1023P - Fate of nasopharyngeal cancer patients who developed distant metastasis as first failure following definitive radiation therapy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Head and Neck Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Ji Hyun Chang
Citation Annals of Oncology (2014) 25 (suppl_4): iv340-iv356. 10.1093/annonc/mdu340
Authors J.H. Chang
  • Radiation Oncology, Seoul National University Hospital, 110744 - Seoul/KR



No consensus has been reached on optimal treatment for nasopharyngeal cancer (NPC) patients developing distant metastasis (DM) following initial radiation therapy (RT). Authors analyzed fate of these patients based on characteristics and treatment aims.


From July 2000 to May 2012, 282 initially non-metastatic NPC patients received curative RT (+/- chemotherapy). Forty-six patients (16.3%) developed DM as first failure, and formed basis of current study.


Median interval from initial RT till DM was 11.6 (3.4-58.5) months. Most common metastatic organ was the lung (27 patients, 58.7%). Based on extent of DM and patients' condition, nine patients (19.6%) received potentially curative treatment, 33 (71.7%) did mainly palliative treatment, and four (8.7%) did supportive management only. With median follow-up of 30 (6-74) months among survivors, rates of overall survival (OS) at 2- and 5-years were 53.7% and 30.5%, respectively. On multivariate analyses, FDG PET-CT as initial staging (p = 0.001), RT plus chemotherapy as initial treatment (p = 0.012), metastatic lesion number <6 (p = 0.012), disease-free interval >9 months (p = 0.044), DM only to the lung (p = 0.006), and potentially curative treatment aim following DM (p = 0.035) were predictive of significantly better OS rates at 2 years.


Based on current study, not all patients had dismal outcomes, even after DM. Aided with high detection rate by FDG-PET/CT, aggressive treatment approach using active locoregional modality should be considered to those with favorable prognosticators.


All authors have declared no conflicts of interest.