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Article: The time course of histologic remission after treatment of patients with nasopharyngeal carcinoma

TitleThe time course of histologic remission after treatment of patients with nasopharyngeal carcinoma
Authors
KeywordsBiopsies
Histologic remission
Nasopharyngeal carcinoma
Radiotherapy
Issue Date1999
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 1999, v. 85 n. 7, p. 1446-1453 How to Cite?
AbstractBACKGROUND. The objective of this study was to define the time course of histologic remission and to evaluate the prognostic significance of delayed histologic remission of patients with nasopharyngeal carcinoma (NPC). METHODS. Between 1986-1994, 803 patients underwent serial postradiotherapy nasopharyngeal biopsies. Patients with positive histology underwent repeated biopsies every 2 weeks until the biopsies were found to be negative or, if remission did not occur by the 12th week after radiotherapy, treatment was initiated for persistent disease. Patients with positive histology found after the fifth week but who achieved spontaneous remission before the twelfth week were considered to have delayed histologic remission. Negative histology by the sixth week was considered early histologic remission. The outcome of patients with delayed histologic remission, early histologic remission, and persistent disease were compared. RESULTS. Six hundred and seventeen patients (76.8%) had negative histology within 12 weeks of the completion of radiotherapy and 55 (6.9%) had persistent disease at Week 12. In 131 patients (16.3%) spontaneous remission was observed in repeat biopsies after initial positive histology. With increasing time after radiotherapy, the incidence of positive histology decreased but more patients were found to have persistent disease. Patients with early and delayed histologic remission had 5-year NPC control rates of 82.4% and 76.8%, respectively (P = 0.35) versus a 40% NPC control rate among patients with persistent disease (P < 0.001). The 5-year survival rates were 75.3%, 79.4%, and 54.2%, respectively, for the 3 groups (P < 0.001). CONCLUSIONS. A high proportion of early positive histology remitted spontaneously. Delayed histologic remission in NPC patients is not a poor prognostic factor and additional treatment is not necessary. A confirmatory biopsy at 10 weeks is recommended before the initiation of salvage treatment.
Persistent Identifierhttp://hdl.handle.net/10722/71933
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorNicholls, Jen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorYuen, PWen_HK
dc.contributor.authorCheng, ACKen_HK
dc.contributor.authorWan, KYen_HK
dc.contributor.authorKwong, PWKen_HK
dc.contributor.authorChoy, DTKen_HK
dc.date.accessioned2010-09-06T06:36:38Z-
dc.date.available2010-09-06T06:36:38Z-
dc.date.issued1999en_HK
dc.identifier.citationCancer, 1999, v. 85 n. 7, p. 1446-1453en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/71933-
dc.description.abstractBACKGROUND. The objective of this study was to define the time course of histologic remission and to evaluate the prognostic significance of delayed histologic remission of patients with nasopharyngeal carcinoma (NPC). METHODS. Between 1986-1994, 803 patients underwent serial postradiotherapy nasopharyngeal biopsies. Patients with positive histology underwent repeated biopsies every 2 weeks until the biopsies were found to be negative or, if remission did not occur by the 12th week after radiotherapy, treatment was initiated for persistent disease. Patients with positive histology found after the fifth week but who achieved spontaneous remission before the twelfth week were considered to have delayed histologic remission. Negative histology by the sixth week was considered early histologic remission. The outcome of patients with delayed histologic remission, early histologic remission, and persistent disease were compared. RESULTS. Six hundred and seventeen patients (76.8%) had negative histology within 12 weeks of the completion of radiotherapy and 55 (6.9%) had persistent disease at Week 12. In 131 patients (16.3%) spontaneous remission was observed in repeat biopsies after initial positive histology. With increasing time after radiotherapy, the incidence of positive histology decreased but more patients were found to have persistent disease. Patients with early and delayed histologic remission had 5-year NPC control rates of 82.4% and 76.8%, respectively (P = 0.35) versus a 40% NPC control rate among patients with persistent disease (P < 0.001). The 5-year survival rates were 75.3%, 79.4%, and 54.2%, respectively, for the 3 groups (P < 0.001). CONCLUSIONS. A high proportion of early positive histology remitted spontaneously. Delayed histologic remission in NPC patients is not a poor prognostic factor and additional treatment is not necessary. A confirmatory biopsy at 10 weeks is recommended before the initiation of salvage treatment.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.rightsCancer. Copyright © John Wiley & Sons, Inc.en_HK
dc.subjectBiopsiesen_HK
dc.subjectHistologic remissionen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subjectRadiotherapyen_HK
dc.subject.meshBiopsyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshNasopharyngeal Neoplasms - mortality - pathology - radiotherapyen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshRemission Inductionen_HK
dc.subject.meshRemission, Spontaneousen_HK
dc.subject.meshTime Factorsen_HK
dc.titleThe time course of histologic remission after treatment of patients with nasopharyngeal carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0008-543X&volume=85&spage=1446&epage=1453&date=1999&atitle=The+time+course+of+histologic+remission+after+treatment+of+patients+with+nasopharyngeal+carcinomaen_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.emailNicholls, J: jmnichol@hkucc.hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.identifier.authorityNicholls, J=rp00364en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/(SICI)1097-0142(19990401)85:7<1446::AID-CNCR4>3.0.CO;2-3en_HK
dc.identifier.pmid10193933en_HK
dc.identifier.scopuseid_2-s2.0-0033121161en_HK
dc.identifier.hkuros39979en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033121161&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume85en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1446en_HK
dc.identifier.epage1453en_HK
dc.identifier.isiWOS:000079316000004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridNicholls, J=7201463077en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridYuen, PW=7103124007en_HK
dc.identifier.scopusauthoridCheng, ACK=36055097300en_HK
dc.identifier.scopusauthoridWan, KY=7102748975en_HK
dc.identifier.scopusauthoridKwong, PWK=7006992418en_HK
dc.identifier.scopusauthoridChoy, DTK=7102939127en_HK

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