Propensity score matching analysis of a phase II study on simultaneous modulated accelerated radiation therapy using helical tomotherapy for nasopharyngeal carcinomas

Autor: Jing Chen, Shouping Xu, Linchun Feng, Lin Ma, Hai-Xia Liu, Chuanbin Xie, Jun Yang, Xinxin Zhang, Lei Du, Bao-Lin Qu
Rok vydání: 2017
Předmět:
Oncology
Male
Cancer Research
Survival
medicine.medical_treatment
Phases of clinical research
030218 nuclear medicine & medical imaging
0302 clinical medicine
Prospective Studies
Child
Aged
80 and over
Univariate analysis
Common Terminology Criteria for Adverse Events
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Treatment Outcome
030220 oncology & carcinogenesis
Female
Research Article
Adult
medicine.medical_specialty
Intensity-modulated radiation therapy
Adolescent
lcsh:RC254-282
Tomotherapy
03 medical and health sciences
Young Adult
Internal medicine
Propensity score matching
Genetics
medicine
Nasopharyngeal carcinoma
Humans
Propensity Score
Dose fractionation
Survival rate
Aged
Retrospective Studies
business.industry
Proportional hazards model
Carcinoma
Retrospective cohort study
Nasopharyngeal Neoplasms
Survival Analysis
Feasibility Studies
Dose Fractionation
Radiation
Radiotherapy
Intensity-Modulated
business
Zdroj: BMC Cancer
BMC Cancer, Vol 17, Iss 1, Pp 1-11 (2017)
ISSN: 1471-2407
Popis: Background Using propensity score matching method (PSM) to evaluate the feasibility and clinical outcomes of simultaneous modulated accelerated radiation therapy (SMART) using helical tomotherapy (HT) in patients with nasopharyngeal carcinoma (NPC). Methods Between August 2007 and January 2016, 381 newly diagnosed NPC patients using HT were enrolled in pre-PSM cohort, including 161 cases in a prospective phase II study (P67.5 study, with a prescription dose of 67.5Gy in 30 fractions to the primary tumour and positive lymph nodes) and 220 cases in a retrospective study (P70 study, with a prescription dose of 70Gy in 33 fractions to the primary tumour and positive lymph nodes). Acute and late toxicities were assessed according to the established RTOG/EORTC criteria and Common Terminology Criteria for Adverse Events (CTCAE) V 3.0. Survival rate were assessed with Kaplan-Meier method, log-rank test and Cox regression. Results After matching, 148 sub-pairs of 296 patients were generated in post-PSM cohort. The incidence of grade 3–4 leukopenia, thrombocytopenia and anemia in the P67.5 group was significantly higher than in the P70 study, but no significant different was found in other acute toxicities or late toxicities between the two groups. The median follow-up was 33 months in the P67.5 and P70 group, ranging 12–54 months and 6–58 months, respectively. No significant differences in 3-year local-regional recurrence free survival (LRRFS), distant metastasis-free survival (DMFS), disease free survival (DFS) and overall survival (OS) were observed between the 2 groups. Univariate analysis showed that age, T stage, clinical stage were the main factors effecting survival. Cox proportional hazards model showed that 67.5Gy/30F pattern seemed superior in 3-year OS (HR = 0.476, 95% CI: 0.236-0.957). Conclusions Through increasing fraction dose and shortening treatment time, the P67.5 study achieved excellent short-term outcomes and potential clinical benefits, with acceptable acute and late toxicities. Trial registration The trial was registered at Chinese Clinical Trial Registry on 5 July 2014 with a registration code of ChiCTRONC-14,004,895.
Databáze: OpenAIRE
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