title: Induction chemotherapy for the treatment of non-endemic locally advanced nasopharyngeal carcinoma.
abstract: BACKGROUND
  The role of induction chemotherapy is less clear in non-endemic locally advanced nanopharyngeal carcinomas (NPC).
  
  
  RESULTS
  With a total of 233 eligible patients and a median follow-up of 36 months, 3-year overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease free survival (DFS) were 84.5%, 94.9%, 78.6% and 69.2%, respectively. The overall failure rate was 21.0% and distant metastasis occurred in 17.2% patients. Multivariate analyses showed that retropharyngeal and bilateral neck lymph node metastasis were significant prognostic factors for DFS and OS. Moreover, patients receiving both GP (gemcitabine+cisplatin) and TP (docetaxel+cisplatin) regimes had significantly higher DFS and OS compared with PF (cisplatin+5-FU) regime. GP regimes lead to significantly improved OS than TP/PF in some subgroup of patients. No severe toxicities were observed.
  
  
  METHODS
  We retrospectively analyzed stage III-IVb NPC patients treated between Jan 2006 and Dec 2014, with induction chemotherapy followed by concurrent chemoradiation (IC-CCRT). Statistical analyses were performed on survival and failure patterns.
  
  
  CONCLUSIONS
  These results suggested IC-CCRT was safe and effective for NPCs from non-endemic region. The choice of induction regimen appeared to affect patient outcomes.
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Man
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
authors.forename: Wen
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
authors.forename: Haitao
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zang
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Shanquan
authors.initials: S
authors.lastname: Luo
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Yongchun
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi'an, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D043823:Taxoids / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D002945:Cisplatin; D000093542:Gemcitabine
keywords: IMRT; WHO II/III; induction chemotherapy; nasopharyngeal carcinoma; non-endemic region