Survival benefit of induction chemotherapy for locally advanced nasopharyngeal carcinoma: prognosis based on a new risk estimation model

Autor: Yunfan Luo, Wei Liu, Ze-Hong Lv, Junzheng Li, Bolong Yu, Juan Lu, Xiaofei Yuan, Yanfei Li, Xiong Liu, Xiaohong Peng, Xinyu Peng, Bijun Liang, Shuting Wu
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Oncology
Adult
Male
Cancer Research
medicine.medical_specialty
Adolescent
Risk Assessment
Disease-Free Survival
03 medical and health sciences
Young Adult
0302 clinical medicine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Genetics
medicine
Nasopharyngeal carcinoma
Humans
Risk estimation model
Survival analysis
RC254-282
Aged
Retrospective Studies
business.industry
Proportional hazards model
Hazard ratio
Induction chemotherapy
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Retrospective cohort study
Nasopharyngeal Neoplasms
Chemoradiotherapy
Middle Aged
medicine.disease
Neoadjuvant Therapy
Exact test
030104 developmental biology
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Female
Radiotherapy
Intensity-Modulated
Neoplasm Recurrence
Local
business
Follow-Up Studies
Research Article
Zdroj: BMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021)
BMC Cancer
ISSN: 1471-2407
Popis: Background Although the National Comprehensive Cancer Network (NCCN) Guidelines recommend CCRT+AC and IC + CCRT as level 2A evidence for treatment of the locoregionally advanced NPC (II-IVa), IC + CCRT+AC could also be an alternative but it is seldom used because of the low completion rates. This article aimed to compare the effectiveness of the three radiotherapy regimens using a large-scale retrospective study. Methods This retrospective single center analysis enrolled 1812 diagnosed NPC patients at Nanfang Hospital from January 2005 to December 2015 and only 729 patients met the inclusion criteria and were analyzed. Patients without distant metastasis, age of 18–70 years, Karnofsky scores of at least 70,stage III-IVb, and adequate adequate bone marrow, liver and renal function. Were enrolled. Adverse events and other categorical variables were compared by Pearson chi-square test or Fishier exact test. Time-to-event data were described with the Kaplan-Meier curves, time-to-event intervals compared with the log-rank test. We did multivariable analyses with the Cox proportional hazards model to test the independent signifi cance of diff erent factors. Cox proportional hazards model was used to estimate the β regression coeffi cient, p value, and hazard ratio and its 95% CI for each of the selected risk predictors. Results The median follow-up time was 47 months. Kaplan-Meier analyses revealed no significant differences among three groups in 3-year failure-free survival (FFS, P = 0.225), 3-year overall survival (OS, P = 0.992), 3-year locoregional failure-free survival (LFFS, P = 0.549), and 3-year distant failure-free survival (DFFS, P = 0.174). Stratified survival analysis based on the risk scoring model revealed no differences in FFS, OS, LFFS, and DFFS between IC + CCRT and CCRT+AC groups for low-risk patients, however, the 3-year OS (88.3% vs. 77.6%, P = 0.049) and 3-year DFFS (84.0% vs.66.8%, P = 0.032) were respectively significantly better in IC + CCRT group compared with CCRT+AC group for high-risk patients. Conclusions Compared with CCRT+AC, IC + CCRT lowers distant metastasis rate and improves OS among patients with locally advanced NPC in high risk group.
Databáze: OpenAIRE
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