BACKGROUND To ascertain if concurrent chemotherapy (CCT) benefits people with stage II nasopharyngeal carcinoma (NPC) treated with two-dimensional radiotherapy (2DRT) or intensity-modulated radiotherapy (IMRT). METHODS A total of 4157 patients diagnosed with stage II NPC were evaluated. Patients received radiotherapy (RT) with/without CCT. Patients were divided into 2DRT and IMRT subgroups. After propensity score matching, the role of CCT was explored in these two subgroups. Overall survival (OS) was the primary endpoint and progression-free survival (PFS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) were secondary endpoints. RESULTS In the 2DRT subgroup, CCT addition to RT benefited cases with T1N1/T2N1 in OS, PFS and LRFS (P < .001, P = .003 and P = .003, respectively) significantly, but no difference was observed in patients with T2N0. DMFS were similar in the two arms. CCT was a significant protective factor for OS, PFS, and LRFS for patients with stage N1. In the IMRT subgroup, RT alone could maintain equivalent OS, PFS, LRFS and DMFS (P = .209, .448, .477 and .602 respectively) and cause less acute toxicity compared with concurrent chemoradiotherapy (CCRT). CONCLUSION CCRT was better than 2DRT alone among patients with T1-2N1M0 stage. CCT application for NPC patients receiving IMRT led to no survival benefit and greater toxic effects.

中文翻译：

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有或没有同时化疗的II期鼻咽癌患者的生存率：一项倾向评分匹配研究。

背景技术为了确定同时化疗（CCT）是否有益于接受二维放疗（2DRT）或强度调制放疗（IMRT）治疗的II期鼻咽癌（NPC）患者。方法对4157例诊断为II期NPC的患者进行评估。患者接受有/无CCT的放疗（RT）。将患者分为2DRT和IMRT亚组。倾向得分匹配后，探讨了CCT在这两个亚组中的作用。总生存期（OS）是主要终点，无进展生存期（PFS），局部无复发生存期（LRFS）和远处无转移生存期（DMFS）是次要终点。结果在2DRT亚组中，在RT，CC和FS分别为T1N1 / T2N1的病例中，RT的CCT获益显着（分别为P <.001，P = .003和P = .003），但在T2N0患者中未观察到差异。DMFS在两个方面相似。CCT是N1期患者OS，PFS和LRFS的重要保护因素。在IMRT亚组中，仅RT可以维持相同的OS，PFS，LRFS和DMFS（分别为P = .209，.448，.477和.602），与同期放化疗相比，其急性毒性较小。结论在T1-2N1M0期患者中，CCRT优于单独的2DRT。在接受IMRT的NPC患者中使用CCT不会带来生存益处，并且会产生更大的毒性作用。与同期放化疗（CCRT）相比，其急性毒性较小。结论在T1-2N1M0期患者中，CCRT优于单独的2DRT。在接受IMRT的NPC患者中使用CCT不会带来生存益处，并且会产生更大的毒性作用。与同期放化疗（CCRT）相比，其急性毒性较小。结论在T1-2N1M0期患者中，CCRT优于单独的2DRT。在接受IMRT的NPC患者中使用CCT不会带来生存益处，并且会产生更大的毒性作用。