Long-term outcomes of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma treated with IMRT: a retrospective study.
This study aimed to evaluate the efficacy of concurrent chemoradiotherapy (CCRT) for stage II nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT). A total of 249 patients were retrospectively reviewed. All patients were treated with IMRT. One hundred forty-three patients treated with CCRT and 106 patients treated with IMRT alone. With a median follow-up of 59.4 months, adding concurrent chemotherapy did not statistically significantly improve the 5-year overall survival (OS) (89.7 % vs 99.0 %, p = 0.278), locoregional relapse-free survival (LRFS) (94.8 % vs 89.3 %, p = 0.167), and distant metastases-free survival (DMFS) (93.4 % vs 97.5 %, p = 0.349). The patients with CCRT significantly experienced more acute toxic effects. The main grades 3-4 toxicity reactions were mucositis (26.6 % vs 15.1 %, p = 0.03) and leukopenia/neutropenia (9.1 % vs 0.9 %, p = 0.005). In subgroup analysis of patients with concurrent platinum single-agent chemotherapy the 5-year OS (98.4 % vs 81.9 %, p = 0.013) and DMFS (96.9 % vs 84.4 %, p = 0.043) of patients with platinum every 3 weeks (Q3W) were significantly higher than those with platinum weekly (QW) and no significant difference for LRFS (96.8 % vs 90.4 %, p = 0.150). CCRT did not improve the survival of patients with stage II NPC but increased the acute toxicity reactions. Patients with platinum Q3W improved the 5-year OS and DMFS, compared with those with platinum QW.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, Guangzhou, 510060, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Zhen
Z
Su
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, Guangzhou, 510060, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Yan-Ping
YP
Mao
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, Guangzhou, 510060, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Jie
J
Tang
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, Guangzhou, 510060, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Xiao-Wen
XW
Lan
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, Guangzhou, 510060, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Pu-Yun
PY
OuYang
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China. xiefy0758@sina.com.|State Key Laboratory of Oncology in South China, Guangzhou, 510060, China. xiefy0758@sina.com.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China. xiefy0758@sina.com.
Fang-Yun
FY
Xie
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D016016:Proportional Hazards Models; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016896:Treatment Outcome
D017239:Paclitaxel; D002945:Cisplatin
Acute toxicity reactions; Concurrent chemotherapy; IMRT; Prognosis; Stage II nasopharyngeal carcinoma; Survival