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Oral Oncol. 2018 Apr;79:40-46. doi: 10.1016/j.oraloncology.2018.02.011. Epub 2018 Feb 16.

Optimizing the induction chemotherapy regimen for patients with locoregionally advanced nasopharyngeal Carcinoma: A big-data intelligence platform-based analysis.

Author information

1
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, PR China.
2
Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, PR China.
3
Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, PR China.
4
Department of Clinical Trials Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, PR China.
5
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, PR China. Electronic address: majun2@mail.sysu.edu.cn.

Abstract

OBJECTIVES:

This study aimed at identifying the optimal induction chemotherapy regimen for patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy.

MATERIALS AND METHODS:

We identified eligible patients with newly-diagnosed stage III-IVA NPC (excluding T3N0) between September 2009 and May 2015. Survival outcomes and grade 3-4 toxicities were compared between different IC regimen groups.

RESULTS:

In total, 3738 patients were eligible for this study, with 1572 (42.1%), 1085 (29.0%) and 1081 (28.9%) receiving TPF, PF and TP, respectively. In the whole population, multivariate analysis found that TPF seems to be better than PF and TP. Howerver, subgroup analysis revealed TPF and TP had same effectiveness in patients receiving a cumulative cisplatin dose (CCD) ≥200mg/m2 in concurrent chemotherapy, while TPF shows relatively better survival benefit in patients receiving CCD<200mg/m2. Grade 3-4 toxicities were similar between TPF and TP groups, but were relatively higher than that in PF group.

CONCLUSIONS:

Our study concluded that induction TP regimen may be enough for patients receiving a CCD≥200mg/m2, while TPF may be superior to TP and PF for patients receiving a CCD<200mg/m2, although grade 3-4 toxic events were more common but tolerable. Further studies are needed to validate our findings.

KEYWORDS:

Induction chemotherapy; Intensity-modulated radiotherapy; Locoregionally advanced; Nasopharyngeal carcinoma; Prognosis

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