Treatment outcomes of induction chemotherapy combined with intensity-modulated radiotherapy and adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma in Southeast China
| Autor: | Chunlin Ke, Chuanshu Cai, Peirong Wang, Feng Dong |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Oncology China medicine.medical_specialty medicine.medical_treatment Observational Study locoregionally advanced nasopharyngeal carcinoma survival chemistry.chemical_compound Internal medicine medicine Humans Stage (cooking) Aged Retrospective Studies Cisplatin Chemotherapy business.industry Induction chemotherapy Nasopharyngeal Neoplasms Induction Chemotherapy General Medicine Middle Aged Prognosis intensity-modulated radiotherapy medicine.disease adjuvant chemotherapy Radiation therapy Treatment Outcome Paclitaxel chemistry Nasopharyngeal carcinoma Chemotherapy Adjuvant Multivariate Analysis Female Radiotherapy Intensity-Modulated business Chemoradiotherapy Research Article medicine.drug |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| DOI: | 10.1097/md.0000000000027023 |
| Popis: | Induction chemotherapy (IC) and adjuvant chemotherapy (AC) are used to enhance tumor locoregional control and support early treatment for distant metastases. However, optimum combinatorial treatment of these chemoradiotherapy regimens with radiotherapy in curing locoregionally advanced nasopharyngeal carcinoma (NPC) remains unclear. Here, we evaluate the efficacy and therapeutic outcome of a combinatorial treatment strategy involving IC, intensity-modulated radiotherapy (IMRT), and AC, by retrospectively analyzing 243 NPC patients who were treated by IC followed by IMRT and AC. The rates of 3-/5-year local-regional control rate, distant failure-free rate (DFFR), progression-free survival (PFS), and overall survival (OS) were 93.3%/90.3%, 84.2%/79.4%, 79.6%/74.4%, and 84.0%/72.6%, respectively. The 3-/5-year OS rates of patients in stage III or IVA were 91.5%/75.1% and 86.5%/56.5%, respectively. Combination cisplatin with paclitaxel showed no significance in OS as compared to cisplatin plus 5-fluorouracil (P-value = .17). Total four-cycle IC and AC was significantly beneficious versus three-cycle in DFFR (P-value = .04), as well as total 6 chemotherapy cycles compared to 4 in DFFR and PFS (P-value = .03 and P-value = .01, respectively). All survival indicators were adversely affected by T-category, while N-category could only predict DFFR and PFS. Radiation dosage represented as a second prognostic factor for local control. We propose that IC combined with IMRT and AC for locoregionally advanced NPC shows effective treatment outcomes. |
| Databáze: | OpenAIRE |
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