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First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study

BACKGROUND: The combined use of immune checkpoint inhibitors (ICIs) with palliative chemotherapy (PCT) is a promising first-line treatment for de novo metastatic nasopharyngeal carcinoma (mNPC). However, the efficacy of ICIs with PCT vs PCT with definitive radiation therapy (DRT) remain unclear. MET...

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Autores principales: Yang, Zhen-Chong, Liu, Ting, Chen, Yan-Zhou, Guo, Chun-Yan, Liu, Li-Ting, Liu, Sai-Lan, Chen, Qiu-Yan, Mai, Hai-Qiang, Guo, Shan-Shan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9445460/
https://www.ncbi.nlm.nih.gov/pubmed/36047451
http://dx.doi.org/10.1177/10732748221124868
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author Yang, Zhen-Chong
Liu, Ting
Chen, Yan-Zhou
Guo, Chun-Yan
Liu, Li-Ting
Liu, Sai-Lan
Chen, Qiu-Yan
Mai, Hai-Qiang
Guo, Shan-Shan
author_facet Yang, Zhen-Chong
Liu, Ting
Chen, Yan-Zhou
Guo, Chun-Yan
Liu, Li-Ting
Liu, Sai-Lan
Chen, Qiu-Yan
Mai, Hai-Qiang
Guo, Shan-Shan
author_sort Yang, Zhen-Chong
collection PubMed
description BACKGROUND: The combined use of immune checkpoint inhibitors (ICIs) with palliative chemotherapy (PCT) is a promising first-line treatment for de novo metastatic nasopharyngeal carcinoma (mNPC). However, the efficacy of ICIs with PCT vs PCT with definitive radiation therapy (DRT) remain unclear. METHODS: Patients with mNPC who received first-line immunochemotherapy (ICI + PCT) or PCT + DRT were included. Propensity score matching (PSM) was applied to balance potential confounders between patients who did and did not undergo DRT (at a ratio of 1:1). Progression free survival (PFS) and overall survival (OS) were compared between the 2 groups using a log-rank test and Cox proportional hazard model. RESULTS: Among all participants, 149 received ICI + PCT. After PSM, 149 patients were included in the PCT + DRT group. First-line immunochemotherapy was associated with significantly improved PFS (median 9.0 months vs 12.0 months, P < .001) and OS (median 12.5 months vs 19.9 months, P < .001). Subgroup analysis revealed that tumor response to immunochemotherapy, metastatic organs, and number of metastatic sites potentially affected the efficacy of DRT after first-line immunochemotherapy. CONCLUSION: Compared with PCT + DRT, first-line immunochemotherapy was associated with improved PFS and OS in patients with mNPC but not in patients with unfavorable tumor response and metastasis involving the liver, distant nodes, or multiple sites.
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spelling pubmed-94454602022-09-07 First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study Yang, Zhen-Chong Liu, Ting Chen, Yan-Zhou Guo, Chun-Yan Liu, Li-Ting Liu, Sai-Lan Chen, Qiu-Yan Mai, Hai-Qiang Guo, Shan-Shan Cancer Control Beyond the known - Head and Neck Cancer BACKGROUND: The combined use of immune checkpoint inhibitors (ICIs) with palliative chemotherapy (PCT) is a promising first-line treatment for de novo metastatic nasopharyngeal carcinoma (mNPC). However, the efficacy of ICIs with PCT vs PCT with definitive radiation therapy (DRT) remain unclear. METHODS: Patients with mNPC who received first-line immunochemotherapy (ICI + PCT) or PCT + DRT were included. Propensity score matching (PSM) was applied to balance potential confounders between patients who did and did not undergo DRT (at a ratio of 1:1). Progression free survival (PFS) and overall survival (OS) were compared between the 2 groups using a log-rank test and Cox proportional hazard model. RESULTS: Among all participants, 149 received ICI + PCT. After PSM, 149 patients were included in the PCT + DRT group. First-line immunochemotherapy was associated with significantly improved PFS (median 9.0 months vs 12.0 months, P < .001) and OS (median 12.5 months vs 19.9 months, P < .001). Subgroup analysis revealed that tumor response to immunochemotherapy, metastatic organs, and number of metastatic sites potentially affected the efficacy of DRT after first-line immunochemotherapy. CONCLUSION: Compared with PCT + DRT, first-line immunochemotherapy was associated with improved PFS and OS in patients with mNPC but not in patients with unfavorable tumor response and metastasis involving the liver, distant nodes, or multiple sites. SAGE Publications 2022-09-01 /pmc/articles/PMC9445460/ /pubmed/36047451 http://dx.doi.org/10.1177/10732748221124868 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Beyond the known - Head and Neck Cancer
Yang, Zhen-Chong
Liu, Ting
Chen, Yan-Zhou
Guo, Chun-Yan
Liu, Li-Ting
Liu, Sai-Lan
Chen, Qiu-Yan
Mai, Hai-Qiang
Guo, Shan-Shan
First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
title First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
title_full First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
title_fullStr First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
title_full_unstemmed First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
title_short First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for de novo Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
title_sort first-line immunochemotherapy versus palliative chemotherapy plus definitive radiation therapy for de novo metastatic nasopharyngeal carcinoma: a matched cohort study
topic Beyond the known - Head and Neck Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9445460/
https://www.ncbi.nlm.nih.gov/pubmed/36047451
http://dx.doi.org/10.1177/10732748221124868
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