Survival without concurrent chemotherapy for locoregionally advanced nasopharyngeal carcinoma treated with induction chemotherapy plus intensity-modulated radiotherapy

Abstract Background: Nasopharyngeal carcinoma (NPC) originates from the mucous epithelium of the nasopharynx. Although induction chemotherapy plus concurrent chemoradiotherapy is the major therapeutic protocol used for locally advanced NPC without metastasis, more researches are needed to evaluate the curative effects.Aims: We aim to identify the therapeutic effects and prognosis after induction chemotherapy plus concurrent chemoradiotherapy in the treatment of locally advancedNPC under the intensity modulated radiotherapy mode.Methods: The patients (N= 544) with locally advanced NPC (III and IVa) after intensity modulated radiotherapy with induction chemotherapy and concurrent chemoradiotherapy were included in this study. We analyzed the characteristics of patients including gender, age, smoking status, tumor-node staging system, clinical stage, pathological type, the therapy protocol of induction chemotherapy and concurrent chemoradiotherapy, and chemotherapy prescription.Results: We have found the 5-year survival rates of OS, PFS, LRRFS, and DMFS were 85.21%, 78.51%, 90.71%, and 85.21% in follow-up and these data indicated that our therapeutic procedure provided beneficial effects on survival rates. Following, the chemotherapy drug base on DOC provided more beneficial effect of survival rate compared with TXT but there was no significant difference between chemotherapy drug base on DDP and NDP treated with NPC patients. The therapeutic effects of induction chemotherapy revealed no difference between TPF and TP. In addition, there was also no significant change between concurrent chemotherapy with TP dual drugs or platinum single drug. Moreover, the survival rate showed no difference between platinum accumulation dose ofmore and less than 150mg/m2for concurrent chemotherapy.Conclusion: Our results indicate that induction chemotherapy plus concurrent chemoradiotherapy under intensity modulated radiotherapy which is the standard therapeutic method for locally advanced NPC provides beneficial therapeutic effects, and it is worthy of further study.

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The role of concurrent chemotherapy to intensity-modulated radiotherapy (IMRT) after neoadjuvant docetaxel and cisplatin treatment in locoregionally advanced nasopharyngeal carcinoma

Medical Oncology ◽

10.1007/s12032-015-0505-2 ◽

2015 ◽

Vol 32 (3) ◽

Cited By ~ 3

Author(s):

Lei Zhang ◽

Guo-ping Shan ◽

Pu Li ◽

Ping-jing Cheng

Keyword(s):

Nasopharyngeal Carcinoma ◽

Intensity Modulated Radiotherapy ◽

Concurrent Chemotherapy ◽

Intensity Modulated

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Treatment outcomes after reduction of the target volume of intensity-modulated radiotherapy following induction chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A prospective, multi-center, randomized clinical trial

Radiotherapy and Oncology ◽

10.1016/j.radonc.2017.07.020 ◽

2018 ◽

Vol 126 (1) ◽

pp. 37-42 ◽

Cited By ~ 32

Author(s):

Hongru Yang ◽

Xin Chen ◽

Sheng Lin ◽

Jinfeng Rong ◽

Mi Yang ◽

...

Keyword(s):

Clinical Trial ◽

Nasopharyngeal Carcinoma ◽

Treatment Outcomes ◽

Randomized Clinical Trial ◽

Induction Chemotherapy ◽

Intensity Modulated Radiotherapy ◽

Target Volume ◽

Intensity Modulated

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Induction Chemotherapy Combined With Intensity-Modulated Radiotherapy for 129 Nasopharyngeal Carcinoma Patients With Synchronous Metastases: A Retrospective Study

Frontiers in Oncology ◽

10.3389/fonc.2021.654871 ◽

2021 ◽

Vol 11 ◽

Author(s):

Mengshan Ni ◽

Lijun Geng ◽

Fangfang Kong ◽

Chengrun Du ◽

Ruiping Zhai ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Nasopharyngeal Carcinoma ◽

Induction Chemotherapy ◽

Survival Rates ◽

Intensity Modulated Radiotherapy ◽

Initial Diagnosis ◽

Intensity Modulated ◽

Synchronous Metastases ◽

Pre Treatment

ObjectiveTo analyze the therapeutic effect and prognostic factors of nasopharyngeal carcinoma (NPC) patients with distant metastases at initial diagnosis receiving induction chemotherapy with intensity-modulated radiotherapy (IMRT).MethodsA total of 129 patients who underwent platinum-based induction chemotherapy followed by definitive IMRT with or without concurrent or adjuvant chemotherapy for newly diagnosed distant metastatic NPC in our center between March 2008 and November 2018 were retrospectively analyzed. 41 patients underwent local therapy for metastatic sites. Kaplan-Meier method was used to estimate survival rates, Log-rank test and Cox proportional hazards model were used to figure out independent prognostic factors of overall survival (OS).ResultsA total of 66 patients had been dead (median follow-up time, 51.5 months). The median overall survival (OS) time was 54.2 months (range, 7-136 months), and the 1-year, 2-year, 3-year, 5-year overall survival rates were 88.0%,71.0%,58.0%, and 47.0%. Multivariate analysis found that the factors correlated with poor overall survival were pre-treatment serum lactate dehydrogenase (SLDH) >180U/L, chemotherapy cycles<4, and M1 stage subdivision (M1b, single hepatic metastasis and/or multiple metastases excluding the liver; and M1c, multiple hepatic metastases). The 5-year OS rates for M1a, M1b and M1c were 62.6%,40.4% and 0%, respectively.ConclusionPlatinum-containing induction chemotherapy combined with IMRT seemed to be advantageous to prolong survival for some NPC patients with synchronous metastases at initial diagnosis. The independent factors to prognosticate OS were pre-treatment SLDH, number of chemotherapy cycles, and M1 subcategories. Prospective clinical trials are needed to confirm the result.

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