Cycle number of neoadjuvant chemotherapy might influence survival of patients with T1-4N2-3M0 nasopharyngeal carcinoma

Wei, Jiawang; Feng, Hui-Xia; Xiao, Weiwei; Wang, Qiaoxuan; Qiu, Bo; Liu, Shiliang; Deng, Meiling; Lü, Lixia; Chang, Hui; Gao, Yuanhong

doi:10.21147/j.issn.1000-9604.2018.01.06

Cited by 20 publications

(22 citation statements)

References 35 publications

(18 reference statements)

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“…Moreover, 91.0% of the NPC‐related deaths had DM. By contrast, only 34.0% of them underwent LR It was in accordance with previous studies that DM, rather than LR, is the primary obstacle to treatment success in N2‐3 NPC patients . As we know, DM is mainly eradicated by chemotherapy.…”

Section: Discussionsupporting

confidence: 87%

“…These studies established the optimal dose interval as 160‐240 mg/m 2 . In our hospital, the cisplatin dose of NACT was 60 mg/m 2 and 80 mg/m 2 in the TPF and the PF regimens, respectively . So the cumulative cisplatin dose for the patients of our study could reach ≥180‐240 mg/m 2 , which was showed to be effective in controlling DM.…”

Section: Discussionmentioning

confidence: 60%

“…Namely, NPC of late N (N2‐3) stages might be an indication for NACT. Furthermore, studies by Peng et al and us found that NACT of ≥3 cycles might be more effective in eradicating DM and improving overall survival (OS) for N2‐3 NPC …”

Section: Introductionmentioning

confidence: 94%

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Necessity of concurrent chemotherapy in N2‐3 nasopharyngeal carcinoma treated with neoadjuvant chemotherapy of ≥3 cycles followed by intensity‐modulated radiotherapy

et al. 2019

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Concurrent chemotherapy (CCT) is used in locally advanced nasopharyngeal carcinoma (NPC) for improved local control, which could also be achieved by intensity‐modulated radiotherapy (IMRT). And for N2‐3 NPC, distant metastasis is the more important cause of death. This study aims to evaluate the value of CCT in N2‐3 NPC when neoadjuvant chemotherapy (NACT) of sufficient cycles is performed to eradicate distant metastasis. It enrolled 959 patients diagnosed with TxN2‐3M0 NPC from July 2011 to December 2015 and treated with NACT of 3‐4 cycles and IMRT. A propensity score matching (PSM) was made between patients treated with and without CCT (called the CCT and non‐CCT groups, respectively), using a series of clinical characteristics (age, gender, T stage, N stage, NACT regimen, and EBV DNA) as covariates. After PSM, the two groups of patients were compared on survivals and acute toxicities. The results indicated that no difference was seen in the overall, disease‐free, recurrence‐free or metastasis‐free survivals between the two groups. But compared with the CCT group, the non‐CCT group had a lower patient proportion of myelosuppression, nausea/vomiting, oral mucositis, cervical dermatitis, xerostomia, and grade 3/4 myelosuppression and oral mucositis (all P values were <0.001). Hence, CCT appeared to bring more acute toxicities, instead of survival benefit, to N2‐3 NPC patients treated with NACT of ≥3 cycles and IMRT. It should be used with cautions in these patients.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 60%

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Necessity of concurrent chemotherapy in N2‐3 nasopharyngeal carcinoma treated with neoadjuvant chemotherapy of ≥3 cycles followed by intensity‐modulated radiotherapy

et al. 2019

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“…Although the results were not entirely consistent, these studies corroborated the fact that additional more cycles of IC might not lead to better survival outcomes. In contrast to these three studies, the scholars in another study reported that the number of IC appeared to be an independent predictor and for N2-3 NPC, survival data of the 4 cycles of IC were better than those of 2 cycles [20]. It is noted that the study paid attention to advance N stage patients and lack of patient receiving 3 cycles of IC.…”

Section: Discussionmentioning

confidence: 82%

Optimize the number of cycles of induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a propensity score matching analysis

Jiang¹,

Chen²,

Yang³

et al. 2022

J. Cancer

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Background: There is no conclusive on the optimal number of cycles of induction chemotherapy (IC) with the greatest benefit to patient survival. This study aimed to assess the efficiency and acute toxicities of different cycles of IC for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Methods: We reviewed data from patients with LA-NPC treated with IC plus concurrent chemoradiation (CCRT). Propensity score matching (PSM) was applied to match paired patients. After PSM, survival outcomes of matched patients were compared between two and three cycles of IC groups. Univariate and multivariate Cox regression analysis were carried out to identify potentially independent predictors. Treatment-related acute toxicities between the two groups were compared by Pearson X 2 test or Fisher's exact test. Results: In total, 189 pairs were selected. The median follow-up time was 60 months (range 5 to 126 months). There was no difference between two and three cycles of IC in terms of 5-year overall survival (87.0% vs. 89.7%, p = 0.991), distant metastasis-free survival (90.1% vs. 86.8%, p = 0.587), locoregional recurrence-free survival (97.0% vs. 93.8%, p = 0.488), or progression-free survival (79.4% vs. 79.3%, p = 0.896). Multivariate Cox analysis showed that T stage, N stage, and clinical stage were independent prognostic factors. Three cycles of IC were associated with a higher incidence of Grade 1-2 acute toxicity than two cycles during IC period. Conclusion:The efficacy of two cycles of IC achieved similar survival outcomes as three cycles and has a lower incidence of treatment-related acute toxicity.

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“…12 The Health-related quality of life (HR-QOL) assessment on NPC patients are essential to assess the success of NPC treatment and identify the effects on certain functional disorders. 13 Wei et al 14 study evaluated the impact of neoadjuvant chemotherapy (NACT) of various NACT cycles before radiotherapy on distant metastases and survival of patients with N2-3. The study results showed overall survival (OS), disease-free survival (DFS), local-relapse-free survival (LRFS) and distant-metastasis-free survival (DMFS) of the four-cycle NACT group was better than the two-cycle NACT group and the two-cycle NACT group patients without NACT.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Neck Nodule Size with Body Mass Index and Karnofsky Status Before and After Neoadjuvant Cisplatin and 5-Fluorouracil Chemotherapy in Nasopharyngeal Carcinoma Type 3 Patients

Efranto

Soehartono

Handoko

2021

Oto Rhino Laryn Indones

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Introduction: Nasopharyngeal carcinoma (NPC) is a malignancy arising from the nasopharyngeal epithelium, usually present in the Rosenmüller fossa. NPC is a cancer of the head and neck that is most common in East Asia and Southeast Asia, including in Indonesia. The main therapeutic for NPC is radiotherapy. Neoadjuvant chemotherapy reduces the local spread of advanced NPC, eradication of micrometastases, and improved local control. Neoadjuvant chemotherapy's effectiveness can be assessed by changes in the patient's neck nodule size (N), the patient's Body Mass Index (BMI), and Karnofsky's Status. Aim: To determine the correlation between N with BMI and Karnofsky status on neoadjuvant chemotherapy Cisplatin and 5-Fu in WHO type 3 of NPC patients. Methods: This study was an analytical observational study using medical record data. In this study, an assessment of N, BMI and Karnofsky status of NPC WHO type 3 patients who had undergone neoadjuvant chemotherapy using the Cisplatin and 5-Fu regimen for three cycles. Twenty-three study subjects were analyzed for N, BMI and Karnofksy status changes while undergoing neoadjuvant chemotherapy for up to 3 cycles. Result: The N value decreased, p = 0.001. BMI value decreased, p = 0.615. Karnofsky's status value experienced insignificant changes, p = 0.564. The correlation between N and BMI before a cycle I neoadjuvant chemotherapy and three cycles of neoadjuvant chemotherapy obtained r = -0.201 and p = 0.358, respectively; r = -0.070 and p = 0.751. Correlation of N with Karnofsky status was obtained r = 0.155 and p = 0.480, before cycle I neoadjuvant chemotherapy. The correlation between N and Karnofsky status was obtained r = 0.571 and p = 0.004 after cycle III neoadjuvant chemotherapy. Conclusion: Neoadjuvant chemotherapy Cisplatin and 5-Fu is effective against changes in N and correlation between N and BMI but less effective in assessing the correlation between N and Karnofsky status after three cycles of neoadjuvant chemotherapy. Correspondence should be addressed to Bagus Harning Efranto; bagushe16@gmail.com

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Cycle number of neoadjuvant chemotherapy might influence survival of patients with T1-4N2-3M0 nasopharyngeal carcinoma

Abstract: For N2-3 NPC, cycle number of NACT appeared to be an independent factor associated with an improvement of survival.

Cited by 20 publications

References 35 publications

Necessity of concurrent chemotherapy in N2‐3 nasopharyngeal carcinoma treated with neoadjuvant chemotherapy of ≥3 cycles followed by intensity‐modulated radiotherapy

Necessity of concurrent chemotherapy in N2‐3 nasopharyngeal carcinoma treated with neoadjuvant chemotherapy of ≥3 cycles followed by intensity‐modulated radiotherapy

Optimize the number of cycles of induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma: a propensity score matching analysis

Correlation of Neck Nodule Size with Body Mass Index and Karnofsky Status Before and After Neoadjuvant Cisplatin and 5-Fluorouracil Chemotherapy in Nasopharyngeal Carcinoma Type 3 Patients

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