Background
Methods
Patients
Radiotherapy
Chemotherapy
Follow-up and statistical analysis
Results
Characteristics of the patients in the propensity-matched groups
Characteristic | CCRT group (n = 49) | IC plus RT group (n = 49) | IC plus CCRT group (n = 49) |
P value
*
|
---|---|---|---|---|
Sex | 0.672 | |||
Male | 32 (65.3 %) | 31 (63.3 %) | 35 (71.4 %) | |
Female | 17 (34.7 %) | 18 (36.7 %) | 14 (28.6 %) | |
Age (years) | 0.696 | |||
≤45 | 19 (38.8 %) | 20 (40.8 %) | 23 (46.9 %) | |
>45 | 30 (61.2 %) | 29 (59.2 %) | 26 (53.1 %) | |
Histological type | - | |||
WHO type I | 0 (0 %) | 0 (0 %) | 0 (0 %) | |
WHO type II/III | 49 (100 %) | 49 (100 %) | 49 (100 %) | |
T-category | 1.000 | |||
T1 | 1 (2 %) | 0 (0 %) | 0 (0 %) | |
T2 | 1 (2 %) | 2 (4.1 %) | 2 (4.1 %) | |
T3 | 32 (65.3 %) | 33 (67.3 %) | 32 (65.3 %) | |
T4 | 15 (30.6 %) | 14 (28.6 %) | 15 (30.6 %) | |
N-category | 0.956 | |||
N0 | 4 (8.2 %) | 4 (8.2 %) | 4 (8.2 %) | |
N1 | 29 (59.2 %) | 27 (55.1 %) | 28 (57.1 %) | |
N2 | 10 (20.4 %) | 13 (26.5 %) | 9 (18.4 %) | |
N3 | 6 (12.2 %) | 5 (10.2 %) | 8 (16.3 %) | |
Stage-group | 0.891 | |||
III | 31 (63.3 %) | 31 (63.3 %) | 29 (59.2 %) | |
IVA-B | 18 (36.7 %) | 18 (36.7 %) | 20 (40.8 %) |
Treatment | CCRT group (n = 49) | IC plus RT group (n = 49) | IC plus CCRT group (n = 49) | P value |
---|---|---|---|---|
RT dose (Gy) | 0.004* | |||
Median (range) | 68 (68–72) | 70 (68–72) | 70 (68–72) | |
RT days | 0.419* | |||
Median (range) | 44 (40–54) | 43 (40–54) | 44 (40–55) | |
IC regimen | 0.838† | |||
PF | - | 28 (57.1 %) | 29 (59.2 %) | |
TP | - | 21 (42.9 %) | 20 (40.8 %) | |
IC cycles | 0.170† | |||
Two cycles | - | 33 (67.3 %) | 39 (79.6 %) | |
Three cycles | - | 16 (32.7 %) | 10 (20.4 %) | |
CCRT cycles | 0.233† | |||
Two cycles | 40 (81.6 %) | - | 45 (91.8 %) | |
Three cycles | 9 (18.4 %) | - | 4 (8.2 %) |
Survival outcomes
Comparison | IC plus RT vs. CCRT | IC plus CCRT vs. CCRT | IC plus CCRT vs. IC plus RT |
---|---|---|---|
(n = 98) | (n = 98) | (n = 98) | |
Three-year DFS | 86.3 % vs. 82.1 % | 87.8 % vs. 82.1 % | 87.8 % vs. 86.3 % |
P value* | 0.592 | 0.533 | 0.924 |
Three-year OS | 91 % vs. 92.8 % | 95.8 % vs. 92.8 % | 95.8 % vs. 91 % |
P value* | 0.987 | 0.318 | 0.390 |
Three-year DMFS | 91.6 % vs. 87 % | 93.8 % vs. 87 % | 93.8 % vs. 91.6 % |
P value* | 0.526 | 0.290 | 0.676 |
Three-year LRRFS | 94.4 % vs. 90.4 % | 93.9 % vs. 90.4 % | 93.9 % vs. 94.4 % |
P value* | 0.425 | 0.646 | 0.709 |
Multivariate analyses
Endpoint | Factor | HR | 95 % CI |
P value
*
|
---|---|---|---|---|
Disease failure | Age >45 yrs vs. ≤45 yrs | 1.30 | 0.48-3.53 | 0.603 |
Sex female vs. male | 0.59 | 0.21-1.65 | 0.310 | |
AJCC T-category T4 vs. T1-3 | 2.47 | 1.01-6.07 | 0.048 | |
AJCC N-category N2-3 vs. N0-1 | 3.72 | 1.49-9.25 | 0.005 | |
RT dose >68 Gy vs. 68 Gy | 0.51 | 0.21-1.23 | 0.133 | |
Treatment group IC plus RT vs. CCRT | 0.83 | 0.29-2.42 | 0.734 | |
Treatment group IC plus CCRT vs. CCRT | 0.79 | 0.26-2.37 | 0.669 | |
Death | Age >45 yrs vs. ≤45 yrs | 2.69 | 0.57-12.76 | 0.212 |
Sex female vs. male | 1.46 | 0.40-5.35 | 0.572 | |
AJCC T-category T4 vs. T1-3 | 1.58 | 0.42-6.00 | 0.499 | |
AJCC N-category N2-3 vs. N0-1 | 2.97 | 0.84-10.54 | 0.092 | |
RT dose >68 Gy vs. 68 Gy | 0.29 | 0.07-1.12 | 0.071 | |
Treatment group IC plus RT vs. CCRT | 1.19 | 0.29-4.93 | 0.813 | |
Treatment group IC plus CCRT vs. CCRT | 0.64 | 0.11-3.85 | 0.622 | |
Distant failure | Age >45 yrs vs. ≤45 yrs | 1.97 | 0.54-7.25 | 0.306 |
Sex female vs. male | 0.59 | 0.15-2.26 | 0.437 | |
AJCC T-category T4 vs. T1-3 | 2.97 | 0.98-9.00 | 0.054 | |
AJCC N-category N2-3 vs. N0-1 | 8.38 | 2.26-31.06 | 0.001 | |
RT dose >68 Gy vs. 68 Gy | 0.53 | 0.18-1.57 | 0.248 | |
Treatment group IC plus RT vs. CCRT | 0.67 | 0.19-2.41 | 0.541 | |
Treatment group IC plus CCRT vs. CCRT | 0.48 | 0.11-2.00 | 0.310 | |
Locoregional | Age >45 yrs vs. ≤45 yrs | 0.62 | 0.15-2.52 | 0.506 |
failure | Sex female vs. male | 0.59 | 0.12-2.86 | 0.514 |
AJCC T-category T4 vs. T1-3 | 2.88 | 0.77-10.72 | 0.115 | |
AJCC N-category N2-3 vs. N0-1 | 1.31 | 0.32-5.41 | 0.705 | |
RT dose >68 Gy vs. 68 Gy | 0.54 | 0.14-1.99 | 0.351 | |
Treatment group IC plus RT vs. CCRT | 0.51 | 0.09-2.82 | 0.443 | |
Treatment group IC plus CCRT vs. CCRT | 0.77 | 0.16-3.65 | 0.738 |
Acute toxicities
Variable | CCRT group (n = 49) | IC plus RT group (n = 49) | IC plus CCRT group (n = 49) | P value* |
---|---|---|---|---|
Total Grade 3–4 acute adverse events | 16 (32.7 %) | 19 (38.8 %) | 20 (40.8 %) | 0.685 |
Hematologic | ||||
Leukopenia | 4 (8.2 %) | 10 (20.4 %) | 11 (22.4 %) | 0.126 |
Neutropenia | 3 (6.1 %) | 9 (18.4 %) | 9 (18.4 %) | 0.135 |
Anemia | 0 (0 %) | 1 (2 %) | 1 (2 %) | 1.000 |
Thrombocytopenia | 2 (4.1 %) | 2 (4.1 %) | 2 (4.1 %) | 1.000 |
Non–hematologic | ||||
Dermatitis | 1 (2 %) | 2 (4.1 %) | 2 (4.1 %) | 1.000 |
Mucositis | 11 (22.4 %) | 7 (14.3 %) | 12 (24.5 %) | 0.415 |
Dysphagia | 1 (2 %) | 0 (0 %) | 1 (2 %) | 1.000 |
Nausea/vomiting | 2 (4.1 %) | 2 (4.1 %) | 3 (6.1 %) | 1.000 |
Dry mouth | 0 (0 %) | 0 (0 %) | 0 (0 %) | - |
Ototoxicity | 0 (0 %) | 0 (0 %) | 0 (0 %) | - |
Hepatoxicity | 0 (0 %) | 3 (6.1 %) | 1 (2 %) | 0.324 |
Nephrotoxicity | 0 (0 %) | 0 (0 %) | 0 (0 %) | - |
Neurotoxicity | 0 (0 %) | 0 (0 %) | 0 (0 %) | - |