Prognostic Factors and Treatment Outcome of Nasopharyngeal Carcinoma with Bone Metastases



This study was aimed to investigate prognostic factors of nasopharyngeal carcinoma (NPC) patients with bone metastases. A total of 72 NPC patients with bone metastases were treated in Salah Azaiz Cancer Institute between 2000 and 2012. Of the 72 patients, 33 patients had synchronous bone metastasis and 39 had metachronous bone metastasis. The survival rate was calculated by Kaplan-Meier method and compared by log-rank test. The 2- and 5- year survival rates of the 72 patients were 45.4 % and 21.7 %, respectively. The median survival was 23 months (range 2–144 months). Univariate analysis showed that the patients with synchronous bone metastasis had significantly poorer overall survival (OS) than that of the patients with metachronous bone metastasis (14 vs. 28 months, P=0.004). The use of biphosphonate therapy was a prognostic factor of NPC with bone metastasis. Patients with only single bone metastases had better survival. Our study revealed that the time of metastases and the use of biphosphonates were prognostic factors associated with better OS. Curative treatment should be considered for patients with single bone metastasis.


nasopharyngeal carcinoma ,bone metastases, prognostic factors

Full Text:

PDF Citation


Frikha M, Toumi N, Ghorbel L. Pediatric nasopharyngeal carcinoma: Anatomoclinic aspects, therapeutic results and evolutive particularities. Cancer Radiother. 2010 Jun;14(3):169-75

Ellouze R, Daoud J, Maalej M. Cancers du nasopharynx. Dans : Maalej M. Cancérologie pratique. Tunis : Centre de Publication Universitaire, 1999 : 161-69.

Ben Abdallah M, Zehani S et al. Le cancer du nasopharynx In: Registre des cancers Nord-Tunisie 1999-2003 (RCNT). Chapitre V: 37-40.

Wei WI, Sham JS: Nasopharyngeal carcinoma. Lancet 2005, 365:2041–2054

Lee AW, Ng WT, Chan YH, Sze H, Chan C: The battle against nasopharyngeal cancer. Radiother Oncol 2012, 104:272–278.

Bensoudaa Y, Kaikania W, Ahbeddoua N et al. Treatment for metastatic nasopharyngeal carcinoma. European Annals of Otorhinolaryngology, Head and Neck diseases 2011; 128:79—85

Noël G, Dessard-Diana B, Vignot S et al. Les traitements des cancers du nasopharynx : revue de la littérature. Cancer Radiother. 2002 ; 6 : 59-84

Zeng L, Tian YM, Huang Y, Sun XM et al. Retrospective analysis of 234 nasopharyngeal carcinoma patients with distant metastasis at initial diagnosis : therapeutic approches and prognostic factors. Plos ONE 2014; 9 (9): e108070.

Shen L, Dong J, Li S, Wang Y et al. M1 stage subdivision and treatment outcome of patients with bone-only metastases of nasopharyngeal carcinoma. The Oncologist2015; 20: 291-298.

Cao X, Han Y, He L et al. Risk subset of the survival for nasopharyngeal carcinoma patients

with bone metastases: Who will benefit from combined treatment? Oral Oncol 2011;47: 747–752.

Teo PM, Kwan WH, Lee WY, Leung SF, Johnson PJ. Prognosticators determining survival subsequent to distant metastasis from nasopharyngeal carcinoma. Cancer 1996 ;77: 2423–2431.

Khanfir A, Frikha M, Ghorbel A, Drira MM, Daoud J, et al. Prognostic factors in metastatic nasopharyngeal carcinoma. Cancer Radiother. 2007; 11: 461–464.

Ong YK, Heng DM, Chung B, Leong SS, Wee J, Fong KW, et al. Design of a prognostic index score for metastatic nasopharyngeal carcinoma. Eur J Cancer 2003; 39:1535–41.

Tian YM, Zeng L, Wang FH, Liu S et al.Prognostic factors in nasopharyngeal carcinoma with synchronous liver metastase: a retrospective study for the management of treatment. Radiation Oncology 2013; 8: 272.

Yeh SA, Tang Y, Lui CC, Huang EY. Treatment outcomes of patients with AJCC stage IVC nasopharyngeal carcinoma: benefits of primary Radiotherapy. Jpn J Clin Oncol 2006, 36:132–136.

Fandi A, Bachouchi M, Azli N, Taamma A, Boussen H, et al. (2000) Long-term disease-free survivors in metastatic undifferentiated carcinoma of nasopharyngeal type. J Clin Oncol 18: 1324–1330.

Au E, Ang PT. A phase II trial of 5-fluorouracil and cisplatinum in

recurrent or metastatic nasopharyngeal carcinoma.2014 Ann Oncol 5: 87–89.

Foo KF, Tan EH, Leong SS, Wee JT, Tan T, et al. (2002) Gemcitabine in metastatic nasopharyngeal carcinoma of the undifferentiated type. Ann Oncol 13: 150–156.

Wang TL, Tan YO. Cisplatin and 5-fluorouracil continuous infusion for metastatic nasopharyngeal carcinoma. Ann Acad Med Singapore 1991; 20: 601–03.

Chi KH, Chan WK, Cooper DL, et al. A phase II study of outpatient chemotherapy with cisplatin, 5-fluorouracil and leucovorin in nasopharyngeal carcinoma. Cancer 1994;73:247—52

Jin Y, An X, Cai YC et al. Zoledronic acid combined with chemotherapy bring survival benefits to patients with bone metastases from nasopharyngeal carcinoma. JCancer ResClin Oncol 2011; 137:1545–1551

Wu JS, Wong R, Johnston M, Bezjak A, Whelan T.Cancer Care Ontario Guidelines Initiative Supportive Care Group. Meta-analysis of dose fractionation radiotherapy trials for the palliation of painful bone metastasis. Int J Radiat Oncol Biol Phys 2003;55 (3):594-605.

Sze WM, Shelley MD, Held I, Wilt TJ, Mason MD. Palliation of metastatic bone pain: single fraction versus multifraction radiotherapy-a systematic review of randomized trials. Clin Oncol (R Coll Radiol) 2003; 15 (6):345-52.

Chow E, Harris K, Fan G, TsaoM, SZE WM. Palliative radiotherapy trials for bone metastasis: a systematic review. J Clin Oncol 2007;25 (11):1423-36.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

eISSN: 2312-0398

Asia Press is a professional Science, Technology and Medicine publisher, who owns rapid publication, Peer-Reviewed, Open Access Journals. Asia Press aims to promote “knowledge sharing”. As you know, the main barrier for free “knowledge sharing” is the cost of publishing and transfer. In order to encourage scholars and scientists to the max, and devote whole power to realize the aim of “knowledge sharing” and the benefit of “all” mankind, Asia Press performs a permanent policy of no charge for publication and access, and always open its door for authors worldwide.

© 2013-2017 by the Asia Press. All rights reserved.