Cargando…

Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study

PURPOSE: This large population-based analysis aims to investigate whether the additional induction chemotherapy to concurrent chemoradiotherapy improved overall survival (OS) and disease-free survival (DFS) for locoregionally advanced nasopharyngeal carcinoma (LRANPC). PATIENTS AND METHODS: The stud...

Descripción completa

Detalles Bibliográficos
Autores principales: Xia, Wei-Xiong, Liang, Hu, Lv, Xing, Wang, Lin, Ye, Yan-Fang, Ke, Liang-Ru, Xu, Lin-Hao, Guo, Xiang, Xiang, Yan-Qun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876219/
https://www.ncbi.nlm.nih.gov/pubmed/31819619
http://dx.doi.org/10.2147/CMAR.S179139
_version_ 1783473174833266688
author Xia, Wei-Xiong
Liang, Hu
Lv, Xing
Wang, Lin
Ye, Yan-Fang
Ke, Liang-Ru
Xu, Lin-Hao
Guo, Xiang
Xiang, Yan-Qun
author_facet Xia, Wei-Xiong
Liang, Hu
Lv, Xing
Wang, Lin
Ye, Yan-Fang
Ke, Liang-Ru
Xu, Lin-Hao
Guo, Xiang
Xiang, Yan-Qun
author_sort Xia, Wei-Xiong
collection PubMed
description PURPOSE: This large population-based analysis aims to investigate whether the additional induction chemotherapy to concurrent chemoradiotherapy improved overall survival (OS) and disease-free survival (DFS) for locoregionally advanced nasopharyngeal carcinoma (LRANPC). PATIENTS AND METHODS: The study group comprised 3,980 patients who were treated either with IC+CCRT (1,888 patients) or CCRT alone (2,092 patients) between January 1998 and June 2013. Survival outcomes were compared using Cox proportional hazards regression models with adjustments for confounding provided by propensity score methods. Primary outcome variables included OS and DFS. RESULTS: Kaplan–Meier analysis showed that CCRT and IC+CCRT were of similar benefit to OS (P=0.099), whereas there was a marginal benefit of CCRT to DFS (P=0.063) in the overall cohort, which showed no differences between the two treatment regimens using multivariate Cox analysis and propensity score. Interestingly, for patients with 2D radiationtherapy (2DRT), CCRT had OS and DFS benefits for stage III, with 5-year and 10-year OS for CCRT vs IC+CCRT being 88% and 75% vs 81% and 67%, respectively (P=0.002); 5-year and 10-year DFS for CCRT vs IC+CCRT being 84% and 74% vs 76% and 66%, respectively (P=0.002). In contrast, IC + CCRT had OS and DFS benefits for stage IVa-b, with 5-year and 10-year OS for CCRT vs IC+CCRT being 71% and 55% vs 76% and 60%, respectively (P=0.037, HR=0.786); 5-year and 10-year DFS for CCRT vs IC+CCRT were 64% and 50% vs 69% and 58%, respectively (P=0.038, HR=0.801). No difference was found in intensity-modulated radiotherapy (IMRT) subgroup. CONCLUSION: Our study indicates that CCRT and IC+CCRT may have similar OS and DFS benefits for overall LRANPC. Stage-specific chemoradiotherapy may be administered based on the greatest benefit of IC+CCRT for stage IVa-b patients and CCRT alone for stage III patients received 2DRT. The optimal chemotherapy pattern in combination with IMRT needs further investigation. TRIAL REGISTRATION:  ClinicalTrials.gov ID: NCT02604472
format Online
Article
Text
id pubmed-6876219
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-68762192019-12-09 Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study Xia, Wei-Xiong Liang, Hu Lv, Xing Wang, Lin Ye, Yan-Fang Ke, Liang-Ru Xu, Lin-Hao Guo, Xiang Xiang, Yan-Qun Cancer Manag Res Original Research PURPOSE: This large population-based analysis aims to investigate whether the additional induction chemotherapy to concurrent chemoradiotherapy improved overall survival (OS) and disease-free survival (DFS) for locoregionally advanced nasopharyngeal carcinoma (LRANPC). PATIENTS AND METHODS: The study group comprised 3,980 patients who were treated either with IC+CCRT (1,888 patients) or CCRT alone (2,092 patients) between January 1998 and June 2013. Survival outcomes were compared using Cox proportional hazards regression models with adjustments for confounding provided by propensity score methods. Primary outcome variables included OS and DFS. RESULTS: Kaplan–Meier analysis showed that CCRT and IC+CCRT were of similar benefit to OS (P=0.099), whereas there was a marginal benefit of CCRT to DFS (P=0.063) in the overall cohort, which showed no differences between the two treatment regimens using multivariate Cox analysis and propensity score. Interestingly, for patients with 2D radiationtherapy (2DRT), CCRT had OS and DFS benefits for stage III, with 5-year and 10-year OS for CCRT vs IC+CCRT being 88% and 75% vs 81% and 67%, respectively (P=0.002); 5-year and 10-year DFS for CCRT vs IC+CCRT being 84% and 74% vs 76% and 66%, respectively (P=0.002). In contrast, IC + CCRT had OS and DFS benefits for stage IVa-b, with 5-year and 10-year OS for CCRT vs IC+CCRT being 71% and 55% vs 76% and 60%, respectively (P=0.037, HR=0.786); 5-year and 10-year DFS for CCRT vs IC+CCRT were 64% and 50% vs 69% and 58%, respectively (P=0.038, HR=0.801). No difference was found in intensity-modulated radiotherapy (IMRT) subgroup. CONCLUSION: Our study indicates that CCRT and IC+CCRT may have similar OS and DFS benefits for overall LRANPC. Stage-specific chemoradiotherapy may be administered based on the greatest benefit of IC+CCRT for stage IVa-b patients and CCRT alone for stage III patients received 2DRT. The optimal chemotherapy pattern in combination with IMRT needs further investigation. TRIAL REGISTRATION:  ClinicalTrials.gov ID: NCT02604472 Dove 2019-11-20 /pmc/articles/PMC6876219/ /pubmed/31819619 http://dx.doi.org/10.2147/CMAR.S179139 Text en © 2019 Xia et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Xia, Wei-Xiong
Liang, Hu
Lv, Xing
Wang, Lin
Ye, Yan-Fang
Ke, Liang-Ru
Xu, Lin-Hao
Guo, Xiang
Xiang, Yan-Qun
Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
title Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
title_full Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
title_fullStr Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
title_full_unstemmed Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
title_short Stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
title_sort stage-specific concurrent chemoradiotherapy with or without induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective, population-based study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876219/
https://www.ncbi.nlm.nih.gov/pubmed/31819619
http://dx.doi.org/10.2147/CMAR.S179139
work_keys_str_mv AT xiaweixiong stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT lianghu stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT lvxing stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT wanglin stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT yeyanfang stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT keliangru stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT xulinhao stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT guoxiang stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy
AT xiangyanqun stagespecificconcurrentchemoradiotherapywithorwithoutinductionchemotherapyforlocoregionallyadvancednasopharyngealcarcinomaaretrospectivepopulationbasedstudy