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ABSTRACT: Background
The effects of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in high-risk (stage III-IVb with EBV DNA?4000 copies/ml) nasopharyngeal carcinoma (NPC) patients are unclear.Methods
A total of 325 high-risk NPC patients treated with IC+CCRT or CCRT alone who were treated with intensity-modulated radiation therapy (IMRT) between March 2007 and March 2013 were included. For each patient in the IC+CCRT group, a matched pair in the CCRT group was matching for: gender, age, T stage, N stage, clinical stage and WHO (World Health Organization) type. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS).Results
There were no significant differences in OS, PFS, DMFS, and LRFS between the IC+CCRT (148 patients) and CCRT (177 patients) groups. After matching, 103 paired patients were analyzed, and there were no differences between the IC+CCRT and CCRT groups regarding clinical outcomes. Based on the subgroup analysis of 156 very-high-risk patients (stage N2-3 with EBV DNA ?4000 copies/ml), the 5-year OS of the IC+CCRT and CCRT groups was 84.3% and 67.5% (P =0.033), respectively. Based on our multivariate analysis, the treatment group was significantly associated with OS (P=0.034; HR0.451, 95%CI 0.216-0.941).Conclusions
IC+CCRT did not improve the clinical outcomes of high-risk NPC patients compared to CCRT alone. However, in very-high-risk patients, IC+CCRT treatment led to increased OS compared to patients received CCRT treatment alone.
SUBMITTER: Guo SS
PROVIDER: S-EPMC5045429 | biostudies-literature | 2016 May
REPOSITORIES: biostudies-literature
Guo Shan-Shan SS Tang Lin-Quan LQ Chen Qiu-Yan QY Zhang Lu L Liu Li-Ting LT Guo Ling L Mo Hao-Yuan HY Luo Dong-Hua DH Huang Pei-Yu PY Xiang Yan-Qun YQ Sun Rui R Chen Ming-Yuan MY Wang Lin L Lv Xing X Zhao Chong C Guo Xiang X Cao Ka-Jia KJ Qian Chao-Nan CN Zeng Mu-Shen MS Bei Jin-Xin JX Hong Ming-Huang MH Shao Jian-Yong JY Sun Ying Y Ma Jun J Mai Hai-Qiang HQ
Oncotarget 20160501 20
<h4>Background</h4>The effects of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in high-risk (stage III-IVb with EBV DNA≥4000 copies/ml) nasopharyngeal carcinoma (NPC) patients are unclear.<h4>Methods</h4>A total of 325 high-risk NPC patients treated with IC+CCRT or CCRT alone who were treated with intensity-modulated radiation therapy (IMRT) between March 2007 and March 2013 were included. For each patient in the IC+CCRT group, a matched pair in the CCRT group was ...[more]