Format

Send to

Choose Destination
Strahlenther Onkol. 2016 Jun;192(6):394-402. doi: 10.1007/s00066-016-0970-3. Epub 2016 May 23.

Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma : A matched-pair multicenter analysis of outcomes.

Author information

1
Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, 15 Lequn Road, 541001, Guilin, PR China.
2
Department of Otorhinolaryngology, Guilin Medical University Affiliated Hospital, 15 Lequn Road, 541001, Guilin, PR China.
3
Department of Otorhinolaryngology, Nan Xishan Hospital, 46 Chongxin Road, 541001, Guilin, PR China.
4
Department of Oncology, Affiliated Hospital of Youjiang Medical University for Nationalities, 18 Zhongshan Second Road, 533000, Baise, PR China.
5
Department of Radiation Oncology, Lingshan People's Hospital, 1 Zhongxiu Road, 535400, Lingshan, PR China.
6
Department of Radiation Oncology, Nan Xishan Hospital, 46 Chongxin Road, 541001, Guilin, PR China.
7
Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, 15 Lequn Road, 541001, Guilin, PR China. weijiang@glmc.edu.cn.

Abstract

PURPOSE:

The benefit of adjuvant chemotherapy (AC) in locoregionally advanced nasopharyngeal carcinoma (NPC) is controversial. This study compared concurrent chemoradiotherapy plus AC (CCRT/AC) with CCRT.

METHODS:

Pair-matched analysis based on eight clinicopathological features of 244 patients treated with platinum-based CCRT/AC or CCRT alone was performed. Survival outcomes were assessed using the Kaplan-Meier method and log-rank test. Toxicities and response rates were compared using Fisher's exact test.

RESULTS:

Four-year overall survival, progression-free survival, distant failure-free survival, and locoregional failure-free survival were 72 %, 61 %, 71 %, and 81 %, respectively, for the CCRT arm, compared to 74 % (hazard ratio, HR 0.89; 95 % confidence interval, CI 0.64-1.23; P = 0.474), 62 % (HR 0.91, 95 % CI 0.68-1.20, P = 0.489), 73 % (HR 0.84, 95 % CI 0.59-1.18, P = 0.316), and 84 % (HR 0.84, 95 % CI 0.52-1.24, P = 0.323), respectively, for the CCRT/AC arm. Cox multivariate regression analysis demonstrated AC was not an independent prognostic factor. Overall, there was a higher incidence of grade 3-4 toxicities in the CCRT/AC arm. The most common grade 3-4 adverse events in the CCRT/AC arm were vomiting (27 %), nausea (43 %), leukopenia/neutropenia (23 %), thrombocytopenia (8.8 %), and anemia (6.2 %).

CONCLUSION:

Addition of AC to CCRT increased toxicities but did not improve survival in locoregionally advanced NPC.

KEYWORDS:

Adverse events; China; Radiation oncology; Survival; Toxicity

PMID:
27215563
DOI:
10.1007/s00066-016-0970-3
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center