Induction chemotherapy for the treatment of non-endemic locally advanced nasopharyngeal carcinoma
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Lina Zhao1, Man Xu1, Wen Jiang2, Haitao Pan3, Jian Zang1, Shanquan Luo1, Jianhua Wang1, Yongchun Zhou1, Mei Shi1
1Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
3Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
Mei Shi, email: firstname.lastname@example.org
Keywords: nasopharyngeal carcinoma, induction chemotherapy, IMRT, non-endemic region, WHO II/III
Received: July 05, 2016 Accepted: December 05, 2016 Published: December 27, 2016
Background: The role of induction chemotherapy is less clear in non-endemic locally advanced nanopharyngeal carcinomas (NPC).
Results: With a total of 233 eligible patients and a median follow-up of 36 months, 3-year overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease free survival (DFS) were 84.5%, 94.9%, 78.6% and 69.2%, respectively. The overall failure rate was 21.0% and distant metastasis occurred in 17.2% patients. Multivariate analyses showed that retropharyngeal and bilateral neck lymph node metastasis were significant prognostic factors for DFS and OS. Moreover, patients receiving both GP (gemcitabine+cisplatin) and TP (docetaxel+cisplatin) regimes had significantly higher DFS and OS compared with PF (cisplatin+5-FU) regime. GP regimes lead to significantly improved OS than TP/PF in some subgroup of patients. No severe toxicities were observed.
Materials and Methods: We retrospectively analyzed stage III-IVb NPC patients treated between Jan 2006 and Dec 2014, with induction chemotherapy followed by concurrent chemoradiation (IC-CCRT). Statistical analyses were performed on survival and failure patterns.
Conclusions: These results suggested IC-CCRT was safe and effective for NPCs from non-endemic region. The choice of induction regimen appeared to affect patient outcomes.
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