeal carcinoma patients with distant metastasis at initial diagnosis: therapeutic approaches and prognostic factors. PLoS One 2014; 9: e108070.</References> </References> </Journal> </Article> </ArticleSet>