{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:02:58Z","timestamp":1790089378664,"version":"4.0.1"},"reference-count":23,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Objective: This study aimed to examine the association between exposure to ambient fine (PM2.5) and coarse (PM10-2.5) particulate matter and survival outcomes among patients with nasopharyngeal carcinoma. Methods: A retrospective study was conducted among patients with nasopharyngeal carcinoma. Annual mean levels of ambient particulate matter and gaseous air pollutants were assessed from the Thailand Pollution Control Department. The Cox proportional hazards model was used to estimate the association between exposure to PM2.5 and PM10-2.5, categorized into four concentration quartiles, and survival outcomes. Results: One hundred and forty patients were included. Five-year overall survival (OS) and disease-free survival (DFS) were 73.1% and 61.9%, respectively. Univariable and multivariable analyses showed that increased PM2.5 exposure was not significantly associated with OS or DFS. In multivariable analysis, higher PM10-2.5 exposure categories were associated with poorer survival outcomes. Compared with patients in the lowest exposure quartile, those in the highest PM10-2.5 exposure quartile demonstrated significantly poorer OS (aHR 8.12, 95% CI 1.30\u201315.27) and DFS (aHR 9.17, 95% CI 4.58\u201313.98) when comparing the 4th with the 1st quartiles of concentration. Conclusions: High exposure to PM10-2.5 was associated with an increased risk of death and disease recurrence in patients with nasopharyngeal carcinoma, with statistically significant associations observed between the highest and lowest exposure quartiles.<\/jats:p>","DOI":"10.3390\/jcm15197367","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:19:03Z","timestamp":1790086743000},"page":"7367","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Fine (PM2.5) and Coarse (PM10-2.5) Particulate Matter on Survival Outcomes in Nasopharyngeal Carcinoma Patients: A Retrospective Cohort Study in a Northern Thailand Tertiary Care Center"],"prefix":"10.3390","volume":"15","author":[{"given":"Weerachai","family":"Watcharatsiriyuth","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Phakhinee","family":"Leesirisopha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Pichit","family":"Sittitrai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Hanpon","family":"Klibngern","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4015-7494","authenticated-orcid":false,"given":"Tapanut","family":"Ariyanon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Orapan","family":"Sangiamporn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Donyarat","family":"Ruenmarkkaew","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet"},{"key":"ref_2","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s40201-024-00900-6","article-title":"Long-term exposure to air pollution on cardio-respiratory, and lung cancer mortality: A systematic review and meta-analysis","volume":"22","author":"Karimi","year":"2024","journal-title":"J. Environ. Health Sci. Eng."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"26998","DOI":"10.1038\/s41598-024-73756-3","article-title":"Air pollution exposure and head and neck cancer incidence","volume":"14","author":"Peleman","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1002\/ijc.35047","article-title":"Potential causal links of long-term exposure to PM2.5 and its chemical components with the risk of nasopharyngeal carcinoma recurrence: A 10-year cohort study in South China","volume":"155","author":"Sun","year":"2024","journal-title":"Int. J. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Fan, H.C., Chen, C.Y., Hsu, Y.C., Chou, R.H., Teng, C.J., Chiu, C.H., Hsu, C.Y., Muo, C.H., Chang, M.Y., and Chang, K.H. (2018). Increased risk of incident nasopharyngeal carcinoma with exposure to air pollution. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204568"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s10311-023-01659-2","article-title":"Adverse prognosis of nasopharyngeal carcinoma following long-term exposure to multiple air pollutants","volume":"22","author":"Lin","year":"2024","journal-title":"Environ. Chem. Lett."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"118041","DOI":"10.1016\/j.ecoenv.2025.118041","article-title":"Loss of survivorship in nasopharyngeal carcinoma attributable to fine particulate matter and its constituents","volume":"293","author":"Lin","year":"2025","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1136\/jim-2019-001119","article-title":"Association between coarse particulate matter (PM10-2.5) and nasopharyngeal carcinoma among Taiwanese men","volume":"68","author":"Huang","year":"2020","journal-title":"J. Investig. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Manisalidis, I., Stavropoulou, E., Stavropoulos, A., and Bezirtzoglou, E. (2020). Environmental and health impacts of air pollution: A review. Front. Public Health, 8.","DOI":"10.3389\/fpubh.2020.00014"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1289\/ehp.1408387","article-title":"Effects of ambient coarse, fine, and ultrafine particles and their biological constituents on systemic biomarkers: A controlled human exposure study","volume":"123","author":"Liu","year":"2015","journal-title":"Environ. Health Perspect."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gavito-Covarrubias, D., Ram\u00edrez-D\u00edaz, I., Guzm\u00e1n-Linares, J., Lim\u00f3n, I.D., Manuel-S\u00e1nchez, D.M., Molina-Herrera, A., Coral-Garc\u00eda, M.\u00c1., Anastasio, E., Anaya-Hern\u00e1ndez, A., and L\u00f3pez-Salazar, P. (2024). Epigenetic mechanisms of particulate matter exposure: Air pollution and hazards on human health. Front. Genet., 14.","DOI":"10.3389\/fgene.2023.1306600"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"24660","DOI":"10.1038\/s41598-024-76696-0","article-title":"Impact of PM2.5 exposure on mortality and tumor recurrence in resectable non-small cell lung carcinoma","volume":"14","author":"Kosanpipat","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Santib\u00e1\u00f1ez-Andrade, M., Chirino, Y.I., Gonz\u00e1lez-Ram\u00edrez, I., S\u00e1nchez-P\u00e9rez, Y., and Garc\u00eda-Cuellar, C.M. (2019). Deciphering the Code between Air Pollution and Disease: The Effect of Particulate Matter on Cancer Hallmarks. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21010136"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Shin, M., Kim, O.J., Yang, S., Choe, S.A., and Kim, S.Y. (2022). Different Mortality Risks of Long-Term Exposure to Particulate Matter across Different Cancer Sites. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19063180"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Eom, S.Y., Kim, Y.D., and Kim, H. (2022). Particulate Matter Exposure after a Cancer Diagnosis and All-Cause Mortality in a Regional Cancer Registry-Based Cohort in South Korea. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19169875"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e2400285","DOI":"10.1200\/GO-24-00285","article-title":"Changing Landscape of Head and Neck Squamous Cell Carcinoma and Nasopharyngeal Carcinoma Treatment and Survival Trends in Thailand: A 13-Year Multicenter Retrospective Study of Patients","volume":"11","author":"Ngamphaiboon","year":"2025","journal-title":"JCO Glob. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e14261","DOI":"10.1016\/j.heliyon.2023.e14261","article-title":"Airborne particulate matter from biomass burning in Thailand: Recent issues, challenges, and options","volume":"9","author":"Suriyawong","year":"2023","journal-title":"Heliyon"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e9207","DOI":"10.7717\/peerj.9207","article-title":"Acute effects of air pollution on all-cause mortality: A natural experiment from haze control measures in Chiang Mai Province, Thailand","volume":"8","author":"Vajanapoom","year":"2020","journal-title":"PeerJ"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2425066","DOI":"10.1080\/07853890.2024.2425066","article-title":"Nasopharyngeal carcinoma survival by histology in endemic and non-endemic areas","volume":"56","author":"Guo","year":"2024","journal-title":"Ann. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105876","DOI":"10.1016\/j.envint.2020.105876","article-title":"Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis","volume":"142","author":"Orellano","year":"2020","journal-title":"Environ. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2875","DOI":"10.12669\/pjms.41.10.12523","article-title":"Effect of particulate matter (PM2.5, PM10) on deaths and disability-adjusted life years (DALYs) in Gulf Cooperation Council countries: Global burden of disease time trend analysis 1990-2021","volume":"41","author":"Meo","year":"2025","journal-title":"Pak. J. Med. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Quartuccio, N., Sireci, F., Pulizzi, S., Nicolosi, S., D\u2019Oppido, D., and Ialuna, S. (2025). Predictive Value of [18F]FDG PET\/CT for Neoadjuvant Chemoradiotherapy Response in Nasopharyngeal Carcinoma. J. Clin. Med., 14.","DOI":"10.3390\/jcm14186508"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7367\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:27:59Z","timestamp":1790087279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":23,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197367"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197367","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]}}}