Tsung-Ming Chen1, Kuan-Chou Lin2, Kevin Sheng-Po Yuan3, Chia-Lun Chang4, Jyh-Ming Chow4, Szu-Yuan Wu5. 1. Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, Taiwan. 2. Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taiwan. 3. Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taiwan. 4. Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University, Taiwan. 5. Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan. Electronic address: szuyuanwu5399@gmail.com.
Abstract
BACKGROUND: No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. METHODS: In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups. RESULTS: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group. CONCLUSION: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.
BACKGROUND: No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. METHODS: In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups. RESULTS: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group. CONCLUSION: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.
Authors: Lei Qin; Yi-Wei Kao; Yueh-Lung Lin; Bou-Yue Peng; Win-Ping Deng; Tsung-Ming Chen; Kuan-Chou Lin; Kevin Sheng-Po Yuan; Alexander T H Wu; Ben-Chang Shia; Szu-Yuan Wu Journal: Cancer Med Date: 2018-07-15 Impact factor: 4.452