Efficacy and Toxicity of Three Induction Chemotherapy Regimens in Locoregionally Advanced Nasopharyngeal Carcinoma: Outcomes of 10-Year Follow-Up

Abstract

Background/ObjectiveWe aimed to compare the 10-year survival outcomes of induction docetaxel plus cisplatin and 5-fluorouracil (TPF), docetaxel plus cisplatin (TP), and cisplatin plus 5-fluorouracil (PF) regimens additional to concurrent chemoradiotherapy (CRT) in locoregionally advanced nasopharyngeal carcinoma (NPC).MethodsEligible patients with newly diagnosed stage III-IVA NPC were included. Propensity score matching (PSM) was used to balance prognostic covariates. Survival outcomes and toxicities between different groups were compared.ResultsA total of 855 patients between 2009 and 2012 were included, with 395 (46.2%), 258 (30.2%), and 202 (23.6%) receiving TPF plus CRT, TP plus CRT, and PF plus CRT regimens, respectively. After a median follow-up of 111.8 months, multivariate analysis both in the whole cohort and PSM selected 202 pairs showed that TPF plus CRT and TP plus CRT achieved significantly better 10-year overall survival (OS) than PF plus CRT. Sensitivity analysis after excluding patients with T3-4N0 disease demonstrated that TPF plus CRT still achieved significantly better OS than PF plus CRT (HR, 0.580; 95% CI, 0.395-0.852; P = 0.005), while the difference between TP plus CRT and PF plus CRT was marginally significant (HR, 0.712; 95% CI, 0.503-1.008; P = 0.056). With regard to toxicity profile, PF regimen achieved the lowest grade 3–5 toxicities (27.3%).ConclusionTPF plus CRT and TP plus CRT were better than PF plus CRT in improving the 10-year OS of patients with stage III-IVA NPC.

Induction chemotherapy regimen of docetaxel plus cisplatin versus docetaxel, cisplatin plus fluorouracil followed by concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: Preliminary results of an open-label, noninferiority, multicentre, randomised, controlled phase 3 trial

“…A big-data platform-based analysis 24 revealed that the induction TP regimen may result in similar survival to TPF for patients receiving a cumulative concurrent cisplatin dose over 200 mg/m 2 , while TPF may be superior to TP and PF for patients receiving a cumulative cisplatin dose less than 200 mg/m 2 , although grade 3–4 toxicities were more common but tolerable. Two other studies suggested selecting the IC regimen by adding the risk characteristics: Xiong et al 25 revealed that the TPF regimen showed a higher 5-year distant metastasis-free survival for relatively advanced stage IVA and N2-3 patients, while for stage III and N0-1, TP might be enough.…”

Effects of CIK Cell Therapy Combined with Camrelizumab on the Quality of Life in Patients with Nasopharyngeal Carcinoma and Analysis of Prognostic Factors

“… Quality of life [ 13 ]: the patients' quality of life 1 week before and 1 week after receiving camrelizumab combined with anrotinib was evaluated. The Functional Assessment of Cancer Therapy-Head and Neck (FACT-H＆N (V4.0)): FACT-G and FACT-HN was adopted.…”

Induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma: A systematic review and meta-analysis

“…On the other hand, published data have demonstrated that TPF achieved significantly better 10-year OS than PF (HR, 0.58; p = 0.005), and the difference between TP and PF was marginally significant (HR, 0.71; p = 0.056) (59). Regarding the 5-year data, TPF regimen significantly improved OS (88% vs. 81; p = 0.042) rate compared with the PF regimen (60).…”