Platinum-based concurrent chemotherapy remains the optimal regimen for nasopharyngeal carcinoma: a large institutional-based cohort study from an endemic area
| Autor: | Ya-Hui Yu, Wang-Zhong Li, Liangru Ke, Wen-Ze Qiu, Yan-Qun Xiang, Wei-Xiong Xia, Hu Liang, Xiang Guo, Xin-Jun Huang, Guo-Ying Liu, Xing Lv |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Subgroup analysis Kaplan-Meier Estimate Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Outcome Assessment Health Care medicine Humans Child Survival analysis Aged Platinum Proportional Hazards Models Retrospective Studies Chemotherapy Proportional hazards model business.industry Nasopharyngeal Neoplasms Chemoradiotherapy General Medicine Middle Aged medicine.disease Regimen 030104 developmental biology Nasopharyngeal carcinoma 030220 oncology & carcinogenesis Cohort Female Cisplatin business Cohort study |
| Zdroj: | Journal of Cancer Research and Clinical Oncology. 144:2231-2243 |
| ISSN: | 1432-1335 0171-5216 |
| Popis: | To retrospectively investigate the optimal regimen of concurrent chemotherapy for nasopharyngeal carcinoma (NPC) by comparing clinical outcomes of patients who received platinum-based and non-platinum-based concurrent chemoradiotherapy (CCRT) regimens. Based on a prospectively maintained database from 1998 to 2013 in an endemic area, a total of 4608 newly diagnosed, biopsy-proven, and non-disseminated NPC patients were identified and allocated into three cohorts based on concurrent chemotherapy regimens: cisplatin-based (CP) chemotherapy cohort, other platinum-based (OP) chemotherapy cohort, and non-platinum-based (NP) chemotherapy cohort. Overall survival (OS) and disease-free survival (DFS) were estimated using the Cox proportional hazards model and propensity score analysis of treatment using an inverse probability weighting model (PSA/IPTW). Finally, sensitivity analysis estimated the effects of potential unmeasured confounders. The median follow-up time was 68.5 months (range 2–194 months). The multivariate Cox model showed that NP regimens were significantly related with worse survival compared with CP or OP regimens (OS: HR 1.51, 95% CI 1.16–2.00, P = 0.002; HR 1.68, 95% CI 1.24–2.27, P = 0.001; DFS: HR 1.31, 95% CI 1.03–1.66, P = 0.031; HR 1.50, 95% CI 1.14–1.97, P = 0.004, respectively). Meanwhile, no significant survival difference was found between OP and CP regimens. The PSA/IPTW method, CCRT-specific and III–IVB NPC cohort subgroup analysis showed similar results. Sensitivity analysis confirmed the robustness of our results. Platinum-based concurrent chemotherapy, including both CP and OP regimens, yields better survival benefits for non-metastatic NPC patients than the NP regimen and remains the optimal regimen for these patients. |
| Databáze: | OpenAIRE |
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