Individualized cumulative cisplatin dose for locoregionally-advanced nasopharyngeal carcinoma patients receiving induction chemotherapy and concurrent chemoradiotherapy

Establishment of a Prognostic Nomogram for Patients With Locoregionally Advanced Nasopharyngeal Carcinoma Incorporating TNM Stage, Post-Induction Chemotherapy Tumor Volume and Epstein-Barr Virus DNA Load

“…Intensive treatments, such as targeted therapy, immunotherapy, and adjuvant therapy, may not produce survival benefits but increase the risk of toxicity and the economic burden. Moreover, a previous study has confirmed that a higher cumulative cisplatin dose during CCRT was not superior to a lower one in terms of survival for LA-NPC patients in the low-risk group with a smaller post-IC tumor volume or undetectable post-IC EBV DNA (37,38). As a result, for these patients, screening needs to be early and the intensity of treatment can be reduced to avoid unnecessary toxicities and costs.…”

“…Wen et al. demonstrated that high-risk patients with advanced T or N stage, higher pre-DNA or larger post-IC tumor volume benefited from CCD ≥ 200 mg/m 2 for PFS and DMFS ( 37 ). A previous study also showed that patients with detectable post-DNA showed significantly improved 3-year PFS and LRFS by receiving ≥ 160 mg/m 2 CCD ( 38 ).…”

Prognostic model for risk stratification of de novo metastatic nasopharyngeal carcinoma patients treated with chemotherapy followed by locoregional radiotherapy

“…Previous studies showed that the CCD of CCRT after IC was not an independent prognostic factor for OS. 20 , 21 , 22 , 23 , 24 However, a dose of CCD ≥200 mg/m 2 had the trend to prolong OS benefit in those with an unfavorable response to IC. In our study, we did not observe a statistically significant difference in OS between de novo mNPC patients treated with radiotherapy alone versus concomitant chemoradiotherapy after first-line chemotherapy.…”

Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline

“…17,123,143 If IC is given in addition to CCRT, retrospective data show that the cumulative cisplatin dose needed in CCRT phase is typically 160 mg/m 2 on the basis of patient tolerance of cumulative cisplatin. [144][145][146] For patients in whom cisplatin is contraindicated, other alternative concurrent agents include carboplatin (area under the curve [AUC] 5-6), 87,94,147 oxaliplatin (70 mg/m 2 weekly), 97 and nedaplatin (100 mg/m 2 triweekly). 56 If platinum-based chemotherapy is contraindicated, fluoropyrimidines such as UFT (uracil and tegafur in a 4:1 M ratio) 101 may also be offered as an option.…”