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Purpose: The efficacy and safety of nimotuzumab (NTZ) added to concurrent chemoradiotherapy (CCRT) was investigated in patients with stage III-IVa nasopharyngeal carcinoma (NPC).Methods: Patients with stage III-IVa NPC treated with CCRT, with or without NTZ, were screened between January 2015 and December 2017. Overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared between these groups. Propensity score matching (PSM) was applied to reduce the selection bias. Nomogram models were developed to predict survival of CCRT with or without NTZ. Results: A total of 426 patients were included after PSM, with 213 patients in each regimen. Compared with NPC patients receiving CCRT alone, patients who received NTZ plus CCRT treatment had significantly better OS (5-year OS, 76.1% vs. 72.3%, P = 0.004), PFS (5-year PFS, 73.2% vs. 69.0%, P = 0.002), and LRFS (5-year LRFS, 73.2% vs. 69.0%, P = 0.028). A multivariate Cox regression analysis demonstrated that, compared with receiving CCRT alone, NTZ plus CCRT was an independently positive factor for OS, PFS, and LRFS. In addition, no significant difference was observed in the major toxicities among the two treatments (all P>0.05). Nomogram models that identified significant prognostic factors were produced.Conclusion: The present study suggested the NTZ plus CCRT treatment presented favorable clinical outcomes for stage III-IVa NPC patients with good tolerance and similar toxicity compared to CCRT alone. A prospective, randomized clinical trial is essential to validate the current findings. |
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