Jing-Lin Mi1, Yi-Liang Meng2, Hong-Liang Wu3, Yi-Lin Cao4, Bin Zhang5, Yu-Fei Pan4, Yuan-Yuan Zhou6, Jin-Fang Fan1, Shu-Fang Liao1, Xiao-Li Qin1, Da-Cheng Yao1, Wei Jiang7. 1. Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, 15 Lequn Road, 541001, Guilin, China. 2. Department of Oncology, Baise People Hospital, 533000, Baise, China. 3. Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Guilin Medical University, 541001, Guilin, China. 4. Department of Oncology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004, Guilin, China. 5. Department of Radiation Oncology, Wuzhou Red Cross Hospital, 543002, Wuzhou, China. 6. Department of Radiation Oncology, Liuzhou General Hospital, 545006, Liuzhou, China. 7. Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, 15 Lequn Road, 541001, Guilin, China. weijiang@glmc.edu.cn.
Abstract
PURPOSE: The efficacy and tolerability of adding chemotherapy to radiotherapy in the era of intensity-modulated radiation therapy (IMRT) remain controversial among older patients with nasopharyngeal carcinoma (NPC). The present study compared IMRT alone with IMRT in combination with chemotherapy in elderly NPC patients. METHODS: Between January 2011 and December 2014, 102 patients aged >65 years with NPC who received IMRT alone (IMRT group) or IMRT in combination with chemotherapy (IMRT/CT group) were enrolled. Patients from both treatment arms were pair-matched (1:1 ratio) based on six clinical factors. Differences in overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) were assessed using the Kaplan-Meier method and Cox proportional hazards models, whereas the toxicity profile was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 4. RESULTS: No significant differences were noted in OS (72.1% vs. 72.5%, p = 0.799), DFS (65.9% vs. 70.1%, p = 0.733), LRRFS (76.4% vs. 71.6%, p = 0.184), and DMFS (90.8% vs. 98.0%, p = 0.610) between the IMRT and IMRT/CT groups. Multivariate analyses showed that chemotherapy was not an independent factor for OS, DFS, LRRFS, and DMFS. However, the incidences of grade 3 vomiting/nausea (p = 0.000), leukopenia/neutropenia (p = 0.000), thrombocytopenia (p = 0.041), and anemia (p = 0.040) were significantly higher in the IMRT/CT group compared with the IMRT group. No grade 4 toxicities were observed. CONCLUSION: IMRT alone was similar to IMRT/CT in treating elderly NPC patients (age >65 years), with comparable survival outcomes and less grade 3 toxicities.
PURPOSE: The efficacy and tolerability of adding chemotherapy to radiotherapy in the era of intensity-modulated radiation therapy (IMRT) remain controversial among older patients with nasopharyngeal carcinoma (NPC). The present study compared IMRT alone with IMRT in combination with chemotherapy in elderly NPC patients. METHODS: Between January 2011 and December 2014, 102 patients aged >65 years with NPC who received IMRT alone (IMRT group) or IMRT in combination with chemotherapy (IMRT/CT group) were enrolled. Patients from both treatment arms were pair-matched (1:1 ratio) based on six clinical factors. Differences in overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) were assessed using the Kaplan-Meier method and Cox proportional hazards models, whereas the toxicity profile was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 4. RESULTS: No significant differences were noted in OS (72.1% vs. 72.5%, p = 0.799), DFS (65.9% vs. 70.1%, p = 0.733), LRRFS (76.4% vs. 71.6%, p = 0.184), and DMFS (90.8% vs. 98.0%, p = 0.610) between the IMRT and IMRT/CT groups. Multivariate analyses showed that chemotherapy was not an independent factor for OS, DFS, LRRFS, and DMFS. However, the incidences of grade 3 vomiting/nausea (p = 0.000), leukopenia/neutropenia (p = 0.000), thrombocytopenia (p = 0.041), and anemia (p = 0.040) were significantly higher in the IMRT/CT group compared with the IMRT group. No grade 4 toxicities were observed. CONCLUSION: IMRT alone was similar to IMRT/CT in treating elderly NPC patients (age >65 years), with comparable survival outcomes and less grade 3 toxicities.
Authors: Stephen B Keysar; Phuong N Le; Bettina Miller; Brian C Jackson; Justin R Eagles; Cera Nieto; Jihye Kim; Binwu Tang; Magdalena J Glogowska; J Jason Morton; Nuria Padilla-Just; Karina Gomez; Emily Warnock; Julie Reisinger; John J Arcaroli; Wells A Messersmith; Lalage M Wakefield; Dexiang Gao; Aik-Choon Tan; Hilary Serracino; Vasilis Vasiliou; Dennis R Roop; Xiao-Jing Wang; Antonio Jimeno Journal: J Natl Cancer Inst Date: 2016-09-15 Impact factor: 13.506