The Second Affiliated Hospital of Nanchang University Nanchang, Jiangxi
L. Zeng; Department Of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
Purpose/Objective(s): To explore the correlation between serum uric acid (SUA) level and the prognosis of patients with advanced nasopharyngeal carcinoma(NPC) who received comprehensive treatment mainly including induction chemotherapy -IMRT- adjuvant chemotherapy. Materials/
Methods: In this study, the case data of 182 patients with advanced NPC who visited the Second Affiliated Hospital of Nanchang University from 2017 to 2021 and were approved by the Ethics Review Committee were retrospectively analyzed.Serum uric acid levels were recorded before treatment, after induction chemotherapy, after IMRT (intensity modulated radiotherapy)and after adjuvant chemotherapy.After adjuvant chemotherapy, the uric acid level is delineated by a median of 350 µmol/L.Use Kaplan-Meier method and Log-rank test to calculate and compare the 3-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS) of patients in the high uric acid group (SUA > 350 µmol/L) and the low uric acid group (SUA = 350 µmol/L). The cox proportional hazards model is used to analyze independent prognostic factors.Serum uric acid levels before treatment, after induction chemotherapy, after IMRT, and after adjuvant chemotherapy were compared among patients using repeated-measures ANOVA, and differences were judged statistically significant at P<0.05. Results: After adjuvant chemotherapy, the 3-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) in the high serum uric acid group (SUA > 350 µmol/L) were superior to the low serum uric acid group (SUA = 350 µmol/L), with statistically significant differences and P-values of 0.037, <0.001, and 0.001, respectively. However, there was no statistically significant difference in locoregional recurrence-free survival (LRFS) with a p-value of 0.424. Univariate analysis results indicated that age, N stage, and post-adjuvant chemotherapy serum uric acid levels were associated with the prognosis of NPC patients. Multivariate analysis results revealed that post-adjuvant chemotherapy serum uric acid is an independent prognostic factor affecting OS, PFS, and DMFS in nasopharyngeal carcinoma patients. According to repeated measures analysis of variance, the serum uric acid levels of NPC patients after intensity-modulated radiotherapy were lower than those before treatment, after induction chemotherapy, and post-adjuvant chemotherapy, with statistically significant differences and p-values of <0.001, <0.001, and <0.001, respectively. Conclusion: The serum uric acid levels of patients with advanced-stage NPC after receiving adjuvant chemotherapy have prognostic value for survival. Higher serum uric acid levels may be beneficial for prognosis. Advanced NPC patients may experience a decrease in uric acid after undergoing IMRT treatment.
