Long-term efficacy of concurrent chemoradiation therapy on patients with nasopharyngeal carcinoma
Keywords:
Nasopharyngeal carcinoma patients, Radiotherapy, Concurrent chemoradiotherapy, Long-term effects
Abstract
The objective of the study is to analyze and evaluate the long-term efficacy of concurrent chemoradiation therapy and the impact of other related factors to the prognosis of patients with nasopharyngeal carcinoma. A total of 897 cases of patients with nasopharyngeal carcinoma who were treated in our hospital in the period from December 2007 to February 2010 were divided into two groups according to the different treatment methods. The first group consists of 769 cases of patients treated with radical radiation therapy alone (radiotherapy group), and the second group consists of 128 patients treated with a combination of radical radiotherapy and chemotherapy (chemoradiotherapy group). While both groups of patients were subjected to the same modes of radiotherapy, an additional 2-3 cycles of concurrent chemotherapy were conducted for the second group of patients (using DDP + 5-Fu + BLM or DDP + 5-Fu). The overall 5-year survival rate of all patients was 51.23%, the 5-year survival rate among patients in the radiotherapy group was 48.46% and the 5-year survival rate of the chemoradiotherapy group was 56.80%. These results were found to be statistically significant (P <0.05). A multivariate stepwise regression analysis indicated that different N staging of nasopharyngeal carcinoma had a very significant effect (P <0.0001) for the patients’ survival. In addition, the different T staging also significantly affected (P <0.05) the patient's survival. The type of treatment (radiotherapy or chemoradiotherapy) administered can also have a significant impact on the prognosis, whereby the chemoradiotherapy group patients’ survival rate was significantly higher than the radiotherapy group (P <0.001). The implementation of concurrent chemoradiotherapy show long-term beneficial effects for naso-pharyngeal carcinoma patients. In particular, chemotherapy has a greater impact towards the survival of N2 and N3 stage nasopharyngeal carcinoma patients.Abstract: The objective of the study is to analyze and evaluate the long-term efficacy of concurrent chemoradiation therapy and the impact of other related factors to the prognosis of patients with nasopharyngeal carcinoma. A total of 897 cases of patients with nasopharyngeal carcinoma who were treated in our hospital in the period from December 2007 to February 2010 were divided into two groups according to the different treatment methods. The first group consists of 769 cases of patients treated with radical radiation therapy alone (radiotherapy group), and the second group consists of 128 patients treated with a combination of radical radiotherapy and chemotherapy (chemoradiotherapy group). While both groups of patients were subjected to the same modes of radiotherapy, an additional 2-3 cycles of concurrent chemotherapy were conducted for the second group of patients (using DDP + 5-Fu + BLM or DDP + 5-Fu). The overall 5-year survival rate of all patients was 51.23%, the 5-year survival rate among patients in the radiotherapy group was 48.46% and the 5-year survival rate of the chemoradiotherapy group was 56.80%. These results were found to be statistically significant (P <0.05). A multivariate stepwise regression analysis indicated that different N staging of nasopharyngeal carcinoma had a very significant effect (P <0.0001) for the patients’ survival. In addition, the different T staging also significantly affected (P <0.05) the patient's survival. The type of treatment (radiotherapy or chemoradiotherapy) administered can also have a significant impact on the prognosis, whereby the chemoradiotherapy group patients’ survival rate was significantly higher than the radiotherapy group (P <0.001). The implementation of concurrent chemoradiotherapy show long-term beneficial effects for naso-pharyngeal carcinoma patients. In particular, chemotherapy has a greater impact towards the survival of N2 and N3 stage nasopharyngeal carcinoma patients.References
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2. Ma J, Mai HQ, Hong MH. Long-term results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone for patients with locoregionally advanced nasopharyngeal carcinoma J. Cancer 2001; 20(5): 505–510.
3. Pan JJ, Lin SJ, Wu JX. Long term results of a prospective randomized study on nasopharyngeal carcinoma by radiotherapy combined with induction or concurrent chemotherapy. Chin J Radiat Oncol 2009; 9(4): 221–224.
4. Li J. The detection and management of adverse reactions during nasopharyngeal concurrent chemotherapy treatment. Mod Med 2008; 24(4): 574–575.
5. Feng XW, Peng ZP, Li Q. Clinical study on concurrent chemoradiotherapy and radiotherapy alone for advanced nasopharygeal carcinoma. J Appl Clin Hosp 2009; 6(5): 50–51.
6. Hu Y, Liu HF. Combination gemcitabine and cisplatin in the treatment for 20 cases with metastatic or recurrent nasopharyngeal carcinoma. J Oncol 2009; 15(1): 82–83.
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12. Chen Y, Ren W, Zheng D, Zhong J, Liu X, et al. Diffusion kurtosis imaging predicts neoadjuvant chemotherapy responses within 4 days in advanced nasopharyngeal carcinoma patients. J Magn Reson Imaging 2015; 42(5):1354–1361. doi: 10.1002/jmri.24910.
13. Golden DW, Witt M, Rudra SR, Nwizu TI, Cohen EE, et al. Outcomes of induction chemotherapy and concurrent chemoradiation for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2012; 84(3): S485–S486. doi: 10.1016/j.ijrobp.2012.07.1288.
14. Wu SY, Wu YH, Yang MW, Hsueh WT, Hsiao JR, et al. Comparison of concurrent chemoradiotherapy versus neoadjuvant chemotherapy followed by radiation in patients with advanced nasopharyngeal carcinoma in endemic area: Experience of 128 consecutive cases with 5 year follow-up. BMC Cancer 2014; 14: 787. doi: 10.1186/1471–2407–14–787.
15. Park KH, Kim JS, Park Y, Seo HY, Park YJ, et al. Concurrent chemoradiation followed by adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma in Korea. Cancer Chemother Pharmacol 2010; 66(4): 643–651. doi: 10.1007/s00280–009–1203–6.
16. Zheng J, Wang G, Yang GY, Wang D, Luo X, et al. Induction chemotherapy with nedaplatin with 5–FU followed by intensity-modulated radiotherapy concurrent with chemotherapy for locoregionally advanced nasopharyngeal carcinoma. Jpn J Clin Oncol 2010; 40(5): 425–431. doi: 10.1093/jjco/hyp183.
17. Kong L, Hu C, Niu X, Zhang Y, Guo Y, et al. Neoadjuvant chemotherapy followed by concurrent chemoradiation for locoregionally advanced nasopharyngeal carcinoma: Interim results from 2 prospective phase 2 clinical trials. Cancer 2013; 119(23): 4111–4118. doi: 10.1002/cncr.28324.
2. Ma J, Mai HQ, Hong MH. Long-term results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone for patients with locoregionally advanced nasopharyngeal carcinoma J. Cancer 2001; 20(5): 505–510.
3. Pan JJ, Lin SJ, Wu JX. Long term results of a prospective randomized study on nasopharyngeal carcinoma by radiotherapy combined with induction or concurrent chemotherapy. Chin J Radiat Oncol 2009; 9(4): 221–224.
4. Li J. The detection and management of adverse reactions during nasopharyngeal concurrent chemotherapy treatment. Mod Med 2008; 24(4): 574–575.
5. Feng XW, Peng ZP, Li Q. Clinical study on concurrent chemoradiotherapy and radiotherapy alone for advanced nasopharygeal carcinoma. J Appl Clin Hosp 2009; 6(5): 50–51.
6. Hu Y, Liu HF. Combination gemcitabine and cisplatin in the treatment for 20 cases with metastatic or recurrent nasopharyngeal carcinoma. J Oncol 2009; 15(1): 82–83.
7. Chen Y, Liang ZB, Wang SY. A clinical study of acute toxicities of concurrent chemoradiotherapy plus adjuvant chomotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. Chin J Pract Med 2010; 5(15): 29–31.
8. Hua YJ, Hong MH, Luo DH, Qiu F, Guo L, et al. Multivariable analysis of prognostic predictors for 406 patients with nasopharyngeal carcinoma. Chin J Clin Oncol 2005; 32(8): 435–438.
9. Chen Y, Liang S, Mao Y, Zong J, Tang L, et al. A prospective randomized trial of concurrent chemoradiotherapy plus adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. Chin J Clin Oncol 2008; 35(14): 785–789.
10. Zou GR, Cao XL. The effect of GP or PF treatment regimens on patients with metastatic nasopharyngeal carcinoma after the initial treatment: A control study. Chin Community Doct 2011; 13(268): 106–108.
11. King AD, Vlantis AC, Yuen TWC, Law BKH, Bhatia KS, et al. Detection of nasopharyngeal carcinoma by MR imaging: Diagnostic accuracy of MRI compared with endoscopy and endoscopic biopsy based on long-term follow-up. ANJR Am J Neuroradiol 2015; 36(12): 2380–2385. doi: 10.3174/ajnr.A4456.
12. Chen Y, Ren W, Zheng D, Zhong J, Liu X, et al. Diffusion kurtosis imaging predicts neoadjuvant chemotherapy responses within 4 days in advanced nasopharyngeal carcinoma patients. J Magn Reson Imaging 2015; 42(5):1354–1361. doi: 10.1002/jmri.24910.
13. Golden DW, Witt M, Rudra SR, Nwizu TI, Cohen EE, et al. Outcomes of induction chemotherapy and concurrent chemoradiation for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2012; 84(3): S485–S486. doi: 10.1016/j.ijrobp.2012.07.1288.
14. Wu SY, Wu YH, Yang MW, Hsueh WT, Hsiao JR, et al. Comparison of concurrent chemoradiotherapy versus neoadjuvant chemotherapy followed by radiation in patients with advanced nasopharyngeal carcinoma in endemic area: Experience of 128 consecutive cases with 5 year follow-up. BMC Cancer 2014; 14: 787. doi: 10.1186/1471–2407–14–787.
15. Park KH, Kim JS, Park Y, Seo HY, Park YJ, et al. Concurrent chemoradiation followed by adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma in Korea. Cancer Chemother Pharmacol 2010; 66(4): 643–651. doi: 10.1007/s00280–009–1203–6.
16. Zheng J, Wang G, Yang GY, Wang D, Luo X, et al. Induction chemotherapy with nedaplatin with 5–FU followed by intensity-modulated radiotherapy concurrent with chemotherapy for locoregionally advanced nasopharyngeal carcinoma. Jpn J Clin Oncol 2010; 40(5): 425–431. doi: 10.1093/jjco/hyp183.
17. Kong L, Hu C, Niu X, Zhang Y, Guo Y, et al. Neoadjuvant chemotherapy followed by concurrent chemoradiation for locoregionally advanced nasopharyngeal carcinoma: Interim results from 2 prospective phase 2 clinical trials. Cancer 2013; 119(23): 4111–4118. doi: 10.1002/cncr.28324.
Published
2017-01-19
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Copyright (c) 2016 Yan Wenming
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