Feasibility and efficiency of double-agent versus single-agent concurrent chemoradiotherapy in patients with nasopharyngeal carcinoma. (July 2020)

• Record Type: Journal Article
• Authors: Qin, Guanjie; Rai, Raju; Zhang, Rongjun; Su, Yixin; Zhang, Bin; Pan, Yuefei; Xiong, Ruihua; Xie, Yuan; Yang, Huiyun; Kong, Xiangyun; Luo, Zan; Ruan, Xiaolan; Mo, Yunyan; Aftab, Omer; Shahisanjeev, ; Jazib, ; Jiang, Wei
• Is Part Of: Oral oncology. Volume 106(2020)
• Publication Date: 2020-07
• Subjects: Nasopharyngeal carcinoma -- Concurrent chemoradiotherapy -- Single-agent chemotherapy -- Double-agent chemotherapy -- Prognosis; NPC nasopharyngeal carcinoma -- RT radiotherapy -- IMRT intensity-modulated radiotherapy -- CCRT concurrent chemoradiotherapy -- d-CCRT double-agent CCRT -- s-CCRT single-agent CCRT -- CR complete response -- PR partial response -- MRI magnetic resonance imaging -- CT computed tomograpy -- OS overall survival -- DFS disease free survival -- LRRFS locoregional relapse-free survival -- DMFS distant metastasis-free survival -- IQR interquartile range -- HR hazard ratio -- CI confidence interval; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2020.104704
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Multivariate analysis showed that CCRT regimen had no significant effects on survival. d-CCRT regimen did not confer significant survival benefits in the treatment of stage II-IV NPC patients. Patients treated with the d-CCRT regimen experienced greater hematological toxicity. Abstract: Purpose: Concurrent chemoradiotherapy (CCRT) is the mainstay of treatment for nasopharyngeal carcinoma (NPC) patients. It remains unclear whether double-agent CCRT (d-CCRT) is more effective than single-agent CCRT (s-CCRT). In this study, we compared the treatment efficiency and toxicity of d-CCRT with s-CCRT in NPC patients. Methods and materials: Patients with stage II-IV NPC treated with d-CCRT or s-CCRT were retrospectively reviewed. The d-CCRT group patients were compared with s-CCRT group patients for overall survival (OS), locoregional relapse-free survival (LRRFS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and toxicity. Differences in baseline characteristics were adjusted using the pair-matching method. Results: In this study, 933 patients who received CCRT for NPC between 2011 and 2014 were pair-matched at a 1:2 ratio (n = 311 for d-CCRT; n = 622 for s-CCRT). The d-CCRT treated patients showed no significant advantages in terms of 4-year OS (87.2% vs. 85.5%), DFS (84.1% vs. 79.5%), LRRFS (94.6% vs. 91.8%), DMFS (87.5% vs. 85.5%) compared with s-CCRT treated patients ( P = 0.450, 0.106, 0.203, 0.366, respectively). Multivariate analysis showed that CCRT regimen had no significant effects on survival. In the d-CCRT group, the incidence of grade 3–4 hematological toxicities was significantly higher. Conclusions: The d-CCRT regimen did not confer significant survival benefits compared with the s-CCRT regimen in the treatment of stage II-IV NPC patients. Furthermore, patients treated with the d-CCRT regimen experienced greater hematological toxicity.