Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Cocktail & Poster Display session

38P - Locoregional radiotherapy improves survival outcomes in de novo metastatic nasopharyngeal carcinoma treated with chemoimmunotherapy


06 Mar 2023


Cocktail & Poster Display session


Yujun Hu


Annals of Oncology (2023) 8 (1suppl_2): 100903-100903. 10.1016/esmoop/esmoop100903


Y. Hu1, T. Lu2, H. Zhang3, M. Fang2, B. Chen4, Q. Guo4, S. Lin4, Y. Wang5, P. Feng5, X. Gong2, J. Pan4, J. Li2, Y. Xia1

Author affiliations

  • 1 Department Of Radiation Oncology, Sun Yat-sen University Cancer Center, 510060 - Guangzhou/CN
  • 2 Department Of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, 330029 - Nanchang/CN
  • 3 Department Of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430000 - Wuhan/CN
  • 4 Department Of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 350014 - Fuzhou/CN
  • 5 Department Of Radiation Oncology, Sun Yat-Sen University Cancer Center, 510060 - Guangzhou/CN


This content is available to ESMO members and event participants.

Abstract 38P


We aimed to investigate the efficacy of locoregional radiotherapy (LRRT) in patients with de novo metastatic nasopharyngeal carcinoma (dmNPC) receiving chemotherapy combined with anti-programmed cell death receptor-1 monoclonal antibodies (anti-PD-1 mAbs) as first-line treatment and to identify optimal LRRT candidates based on Epstein-Barr Virus DNA (EBV DNA).


We enrolled patients with dmNPC receiving platinum-based palliative chemotherapy and anti-PD-1 mAbs followed or not followed by LRRT from four centers. The endpoints were progression-free survival (PFS), objective response rate (ORR), and overall survival (OS). Additionally, we used the inverse probability of treatment weighting (IPTW) to balance baseline characteristics of the LRRT and no-LRRT groups to minimize selection bias before the comparative analyses. Multivariate analyses were performed using the Cox proportional hazards model.


We included 163 patients with dmNPC (median follow-up: 22 months). The median PFS was 20 months, and the ORR was 69.2%; the median OS was not achieved. After the IPTW adjustments, patients who received LRRT had a significant survival benefit over those who did not receive LRRT (median PFS: 28 months vs. 14 months; ORR: 81.0% vs. 48.3%; all P <0.001). The EBV DNA level after four to six cycles of anti-PD-1 mAbs (weighted hazard ratio [HR]: 2.01, 95% confidence interval [CI]: 1.11−3.65, P = 0.02) and LRRT (weighted HR: 0.58, 95% CI: 0.34−0.99, P = 0.04) were independent prognostic factors. Patients with undetectable EBV DNA levels after four to six cycles of anti-PD-1 mAbs (early EBV DNA clearance) benefitted from LRRT (HR: 0.43, 95% CI: 0.23−0.80, P = 0.007), whereas patients with detectable levels did not (HR: 1.03, 95% CI: 0.47−2.26, P = 0.93).


Palliative chemotherapy combined with anti-PD-1 mAbs followed by LRRT was associated with improved survival outcomes in patients with dmNPC, especially for patients with early EBV DNA clearance.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.