Jianyuan Zhang1, Shaojun Chen2, Guisheng Li2, Weihua Zhang1, Tingting Qin1, Ping Yin1, Haixin Huang3, Hongwei Jiang4. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. 2. Department of Oncology, The Forth Affiliated Hospital of Guangxi Medical University, Liuzhou, 545005, Guangxi, China. 3. Department of Oncology, The Forth Affiliated Hospital of Guangxi Medical University, Liuzhou, 545005, Guangxi, China. huanghaixinliuzhou@163.com. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. jhwccc@126.com.
Abstract
PURPOSE: To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC). METHODS: We reviewed data of locoregionally advanced NPC patients who underwent 2 different treatment plans, 1 with induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) and the other with only concurrent chemoradiotherapy (CCRT). All patients received cisplatin 80 mg/m2 3 weeks one cycle concurrently with intensity-modulated radiation therapy, and three IC protocols were included for the IC + CCRT group. RESULTS: Data of 262 patients treated from May 2011 to November 2014 were found eligible for our study. With a median follow-up of 29.02 months, no significant differences were detected between the two groups on the 2-year overall survival or OS rates (96.63 vs. 92.86%, P = 0.169), 2-year distant metastasis-free survival or DMFS rates (91.57 vs. 86.90%, P = 0.246) and 3-year DMFS rates (90.45 vs. 82.14%, P = 0.093). However, they were statistically different on 2-year locoregional failure-free survival or LFFS rates (94.94 vs. 86.90%, P = 0.020), 3-year OS rates (95.51 vs. 82.14%, P = 0.002) and 3-year LFFS rates (93.82 vs. 79.76%, P = 0.001). The most common severe (grade 3-4) adverse events we recorded were Nausea/vomiting (36.52 vs. 33.33%), leukopenia (14.04 vs. 4.76%), thrombocytopenia (3.93 vs. 3.57%) and hepatic toxicity (3.37 vs. 2.38%). CONCLUSION: Compared with CCRT, the treatment plan IC + CCRT produced significantly encouraging outcomes in locoregionally advanced NPC patients on local progression-free survival and 3-year overall survival position, but might raise the risk of certain adverse reactions.
PURPOSE: To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC). METHODS: We reviewed data of locoregionally advanced NPCpatients who underwent 2 different treatment plans, 1 with induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) and the other with only concurrent chemoradiotherapy (CCRT). All patients received cisplatin 80 mg/m2 3 weeks one cycle concurrently with intensity-modulated radiation therapy, and three IC protocols were included for the IC + CCRT group. RESULTS: Data of 262 patients treated from May 2011 to November 2014 were found eligible for our study. With a median follow-up of 29.02 months, no significant differences were detected between the two groups on the 2-year overall survival or OS rates (96.63 vs. 92.86%, P = 0.169), 2-year distant metastasis-free survival or DMFS rates (91.57 vs. 86.90%, P = 0.246) and 3-year DMFS rates (90.45 vs. 82.14%, P = 0.093). However, they were statistically different on 2-year locoregional failure-free survival or LFFS rates (94.94 vs. 86.90%, P = 0.020), 3-year OS rates (95.51 vs. 82.14%, P = 0.002) and 3-year LFFS rates (93.82 vs. 79.76%, P = 0.001). The most common severe (grade 3-4) adverse events we recorded were Nausea/vomiting (36.52 vs. 33.33%), leukopenia (14.04 vs. 4.76%), thrombocytopenia (3.93 vs. 3.57%) and hepatic toxicity (3.37 vs. 2.38%). CONCLUSION: Compared with CCRT, the treatment plan IC + CCRT produced significantly encouraging outcomes in locoregionally advanced NPCpatients on local progression-free survival and 3-year overall survival position, but might raise the risk of certain adverse reactions.