PMID- 30732946
OWN - NLM
STAT- In-Data-Review
LR  - 20190208
IS  - 1879-0593 (Electronic)
IS  - 1368-8375 (Linking)
VI  - 89
DP  - 2019 Feb
TI  - Optimizing the cumulative cisplatin dose during radiotherapy in nasopharyngeal
      carcinoma: Dose-effect analysis for a large cohort.
PG  - 102-106
LID - S1368-8375(18)30491-3 [pii]
LID - 10.1016/j.oraloncology.2018.12.028 [doi]
AB  - OBJECTIVES: Definitive concurrent chemoradiotherapy (CCRT) is the standard
      treatment for locoregionally advanced nasopharyngeal carcinoma (NPC). The
      cumulative cisplatin dose (CCD) during radiotherapy is an important prognostic
      factor; however, the optimal CCD is undetermined. MATERIALS AND METHODS: In this 
      retrospective analysis, patients with locoregionally advanced NPC treated with
      single-agent cisplatin-based CCRT or RT alone from 2009 through 2015 were
      identified. CCD was entered into a multivariate Cox regression model as a
      continuous variable using natural cubic splines to allow for a nonlinear
      relationship between CCD and outcomes. The primary endpoint was overall survival,
      and the secondary endpoints were locoregional relapse-free survival and distant
      metastasis-free survival. RESULTS: A total of 2 924 patients were included in our
      study, with a median CCD of 160mg/m(2) (range, 0-300mg/m(2)). As the CCD
      increased, the risk of death remained steady until 180mg/m(2), then decreased
      sharply until 250mg/m(2), and then increased until 300mg/m(2). The optimal CCD of
      230-270mg/m(2) was associated with the lowest risk of death and disease relapse. 
      However, the CCD had less prognostic value for disease control, especially for
      distant control among high-risk patients (N2-3 or T4). CONCLUSIONS: A CCD dose of
      230-270mg/m(2) (240mg/m(2) is recommended) is optimal for patients with
      locoregionally advanced NPC, especially for those at low risk (T1-3 and N0-1).
      For high-risk patients (N2-3 or T4), additional chemotherapy should be
      administered before or after CCRT.
CI  - Copyright (c) 2019 Elsevier Ltd. All rights reserved.
FAU - Peng, Liang
AU  - Peng L
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Xu, Cheng
AU  - Xu C
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Chen, Yu-Pei
AU  - Chen YP
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Guo, Rui
AU  - Guo R
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Mao, Yan-Ping
AU  - Mao YP
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Sun, Ying
AU  - Sun Y
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Ma, Jun
AU  - Ma J
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China.
FAU - Tang, Ling-Long
AU  - Tang LL
AD  - Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key
      Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer
      Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and
      Therapy, Guangzhou, China. Electronic address: tangll@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20181231
PL  - England
TA  - Oral Oncol
JT  - Oral oncology
JID - 9709118
OTO - NOTNLM
OT  - Cisplatin
OT  - Concurrent chemoradiotherapy
OT  - Dose intensity
OT  - Dose-effect analysis
OT  - Nasopharyngeal carcinoma
EDAT- 2019/02/09 06:00
MHDA- 2019/02/09 06:00
CRDT- 2019/02/09 06:00
PHST- 2018/10/01 00:00 [received]
PHST- 2018/12/02 00:00 [revised]
PHST- 2018/12/25 00:00 [accepted]
PHST- 2019/02/09 06:00 [entrez]
PHST- 2019/02/09 06:00 [pubmed]
PHST- 2019/02/09 06:00 [medline]
AID - S1368-8375(18)30491-3 [pii]
AID - 10.1016/j.oraloncology.2018.12.028 [doi]
PST - ppublish
SO  - Oral Oncol. 2019 Feb;89:102-106. doi: 10.1016/j.oraloncology.2018.12.028. Epub
      2018 Dec 31.