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Long-term outcomes of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma treated with IMRT: a retrospective study

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Tumor Biology

Abstract

This study aimed to evaluate the efficacy of concurrent chemoradiotherapy (CCRT) for stage II nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT). A total of 249 patients were retrospectively reviewed. All patients were treated with IMRT. One hundred forty-three patients treated with CCRT and 106 patients treated with IMRT alone. With a median follow-up of 59.4 months, adding concurrent chemotherapy did not statistically significantly improve the 5-year overall survival (OS) (89.7 % vs 99.0 %, p = 0.278), locoregional relapse-free survival (LRFS) (94.8 % vs 89.3 %, p = 0.167), and distant metastases-free survival (DMFS) (93.4 % vs 97.5 %, p = 0.349). The patients with CCRT significantly experienced more acute toxic effects. The main grades 3–4 toxicity reactions were mucositis (26.6 % vs 15.1 %, p = 0.03) and leukopenia/neutropenia (9.1 % vs 0.9 %, p = 0.005). In subgroup analysis of patients with concurrent platinum single-agent chemotherapy the 5-year OS (98.4 % vs 81.9 %, p = 0.013) and DMFS (96.9 % vs 84.4 %, p = 0.043) of patients with platinum every 3 weeks (Q3W) were significantly higher than those with platinum weekly (QW) and no significant difference for LRFS (96.8 % vs 90.4 %, p = 0.150). CCRT did not improve the survival of patients with stage II NPC but increased the acute toxicity reactions. Patients with platinum Q3W improved the 5-year OS and DMFS, compared with those with platinum QW.

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    Authors and Affiliations

    1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China

      Zhen Su, Yan-Ping Mao, Jie Tang, Xiao-Wen Lan, Pu-Yun OuYang & Fang-Yun Xie

    2. State Key Laboratory of Oncology in South China, Guangzhou, 510060, China

      Zhen Su, Yan-Ping Mao, Jie Tang, Xiao-Wen Lan, Pu-Yun OuYang & Fang-Yun Xie

    3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China

      Zhen Su, Yan-Ping Mao, Jie Tang, Xiao-Wen Lan, Pu-Yun OuYang & Fang-Yun Xie

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    1. Zhen Su
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    Correspondence to Fang-Yun Xie.

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    This study was reviewed and approved by the institutional review board and ethics committee of Sun Yat-sen University Cancer Center. The study was retrospective. Patient records were anonymized and de-identified prior to analysis.

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    Zhen Su, Yan-Ping Mao and Jie Tang contributed equally to this work.

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    Su, Z., Mao, YP., Tang, J. et al. Long-term outcomes of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma treated with IMRT: a retrospective study. Tumor Biol. 37, 4429–4438 (2016). https://doi.org/10.1007/s13277-015-4266-5

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    • DOI: https://doi.org/10.1007/s13277-015-4266-5

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