Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee
Cancer Res Treat. 2016;48(1):425-425. Published online January 10, 2016
Jin Ho Song, Hong-Gyun Wu, Bhum Suk Keam, Jeong Hun Hah, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Hyo Jung Park, Chang Geol Lee, Ki Chang Keum, Jihye Cha, Kwan Ho Cho, Sung Ho Moon, Ji-Yoon Kim, Woong-Ki Chung, Young Taek Oh, Won Taek Kim, Moon-June Cho, Chul Seung Kay, Yeon-Sil Kim
Cancer Res Treat. 2016;48(3):917-927. Published online December 28, 2015
Purpose We compared the treatment results and toxicity in nasopharyngeal carcinoma (NPC) patients treated with concurrent chemotherapy (CCRT) alone (the CRT arm) or neoadjuvant chemotherapy followed by CCRT (the NCT arm). Materials and Methods A multi-institutional retrospective study was conducted to review NPC patterns of care and treatment outcome. Data of 568 NPC patients treated by CCRT alone or by neoadjuvant chemotherapy followed by CCRT were collected from 15 institutions. Patients in both treatment arms were matched using the propensity score matching method, and the clinical outcomes were analyzed.
Results After matching, 300 patients (150 patients in each group) were selected for analysis. Higher 5-year locoregional failure-free survival was observed in the CRT arm (85% vs. 72%, p=0.014). No significant differences in distant failure-free survival (DFFS), disease-free survival (DFS), and overall survival were observed between groups. In subgroup analysis, the NCT arm showed superior DFFS and DFS in stage IV patients younger than 60 years. No significant difference in compliance and toxicity was observed between groups, except the radiation therapy duration was slightly shorter in the CRT arm (50.0 days vs. 53.9 days, p=0.018). Conclusion This study did not show the superiority of NCT followed by CCRT over CCRT alone. Because NCT could increase the risk of locoregional recurrences, it can only be considered in selected young patients with advanced stage IV disease. The role of NCT remains to be defined and should not be viewed as the standard of care.
Citations
Citations to this article as recorded by
Age is a significant biomarker for the selection of neoadjuvant chemotherapy plus radiotherapy versus concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma Yihong Lin, Xiongbin Yu, Linbin Lu, Hong Chen, Junxian Wu, Yaying Chen, Qin Lin, Xuewen Wang, Xi Chen, Xiong Chen Cancer Biomarkers.2023; 37(1): 1. CrossRef
Effect of Induction Chemotherapy in Nasopharyngeal Carcinoma: An Updated Meta-Analysis Shan-Shan Yang, Jian-Gui Guo, Jia-Ni Liu, Zhi-Qiao Liu, En-Ni Chen, Chun-Yan Chen, Pu-Yun OuYang, Fei Han, Fang-Yun Xie Frontiers in Oncology.2021;[Epub] CrossRef
Concurrent chemoradiotherapy with additional chemotherapy for nasopharyngeal carcinoma: A pooled analysis of propensity score‐matching studies Minmin Li, Bin Zhang, Qiuying Chen, Lu Zhang, Xiaokai Mo, Zhuozhi Chen, Zhe Jin, Luyan Chen, Jingjing You, Shuixing Zhang Head & Neck.2021; 43(6): 1912. CrossRef
Longitudinal Assessment of Intravoxel Incoherent Motion Diffusion Weighted Imaging in Evaluating the Radio-sensitivity of Nasopharyngeal Carcinoma Treated with Intensity-Modulated Radiation Therapy Youping Xiao, Ying Chen, Yunbin Chen, Zhuangzhen He, Yiqi Yao, Jianji Pan Cancer Research and Treatment.2019; 51(1): 345. CrossRef
Less is more: role of additional chemotherapy to concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal cancer management Yong Chan Ahn Radiation Oncology Journal.2019; 37(2): 67. CrossRef
A Pairwise Meta-Analysis of Induction Chemotherapy in Nasopharyngeal Carcinoma Pu-Yun OuYang, Xiao-Min Zhang, Xing-Sheng Qiu, Zhi-Qiao Liu, Lixia Lu, Yuan-Hong Gao, Fang-Yun Xie The Oncologist.2019; 24(4): 505. CrossRef
Induction chemotherapy for locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiation: A systematic review and meta-analysis Teng Hwee Tan, Yu Yang Soon, Timothy Cheo, Francis Ho, Lea Choung Wong, Jeremy Tey, Ivan W.K. Tham Radiotherapy and Oncology.2018; 129(1): 10. CrossRef
Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma Jiraporn Setakornnukul, Kullathorn Thephamongkhol BMC Cancer.2018;[Epub] CrossRef
TPF induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma: Long term results of a Tunisian series N. Toumi, W. Ben Kridis, W. Mnejja, R. Bouzguenda, A. Khanfir, A. Ghorbel, J. Daoud, M. Frikha Cancer/Radiothérapie.2018; 22(3): 216. CrossRef
Does concurrent chemoradiotherapy preceded by chemotherapy improve survival in locally advanced nasopharyngeal cancer patients? Experience from Ghana Joel Yarney, Naa A. Aryeetey, Alice Mensah, Emmanuel D. Kitcher, Verna Vanderpuye, Charles Aidoo, Kenneth Baidoo Cancers of the Head & Neck.2017;[Epub] CrossRef
Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in nasopharyngeal carcinoma patients with cervical nodal necrosis Mei Lan, Chunyan Chen, Ying Huang, Li Tian, Zhijun Duan, Fei Han, Junfang Liao, Meiling Deng, Terence T. Sio, Anussara Prayongrat, Lie Zheng, Shaoxiong Wu, Taixiang Lu Scientific Reports.2017;[Epub] CrossRef
A retrospective paired study: efficacy and toxicity of nimotuzumab versus cisplatin concurrent with radiotherapy in nasopharyngeal carcinoma H. M. Li, P. Li, Y. J. Qian, X. Wu, L. Xie, F. Wang, H. Zhang, L. Liu BMC Cancer.2016;[Epub] CrossRef
Min Kyu Kang, Dongryul Oh, Kwan Ho Cho, Sung Ho Moon, Hong-Gyun Wu, Dae-Seog Heo, Yong Chan Ahn, Keunchil Park, Hyo Jung Park, Jun Su Park, Ki Chang Keum, Jihye Cha, Jun Won Kim, Yeon-Sil Kim, Jin Hyoung Kang, Young-Taek Oh, Ji-Yoon Kim, Sung Hwan Kim, Jin-Hee Kim, Chang Geol Lee
Cancer Res Treat. 2015;47(4):871-878. Published online February 13, 2015
Purpose To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy. Materials and Methods From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy).
Results Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last followup, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival. Conclusion Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.
Citations
Citations to this article as recorded by
Concurrent chemoradiotherapy versus radiotherapy alone in older patients with stage II nasopharyngeal carcinoma after intensity-modulated radiotherapy: A propensity score-matched cohort study Fang Wang, Lu Zhou, Li-Jun Zhang, Chang-Bin Xie, Zhi-Wei Liao, Xiao-Dan Lin, Yue-Feng Wen Radiotherapy and Oncology.2024; 191: 110081. CrossRef
A Systematic Review and Meta-Analysis of Studies Comparing Concurrent Chemoradiotherapy With Radiotherapy Alone in the Treatment of Stage II Nasopharyngeal Carcinoma Yao-Can Xu, Kai-Hua Chen, Zhong-Guo Liang, Xiao-Dong Zhu Frontiers in Oncology.2022;[Epub] CrossRef
MRI-identified multidimensional nodal features predict survival and concurrent chemotherapy benefit for stage II nasopharyngeal carcinoma Yang Liu, Jianghu Zhang, Jingbo Wang, Runye Wu, Xiaodong Huang, Kai Wang, Yuan Qu, Xuesong Chen, Yexiong Li, Ye Zhang, Junlin Yi Radiology and Oncology.2022; 56(4): 479. CrossRef
The efficacy of chemotherapy in survival of stage II nasopharyngeal carcinoma Xin-Bin Pan, Ling Li, Song Qu, Long Chen, Shi-Xiong Liang, Xiao-Dong Zhu Oral Oncology.2020; 101: 104520. CrossRef
Survival of stage II nasopharyngeal carcinoma patients with or without concurrent chemotherapy: A propensity score matching study Di‐Han Liu, Xiao‐Yu Zhou, You‐Guang Pan, Si Chen, Zheng‐Hao Ye, Gang‐Dong Chen Cancer Medicine.2020; 9(4): 1287. CrossRef
Concurrent Chemoradiotherapy With or Without Induction Chemotherapy for Patients with Stage II Nasopharyngeal Carcinoma: An Update Ting Jin, Qun Zhang, Dong-Hua Luo, Feng Jiang, Qi-Feng Jin, Yuan-Yuan Chen, Xiao-Zhong Chen, Wei-Min Mao Translational Oncology.2020; 13(1): 25. CrossRef
Predictive factors of chemotherapy use in stage II nasopharyngeal carcinoma Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Yan-Ming Jiang, Xiao-Dong Zhu Medicine.2019; 98(7): e14512. CrossRef
The role of chemotherapy in the treatment of stage II nasopharyngeal carcinoma: Retrospective analysis of the national cancer database Zaheer Ahmed, Lara Kujtan, Kevin Kennedy, Valerie Wood, David Schomas, Janakiraman Subramanian Cancer Medicine.2019; 8(4): 1500. CrossRef
Patterns of Failure and Survival Trends in 3,808 Patients with Stage II Nasopharyngeal Carcinoma Diagnosed from 1990 to 2012: A Large-Scale Retrospective Cohort Study Xue-Song Sun, Di-Han Liu, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Ming-Huang Hong, Jun Ma, Lin-Quan Tang, Hai-Qiang Mai Cancer Research and Treatment.2019; 51(4): 1449. CrossRef
Combined chemoradiation vs radiation therapy alone in stage-II nasopharyngeal carcinoma: A meta-analysis of the published literature Sufang Wang, Shan Li, Liangfang Shen Current Problems in Cancer.2018; 42(3): 302. CrossRef
The efficacy of induction chemotherapy in the treatment of stage II nasopharyngeal carcinoma in intensity modulated radiotherapy era Pei-Jing Li, Hao-Yuan Mo, Dong-Hua Luo, Wei-Han Hu, Ting Jin Oral Oncology.2018; 85: 95. CrossRef
Concurrent chemoradiotherapy degrades the quality of life of patients with stage II nasopharyngeal carcinoma as compared to radiotherapy Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Yan-Ming Jiang, Jia-Lin Ma, Song Qu, Ling Li, Long Chen, Xiao-Dong Zhu Oncotarget.2017; 8(8): 14029. CrossRef
Chemotherapy use and survival in stage II nasopharyngeal carcinoma Xin-Bin Pan, Shi-Ting Huang, Kai-Hua Chen, Xiao-Dong Zhu Oncotarget.2017; 8(60): 102573. CrossRef
Long-term survival of nasopharyngeal carcinoma patients with Stage II in intensity-modulated radiation therapy era Qiaojuan Guo, Tianzhu Lu, Shaojun Lin, Jingfeng Zong, Zhuhong Chen, Xiaofei Cui, Yu Zhang, Jianji Pan Japanese Journal of Clinical Oncology.2016; 46(3): 241. CrossRef
Comparison of the efficacy between concurrent chemoradiotherapy with or without adjuvant chemotherapy and intensity-modulated radiotherapy alone for stage II nasopharyngeal carcinoma Kai-Hua Chen, Xiao-Dong Zhu, Ling Li, Song Qu, Zhen-Qiang Liang, Xia Liang, Xin-Bin Pan, Zhong-Guo Liang, Yan-Ming Jiang Oncotarget.2016; 7(42): 69041. CrossRef
Propensity score matching analysis of cisplatin-based concurrent chemotherapy in low risk nasopharyngeal carcinoma in the intensity-modulated radiotherapy era Lu-Ning Zhang, Yuan-Hong Gao, Xiao-Wen Lan, Jie Tang, Zhen Su, Jun Ma, Wuguo Deng, Pu-Yun OuYang, Fang-Yun Xie Oncotarget.2015; 6(41): 44019. CrossRef