Article ; Online: Adjuvant chemotherapy following combined induction chemotherapy and concurrent chemoradiotherapy improves survival in N2-3-positive nasopharyngeal carcinoma patients.
Journal of cancer research and clinical oncology
2021 Volume 148, Issue 11, Page(s) 2959–2969
Abstract: Objective: This study aimed to explore the clinical value of adjuvant chemotherapy (ACT) following concurrent chemo-radiotherapy (CCRT) and induction chemotherapy (ICT) in loco-regionally advanced nasopharyngeal carcinoma (LANC).: Methods: We ... ...
| Abstract | Objective: This study aimed to explore the clinical value of adjuvant chemotherapy (ACT) following concurrent chemo-radiotherapy (CCRT) and induction chemotherapy (ICT) in loco-regionally advanced nasopharyngeal carcinoma (LANC). Methods: We included 839 newly diagnosed LANC patients in this study. ICT plus CCRT (ICT + CCRT group) was administered to 443 patients, and 396 patients received ACT after ICT plus CCRT (ICT + CCRT + ACT group). Univariate and multivariate Cox regression analyses were carried out. Furthermore, propensity score matching (PSM) was applied to balance the study and control groups. Results: A total of 373 pairs of LANC patients were obtained after PSM analysis. We found that ACT following ICT + CCRT has no significant effect on improving the survival of LANC patients. By further exploring the ICT + CCRT + ACT treatment protocol, we excluded N0-1-positive patients and re-performed PSM in the ICT + CCRT and ICT + CCRT + ACT groups. Each group consisted of 237 patients. Kaplan-Meier analysis revealed that there were differences between the ICT + CCRT and ICT + CCRT + ACT groups in terms of the 5-year overall survival (OS) (78.9% vs. 85.0%, P = 0.034), disease-free survival (DFS) (73.4% vs. 81.7%, P = 0.029), and distant metastasis-free survival (DMFS) (84.9% vs. 76.0%, P = 0.019). In addition, the ICT + CCRT + ACT group had a higher incidence of grade 3/4 acute leukocytopenia/neutropenia. Conclusion: Compared with ICT + CCRT, ACT following ICT plus CCRT can reduce distant metastasis of N2-3-positive LANC and improve the OS and DFS. The results demonstrated the feasibility and clinical utility of ACT following ICT plus CCRT. |
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| MeSH term(s) | Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemoradiotherapy/methods ; Chemotherapy, Adjuvant/methods ; Cisplatin/adverse effects ; Humans ; Induction Chemotherapy/methods ; Leukopenia/chemically induced ; Nasopharyngeal Carcinoma/drug therapy ; Nasopharyngeal Neoplasms/pathology ; Retrospective Studies | |||||
| Chemical Substances | Cisplatin (Q20Q21Q62J) | |||||
| Language | English | |||||
| Publishing date | 2021-11-25 | |||||
| Publishing country | Germany | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 134792-5 | |||||
| ISSN | 1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382 | |||||
| ISSN (online) | 1432-1335 | |||||
| ISSN | 0171-5216 ; 0084-5353 ; 0943-9382 | |||||
| DOI | 10.1007/s00432-021-03846-6 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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