Regular post-treatment surveillance is associated with improved survival in nasopharyngeal carcinoma: a retrospective study.

IF 5.8 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2026-10-10 DOI:10.1016/j.radonc.2026.111818

Chen-Fei Wu, Qiu-Yi Pan, Yu-Xian Yang, Jia Kou, Yan-Fu Peng, Li-Lin, Jun Ma, Ying Sun, Jia-Wei Lv, Guan-Qun Zhou

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引用次数: 0

Abstract

Purpose: Benefit of post-treatment surveillance in nasopharyngeal carcinoma (NPC), characterized by high recurrence risk, remains unexplored. We explored whether regular post-treatment surveillance facilitates earlier recurrence detection and improves survival.

Methods and materials: We identified 8,798 patients with non-metastatic stage I-IVA NPC at Sun Yat-sen University Cancer Center. The 1-year landmark analysis was chosen as representative of surveillance patterns, dividing patients into regular and irregular surveillance group based on surveillance intensity. Cox proportional hazards models clarified the association between overall survival (OS) and surveillance intensity, with subgroup analyses stratified by clinical stage and pretreatment Epstein-Barr virus DNA level. Survival impact of surveillance imaging for local, regional, and distant sites were also investigated.

Results: Median follow-up was 64.8 months. 1-year landmark analysis comprised 4,078 and 4,720 patients receiving regular (≥ 4 visits in the first year) and irregular surveillance (< 4 visits), respectively. Regular surveillance was linked to shorter median recurrence time (26.1 versus 27.0 months) and improved OS (HR, 0.86; 95% CI, 0.74-0.99; P = 0.032) after multivariable adjustment. Notably, patients receiving regular imaging surveillance for distant site had better OS (HR, 0.69; 95% CI, 0.57-0.82; P < 0.001) whereas imaging for local (HR, 1.36; 95% CI, 0.90-2.04; P = 0.140) and regional site (HR, 0.85; 95% CI, 0.57-1.27; P = 0.428) did not. Regular surveillance patients with distant metastases exhibited fewer metastatic organs (P < 0.001) and earlier recurrence stages (P < 0.001), translating into prolonged post-recurrence survival (HR, 0.68; 95% CI, 0.58-0.80; P < 0.001).

Conclusions: Regular post-treatment surveillance, particularly distant imaging, could improve NPC survival, highlighting an urgency for evidence-based post-treatment surveillance strategies.

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常规治疗后监测与鼻咽癌患者生存率提高相关：一项回顾性研究。

目的：鼻咽癌（NPC）具有高复发风险，治疗后监测的益处尚不清楚。我们探讨了定期的治疗后监测是否有助于早期发现复发并提高生存率。方法和材料：我们在中山大学肿瘤中心鉴定了8798例非转移性I-IVA期鼻咽癌患者。选择1年里程碑式分析作为监测模式的代表，根据监测强度将患者分为定期监测组和不定期监测组。Cox比例风险模型明确了总生存期（OS）与监测强度之间的关系，并根据临床分期和预处理Epstein-Barr病毒DNA水平进行亚组分析。监测成像对当地、区域和遥远地点的生存影响也进行了调查。结果：中位随访时间为64.8 个月。1年里程碑式分析包括4,078例和4,720例患者，分别接受定期（第一年≥4次）和不定期（< 4次）监测。多变量调整后，定期监测与较短的中位复发时间（26.1 vs 27.0 个月）和改善的OS （HR, 0.86; 95% CI, 0.74-0.99; P = 0.032）相关。值得注意的是，定期接受远端影像学监测的患者有更好的OS （HR, 0.69; 95% CI, 0.57-0.82; P ）结论：定期治疗后监测，特别是远端影像学监测，可以提高鼻咽癌生存率，强调了循证治疗后监测策略的紧迫性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.