Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy

Wang, Wen-Jie; Li, Miao; Pan, Xin-Bin

doi:10.7150/jca.77768

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J Cancer 2022; 13(13):3452-3462. doi:10.7150/jca.77768 This issue Cite

Research Paper

Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy

Wen-Jie Wang^1*, Miao Li^1*, Xin-Bin Pan^2✉

1. Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China.
2. Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi 530021, P.R. China.
* Wen-Jie Wang and Miao Li contributed equally to this work.

Citation:

Wang WJ, Li M, Pan XB. Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy. J Cancer 2022; 13(13):3452-3462. doi:10.7150/jca.77768. https://www.jcancer.org/v13p3452.htm

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Abstract

Purpose: To identify risk factors of secondary cancer in nasopharyngeal carcinoma (NPC) patients after radiotherapy.

Materials and methods: The data of NPC patients with secondary cancer were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2016. Univariate and multivariate logistic regression analysis was performed to identify risk factors of secondary cancer. Risk factors selected from the multivariable logistic regression analysis were used to build a predicting model.

Results: A total of 3931 patients were included: 329 (8.37%) patients developed secondary cancers and 3602 (91.63%) patients did not have secondary cancers. Univariate logistic regression analysis revealed that age, race, and the American Joint Committee on Cancer (AJCC) stage were risk factors of secondary cancer. Multivariable analysis demonstrated that age [Odds ratio (OR) = 1.03, P < 0.001], race (OR = 1.17, P = 0.010), AJCC stage (OR = 0.82, P = 0.002), and chemotherapy (OR = 1.55, P = 0.028) were independent risk factors of secondary cancer. Age, race, AJCC stage, and chemotherapy were entered into a nomogram for predicting secondary cancer. The area under the ROC curve of the nomogram was 0.645 [95% confidence interval (CI): 0.617-0.673]. The decision curve showed that if the threshold probability is between 4% and 25%, using the nomogram added more benefit than either the treat-all-patients scheme or the treat-none scheme.

Conclusion: Age, race, AJCC stage, and chemotherapy were independent risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy.

Keywords: nasopharyngeal carcinoma, secondary cancer, risk factor, nomogram

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APA

Wang, W.J., Li, M., Pan, X.B. (2022). Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy. Journal of Cancer, 13(13), 3452-3462. https://doi.org/10.7150/jca.77768.

ACS

Wang, W.J.; Li, M.; Pan, X.B. Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy. J. Cancer 2022, 13 (13), 3452-3462. DOI: 10.7150/jca.77768.

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CSE

Wang WJ, Li M, Pan XB. 2022. Risk factors of secondary cancer in nasopharyngeal carcinoma patients after radiotherapy. J Cancer. 13(13):3452-3462.

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