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14.08.2018 | Original Article – Clinical Oncology | Ausgabe 11/2018

Journal of Cancer Research and Clinical Oncology 11/2018

Platinum-based concurrent chemotherapy remains the optimal regimen for nasopharyngeal carcinoma: a large institutional-based cohort study from an endemic area

Zeitschrift:
Journal of Cancer Research and Clinical Oncology > Ausgabe 11/2018
Autoren:
Yahui Yu, Hu Liang, Xing Lv, Liangru Ke, Wenze Qiu, Xinjun Huang, Guoying Liu, Wangzhong Li, Xiang Guo, Yanqun Xiang, Weixiong Xia
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00432-018-2721-6) contains supplementary material, which is available to authorized users.
Yahui Yu, Hu Liang, and Xing Lv contributed equally to this study.

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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