title: The effect of adjuvant chemotherapy on survival in patients with residual nasopharyngeal carcinoma after undergoing concurrent chemoradiotherapy.
abstract: BACKGROUND
  Guidelines from the U.S. National Comprehensive Cancer Network have recommended use of concurrent chemoradiotherapy (CCRT), followed by a 3-cycles combination of platinum and 5-fluorouracil chemotherapy as standard treatment for nasopharyngeal carcinoma (NPC). The benefits of CCRT for treatment of locally advanced NPC have been established. Whether platinum and 5-fluorouracil chemotherapy should be routinely added to locally advanced NPC after CCRT is still open to debate. Whether adjuvant chemotherapy provides an additional survival benefit for the subgroup of patients with residual nasopharyngeal carcinoma who have undergone CCRT is also unclear. This retrospective study was initiated to determine the survival benefit of adjuvant chemotherapy (AC) in residual NPC patients who have undergone concurrent chemoradiotherapy.
  
  
  METHODS
  The retrospective study included 155 nasopharyngeal carcinoma patients who had local residual lesions after the platinum-based CCRT without or with AC. Kaplan-Meier analysis and the log-rank test were used to estimate overall survival (OS), failure-free survival (FFS), local relapse-free survival (LRFS) and distant metastasis-free survival (DMFS).
  
  
  RESULTS
  Median follow-up was 47 months. Adjuvant cisplatin or nedaplatin plus 5-fluorouracil chemotherapy did not significantly improve 3-year OS, LRFS, FFS, and DMFS for patients with residual nasopharyngeal carcinoma after undergoing CCRT. The 3-year OS rates for the no-AC group and AC group were 71.6% and 73.7%, respectively (P= 0.44). The 3-year FFS rates for no-AC group and AC group were 57.5% and 66.9%, respectively ((P= 0.19). The 3-year LRFS rates for no-AC group and AC group were 84.7% and 87.9%, respectively ((P= 0.51). The 3-year DMFS rates for no-AC group and AC group were 71.4% and 77.4%, respectively ((P= 0.23).
  
  
  CONCLUSIONS
  Since we did not find sufficient data to support significant survival in 3-year OS, LRFS, FFS, and DMFS, whether Adjuvant cisplatin or nedaplatin and 5-fluorouracil chemotherapy should be routinely added to residual nasopharyngeal carcinoma patients after undergoing CCRT remain uncertain.
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Shiping
authors: S
authors: Yang
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Shaomin
authors: S
authors: Lin
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Qiang
authors: Q
authors: Fu
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Baizhen
authors: B
authors: Cai
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Fei
authors: F
authors: Kong
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Guang
authors: G
authors: Huang
authors: Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China.
authors: Fafen
authors: F
authors: Li
authors: Department of Physiology, Hainan Medical college, Haikou, Hainan, PR China.
authors: Han
authors: H
authors: Wang
mesh_terms: D000328:Adult; D002277:Carcinoma; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D018365:Neoplasm, Residual; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis