Combined CT-guided radiofrequency ablation with systemic chemotherapy improves the survival for nasopharyngeal carcinoma with oligometastasis in liver: Propensity score matching analysis

// Wang Li 1, * , Yutong Bai 2, * , Ming Wu 2 , Lujun Shen 1 , Feng Shi 1 , Xuqi Sun 2 , Caijin Lin 2 , Boyang Chang 1 , Changchuan Pan 3 , Zhiwen Li 2 and Peihong Wu 1 1 Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 51060, P. R. China 2 Zhong Shan Medical School, Sun Yat-sen University, Guangzhou 510080, People’s Republic of China 3 Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Second People’s Hospital of Sichuan Province, Chengdu, Sichuan 610041, P. R. China * Wang Li and Yutong Bai were co-first authors and contributed equally to this work Correspondence to: Peihong Wu, email: wuph@sysucc.org.cn Keywords: Nasopharyngeal carcinoma, liver metastasis, radiofrequency ablation, palliative chemotherapy, prognosis Received: February 25, 2016     Accepted: June 09, 2016     Published: July 02, 2016 ABSTRACT The aim of this study was to retrospectively compare the treatment efficacy of systemic chemotherapy combined with sequential CT-guided radiofrequency ablation (Chemo-RFA) to chemotherapy alone (Chemo-only) in the management of nasopharyngeal carcinoma (NPC) with liver metastasis. Between 2003 and 2011, 328 NPC patients diagnosed with liver metastasis at Sun Yat-sen University Cancer Center were enrolled. One-to-one matched pairs between Chemo-RFA group with the Chemo-only group were generated using propensity score matching. The associations of treatment modality with overall survival (OS) and progression-free survival (PFS) were determined by Cox regression. Of the patients enrolled, 37 patients (11.8 %) received combined treatment, 291 (82.2) received chemotherapy alone. The patients in Chemo-RFA group were more frequently classified as lower number (≤3) of liver metastatic lesions (P<0.001), had lower rates of bi-lobar liver metastasis (P<0.001) and extra-hepatic metastasis (P<0.001) than patients in Chemo-only group. After propensity score matching, 37 pairs of well-matched liver metastatic NPC patients were selected from different treatment groups. The adjusted hazard ratio in OS and PFS of the choice for Chemo-RFA approach to Chemo-only was 0.53 (95%CI, 0.30-0.93) and 0.60 (95%CI, 0.36-0.97), respectively. In conclusion, combined CT-guided RFA and chemotherapy approach offer the chance of improved survival for NPC patients with oligometastasis in liver, and should be considered if the ablation is technically feasible.