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Explore the Value of Adding Induction Chemotherapy to Concurrent Chemoradiotherapy in T3-4N0M0 Nasopharyngeal Carcinoma Patients: A Retrospective Study
Cancer Management and Research ( IF 3.3 ) Pub Date : 2021-09-09 , DOI: 10.2147/cmar.s321471 Peijing Li 1, 2 , Qun Zhang 3 , Donghua Luo 4, 5, 6 , Feng Jiang 1, 2 , Qifeng Jin 1, 2 , Yonghong Hua 1, 2 , Ting Jin 1, 2 , Xiaozhong Chen 1, 2
Cancer Management and Research ( IF 3.3 ) Pub Date : 2021-09-09 , DOI: 10.2147/cmar.s321471 Peijing Li 1, 2 , Qun Zhang 3 , Donghua Luo 4, 5, 6 , Feng Jiang 1, 2 , Qifeng Jin 1, 2 , Yonghong Hua 1, 2 , Ting Jin 1, 2 , Xiaozhong Chen 1, 2
Affiliation
Purpose: Patients with T3-4N0M0 nasopharyngeal carcinoma (NPC) are a unique subgroup of locoregional advanced NPC, which generally have a better prognosis than others and are often excluded in most randomized controlled clinical trials focusing on locoregional advanced NPC. The management of this population is still controversial. This study aims to evaluate the outcomes of T3-4N0M0 NPC patients treated with sequential induction chemotherapy and concurrent chemoradiotherapy (IC+CCRT) or chemoradiotherapy (CCRT) alone.
Patients and Methods: We included 362 patients diagnosed with T3-4N0M0 NPC from two hospitals between December 2005 and December 2014. All patients were received IC + CCRT (n=146) or CCRT (n=216). Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were retrospectively estimated.
Results: The median follow-up was 95 (range: 11– 168) months. Univariable analyses have shown that 5-year LRFFS, DFS and OS in the IC+CCRT group and the CCRT group were 87.4% vs 93.4% (P = 0.035), 80.4% vs 87.0% (P = 0.047) and 86.3% vs 93.0% (P = 0.040). Multivariate analyses demonstrated that only the T stage was the independent prognostic factor for LRFFS, DFS, and OS in the entire group analysis. Subgroup analysis revealed that patients with T3 tumors who received IC+CCRT had significantly lower LRFFS, DFS, and OS than those treated with CCRT. For T4 patients, the outcomes had no significant difference between the two groups.
Conclusion: This retrospective study showed that T3N0M0 patients who received CCRT had better prognosis than those treated with IC+CCRT. In terms of T4N0M0 disease, treatment outcomes are similar in both treatment groups. However, these results require further confirmation of large sample size, prospectively, randomized controlled trials.
Keywords: nasopharyngeal carcinoma, chemotherapy, intensity-modulated radiation therapy
中文翻译：
探索在 T3-4N0M0 鼻咽癌患者同步放化疗中加入诱导化疗的价值：一项回顾性研究
目的： T3-4N0M0 鼻咽癌 (NPC) 患者是局部晚期 NPC 的独特亚组，其预后通常比其他人更好，并且在大多数针对局部晚期 NPC 的随机对照临床试验中经常被排除在外。该人群的管理仍存在争议。本研究旨在评估 T3-4N0M0 NPC 患者接受序贯诱导化疗和同步放化疗 (IC+CCRT) 或单独放化疗 (CCRT) 治疗的结果。
患者和方法：我们纳入了 2005 年 12 月至 2014 年 12 月期间来自两家医院的 362 名诊断为 T3-4N0M0 NPC 的患者。所有患者均接受了 IC + CCRT (n=146) 或 CCRT (n=216)。回顾性评估了局部区域无失败生存期（LRFFS）、无远处转移生存期（DMFS）、无病生存期（DFS）和总生存期（OS）。
结果：中位随访时间为 95（范围：11-168）个月。单变量分析显示，IC+CCRT 组和 CCRT 组的 5 年 LRFFS、DFS 和 OS 分别为 87.4% vs 93.4%（P = 0.035）、80.4% vs 87.0%（P = 0.047）和 86.3% vs 93.0 %（P = 0.040）。多变量分析表明，在整组分析中，只有 T 分期是 LRFFS、DFS 和 OS 的独立预后因素。亚组分析显示，接受 IC+CCRT 治疗的 T3 肿瘤患者的 LRFFS、DFS 和 OS 显着低于接受 CCRT 治疗的患者。对于 T4 患者，两组的结果没有显着差异。
结论：这项回顾性研究表明，接受 CCRT 的 T3N0M0 患者的预后优于接受 IC+CCRT 治疗的患者。在 T4N0M0 疾病方面，两个治疗组的治疗结果相似。然而，这些结果需要进一步证实大样本、前瞻性、随机对照试验。
【关键词】：鼻咽癌 化疗 调强放疗
更新日期：2021-09-09
Patients and Methods: We included 362 patients diagnosed with T3-4N0M0 NPC from two hospitals between December 2005 and December 2014. All patients were received IC + CCRT (n=146) or CCRT (n=216). Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were retrospectively estimated.
Results: The median follow-up was 95 (range: 11– 168) months. Univariable analyses have shown that 5-year LRFFS, DFS and OS in the IC+CCRT group and the CCRT group were 87.4% vs 93.4% (P = 0.035), 80.4% vs 87.0% (P = 0.047) and 86.3% vs 93.0% (P = 0.040). Multivariate analyses demonstrated that only the T stage was the independent prognostic factor for LRFFS, DFS, and OS in the entire group analysis. Subgroup analysis revealed that patients with T3 tumors who received IC+CCRT had significantly lower LRFFS, DFS, and OS than those treated with CCRT. For T4 patients, the outcomes had no significant difference between the two groups.
Conclusion: This retrospective study showed that T3N0M0 patients who received CCRT had better prognosis than those treated with IC+CCRT. In terms of T4N0M0 disease, treatment outcomes are similar in both treatment groups. However, these results require further confirmation of large sample size, prospectively, randomized controlled trials.
Keywords: nasopharyngeal carcinoma, chemotherapy, intensity-modulated radiation therapy
中文翻译：
探索在 T3-4N0M0 鼻咽癌患者同步放化疗中加入诱导化疗的价值：一项回顾性研究
目的： T3-4N0M0 鼻咽癌 (NPC) 患者是局部晚期 NPC 的独特亚组，其预后通常比其他人更好，并且在大多数针对局部晚期 NPC 的随机对照临床试验中经常被排除在外。该人群的管理仍存在争议。本研究旨在评估 T3-4N0M0 NPC 患者接受序贯诱导化疗和同步放化疗 (IC+CCRT) 或单独放化疗 (CCRT) 治疗的结果。
患者和方法：我们纳入了 2005 年 12 月至 2014 年 12 月期间来自两家医院的 362 名诊断为 T3-4N0M0 NPC 的患者。所有患者均接受了 IC + CCRT (n=146) 或 CCRT (n=216)。回顾性评估了局部区域无失败生存期（LRFFS）、无远处转移生存期（DMFS）、无病生存期（DFS）和总生存期（OS）。
结果：中位随访时间为 95（范围：11-168）个月。单变量分析显示，IC+CCRT 组和 CCRT 组的 5 年 LRFFS、DFS 和 OS 分别为 87.4% vs 93.4%（P = 0.035）、80.4% vs 87.0%（P = 0.047）和 86.3% vs 93.0 %（P = 0.040）。多变量分析表明，在整组分析中，只有 T 分期是 LRFFS、DFS 和 OS 的独立预后因素。亚组分析显示，接受 IC+CCRT 治疗的 T3 肿瘤患者的 LRFFS、DFS 和 OS 显着低于接受 CCRT 治疗的患者。对于 T4 患者，两组的结果没有显着差异。
结论：这项回顾性研究表明，接受 CCRT 的 T3N0M0 患者的预后优于接受 IC+CCRT 治疗的患者。在 T4N0M0 疾病方面，两个治疗组的治疗结果相似。然而，这些结果需要进一步证实大样本、前瞻性、随机对照试验。
【关键词】：鼻咽癌 化疗 调强放疗
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