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Erschienen in:
23.05.2016 | Original Article
Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma
A matched-pair multicenter analysis of outcomes
Erschienen in: Strahlentherapie und Onkologie | Ausgabe 6/2016
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Purpose
The benefit of adjuvant chemotherapy (AC) in locoregionally advanced nasopharyngeal carcinoma (NPC) is controversial. This study compared concurrent chemoradiotherapy plus AC (CCRT/AC) with CCRT.
Methods
Pair-matched analysis based on eight clinicopathological features of 244 patients treated with platinum-based CCRT/AC or CCRT alone was performed. Survival outcomes were assessed using the Kaplan–Meier method and log-rank test. Toxicities and response rates were compared using Fisher’s exact test.
Results
Four-year overall survival, progression-free survival, distant failure-free survival, and locoregional failure-free survival were 72 %, 61 %, 71 %, and 81 %, respectively, for the CCRT arm, compared to 74 % (hazard ratio, HR 0.89; 95 % confidence interval, CI 0.64–1.23; P = 0.474), 62 % (HR 0.91, 95 % CI 0.68–1.20, P = 0.489), 73 % (HR 0.84, 95 % CI 0.59–1.18, P = 0.316), and 84 % (HR 0.84, 95 % CI 0.52–1.24, P = 0.323), respectively, for the CCRT/AC arm. Cox multivariate regression analysis demonstrated AC was not an independent prognostic factor. Overall, there was a higher incidence of grade 3–4 toxicities in the CCRT/AC arm. The most common grade 3–4 adverse events in the CCRT/AC arm were vomiting (27 %), nausea (43 %), leukopenia/neutropenia (23 %), thrombocytopenia (8.8 %), and anemia (6.2 %).
Conclusion
Addition of AC to CCRT increased toxicities but did not improve survival in locoregionally advanced NPC.