J Cancer 2019; 10(16):3618-3623. doi:10.7150/jca.32621

Research Paper

Association between Pretreatment Serum High-density Lipoprotein Cholesterol and Treatment Outcomes in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy: Findings from a Randomised Trial

Cheng-Tao Wang3*, Ming-Yuan Chen1*, Xiang Guo1, Ling Guo1, Hao-Yuan Mo1, Chao-Nan Qian1, Bi-Xiu Wen3, Ming-Huang Hong2✉, Pei-Yu Huang1✉

1. Department of Nasopharyngeal carcinoma, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China.
2. Department of Epidemiology, Clinical Trial Study Center,Sun Yat-sen University Cancer Center,Guangzhou, P. R. China.
3. Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University,Guangzhou, P. R. China.
*Cheng-Tao Wang, Ming-Yuan Chen contributed equally to this article.

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Citation:
Wang CT, Chen MY, Guo X, Guo L, Mo HY, Qian CN, Wen BX, Hong MH, Huang PY. Association between Pretreatment Serum High-density Lipoprotein Cholesterol and Treatment Outcomes in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy: Findings from a Randomised Trial. J Cancer 2019; 10(16):3618-3623. doi:10.7150/jca.32621. Available from http://www.jcancer.org/v10p3618.htm

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Abstract

Background: To investigate the relationship between the pretreatment serum lipid concentrations and the clinical outcomes in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) who were treated with a combination of chemotherapy and radiotherapy.

Methods: From August 2002 to April 2005, 400 patients with stage III or stage IVa nasopharyngeal carcinoma were recruited for a randomised clinical trial of induction chemotherapy combined with radiotherapy or concurrent chemoradiotherapy. Pretreatment serum lipid concentrations were examined in 342 patients. Both univariate and multivariate analyses were conducted to investigate the association of serum lipid levels with different treatment outcomes.

Results: The 5-year failure-free survival rate for the low- high-density lipoprotein cholesterol (HDL-C) and high-HDL-C groups was 52.1% and 65.5%, respectively (p=0.017), and the 5-year overall survival rate was 64.7% and 72.5%, respectively (p=0.094). The pretreatment serum level of HDL-C was a favourable prognostic factor of overall survival and failure-free survival in a Cox regression model with HR 0.65 (95% CI 0.43-0.97; p=0.036) and 0.60 (95% CI 0.41-0.88; p =0.008). No significant correlation was observed between the prognosis of patients with NPC and serum levels of total cholesterol (TC), triglyceride (TG), or low-density lipoprotein cholesterol (LDL-C).

Conclusions: The pretreatment serum level of HDL-C was an independent prognostic factor for patients with locoregionally advanced nasopharyngeal carcinoma who were treated with chemoradiotherapy.

Keywords: high-density lipoprotein cholesterol, chemoradiotherapy, nasopharyngeal carcinoma