J Cancer 2018; 9(1):54-63. doi:10.7150/jca.22190

Research Paper

Pre-treatment Serum Lactate Dehydrogenase is Predictive of Survival in Patients with Nasopharyngeal Carcinoma Undergoing Intensity-Modulated Radiotherapy

Ronald Wihal Oei1,2*, Lulu Ye1,2*, Fangfang Kong1,2, Chengrun Du1,2, Ruiping Zhai1,2, Tingting Xu1,2, Chunying Shen1,2, Xiaoshen Wang1,2, Xiayun He1,2, Lin Kong1,2, Chaosu Hu1,2, Hongmei Ying1,2✉

1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P.R China;
2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, P.R China.
*Ronald Wihal Oei and Lu-Lu Ye made equal contribution to this work.

Abstract

Objective: To analyze the prognostic value of pre-treatment serum lactate dehydrogenase (SLDH) level in patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT) with or without chemotherapy.

Methods: From January 2010 to March 2013, 427 eligible patients were reviewed. Pre-treatment SLDH level was measured within 2 weeks prior to treatment. Receiver operating characteristic (ROC) curve analysis was performed to select the optimal cutoff point. The impact of pre-treatment SLDH on overall survival (OS), progression-free survival (PFS) and distant metastasis-free survival (DMFS) were analyzed using Kaplan-Meier method and Cox proportional hazards model. Further propensity score matching was carried out to adjust bias.

Results: The optimal cutoff point of 168.5 IU/L was selected based on ROC curve analysis. Multivariate analysis showed that high pre-treatment SLDH level was an independent prognostic factor for OS (P=0.001), PFS (P=0.004) and DMFS (P=0.001). After propensity score matching was performed, it remained to be significantly associated with poor OS (P=0.009), PFS (P=0.015) and DMFS (P=0.008) in the adjusted model.

Conclusion: High pre-treatment SLDH level predicts poor survival in patients with NPC treated with IMRT-based therapy. As a routinely performed biomarker, pre-treatment SLDH can be utilized in combination with current Tumor-Node-Metastasis staging to predict survival and to plan a personalized treatment in these patients.

Keywords: Lactate dehydrogenase, Nasopharyngeal carcinoma, Intensity-modulated radiotherapy, Survival.

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How to cite this article:
Oei RW, Ye L, Kong F, Du C, Zhai R, Xu T, Shen C, Wang X, He X, Kong L, Hu C, Ying H. Pre-treatment Serum Lactate Dehydrogenase is Predictive of Survival in Patients with Nasopharyngeal Carcinoma Undergoing Intensity-Modulated Radiotherapy. J Cancer 2018; 9(1):54-63. doi:10.7150/jca.22190. Available from http://www.jcancer.org/v09p0054.htm