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Determination of optimum number of cycles of induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a single-center retrospective study

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Abstract

Background

Induction chemotherapy (IC) followed by concurrent chemo-radiotherapy (CCRT) is the current standard of care for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) patients. However, there is still no consensus on the optimum number of IC cycles. In this study, we aimed to assess the efficacy and toxicities of two or more cycles of IC for LA-NPC patients.

Methods

Data of LA-NPC patients consecutively treated with IC followed by concurrent chemo-radiotherapy (CCRT) in our institute from 2017 to 2022 were retrospectively retrieved and analyzed. Survival outcomes of patients who received two IC cycles were compared with those who received more than two IC cycles. Univariate and multivariate Cox regression analysis were then performed to determine factors that could be independent predictors of survival. Chi-square test and Fisher’s exact test were used to compare treatment associated acute toxicities between the two groups.

Results

A total of 125 patients were recruited in this study. There were 89 patients who received 2 cycles (IC = 2) of IC and 36 received more than 2 cycles (IC > 2) of IC. The median follow-up time was 26 months [IQR 16–38]. The 3-year overall survival rate was not statistically significant between the two groups (95.50% vs. 86.11%, P = 0.501). Similarly, loco-regional recurrence free survival and progression free survival were not significant (97.75% vs. 97.22%, P = 0.694; and 88.76% vs. 83.33%, P = 0.129), but distant metastasis free survival was significant (88.76% vs. 86.11%, P = 0.049). Multivariate Cox regression analysis showed that IC regimen was an independent prognostic factor.

Conclusions

Two cycles of IC is effective and more than two does not add any additional benefit to the survival outcomes of LA-NPC patients.

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Acknowledgements

We deeply thank all the participants for their participation and their contribution to this study.

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There is no funding support.

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Author notes

  1. Abdullahi Omar Ahmed, Juan Wang have contributed equally to this work.

Authors and Affiliations

  1. Hubei Key Laboratory of Tumor Biological Behaviors, Department of Radiation and Medical Oncology, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China

    Abdullahi Omar Ahmed, Juan Wang, Qiuji Wu & Yahua Zhong

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  1. Abdullahi Omar Ahmed
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  2. Juan Wang
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  3. Qiuji Wu
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Contributions

Conceptualization: AOA, QW and YZ. Methodology: AOA, and JW. Formal analysis and investigation: AOA and JW. Writing—original draft preparation: AOA. Writing—review and editing: JW, QW, YZ. Resources: QW and YZ. Supervision: QW and YZ.

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Correspondence to Qiuji Wu or Yahua Zhong.

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Ahmed, A.O., Wang, J., Wu, Q. et al. Determination of optimum number of cycles of induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a single-center retrospective study. Eur Arch Otorhinolaryngol 280, 1999–2006 (2023). https://doi.org/10.1007/s00405-022-07794-w

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