Induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma

Li, Wen Fei; Chen, Lei; Sun, Ying; Ma, Jun

doi:10.1186/s40880-016-0157-4

Cited by 18 publications

(20 citation statements)

References 20 publications

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“…However, due to the limitations of the database that was used in this study, we are unable to draw any conclusions regarding the use of various chemotherapy regimens and its effect on OS. Several randomized trials assessing various induction chemotherapy regimens are currently underway and will assist in confirming the most optimal induction regimen 25. It is believed that induction therapy may have more of a role with WHO type 2/3 tumors compared to WHO type 1 26, 27.…”

Section: Discussionmentioning

confidence: 99%

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

et al. 2018

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The role of induction chemotherapy in nasopharyngeal carcinoma (NPC) remains controversial. The primary aim of this study was to use the National Cancer Database to evaluate the patterns of care of induction chemotherapy in NPC and its impact on overall survival (OS). Patients with NPC from 2004 to 2014 were obtained from the NCDB. Patients were considered to have received induction chemotherapy if it was started ≥43 days before the start of RT and concurrent CRT if chemotherapy started within 21 days after the start of RT. Propensity score matching was used to control for selection bias. Cox proportional hazards model was used to determine significant predictors of OS. Logistic regression model was used to determine predictors of the use of induction chemotherapy. Significance was defined as a P value <.05. A total of 4857 patients were identified: 4041 patients (87.2%) received concurrent CRT and 816 patients (16.8%) received induction chemotherapy. The use of induction therapy remained stable between 2004 and 2014. Younger patients and those with higher T‐ and N‐stage had a higher likelihood of being treated with induction chemotherapy. The 5‐year OS in patients treated with induction chemotherapy and CRT was 66.3% vs 69.1%, respectively (P = .25). There was no difference in OS when these two groups were analyzed after propensity score matching. No differences in OS existed between these treatment groups in patients with T3‐T4N1 or TanyN2‐3 disease (P = .76). Propensity score matching also did not reveal any difference in OS in patients with T3‐T4N1 or TanyN2‐3 disease. The use of induction chemotherapy has remained stable in the last decade. In this study of patients with NPC, induction chemotherapy was not associated with improved OS compared to CRT alone.

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Section: Discussionmentioning

confidence: 99%

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

et al. 2018

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“…[20]. According to Wen-Fei Li and al,the addition of TPF induction chemotherapy to RCTsignificantly increased failure-free survival, overall survival , and distant failure-free survival rates [21]. A Chinese study showed that IC followed by RCT was an effective treatment strategy for LA-NPC.…”

Section: Resultsmentioning

confidence: 99%

Complete Clinical Response after Induction Chemotherapy Followed by Chemoradiotherapy in Nasopharyngeal Carcinoma: Impact on Oncologic Outcomes

Letaief¹,

Berrazaga²,

Ayadi³

et al. 2017

Journal of Cancer science and Clinical Oncology

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Objective: Concomitant chemoradiation (RCT) represents the standard of care for locally-advanced nasopharyngeal carcinoma (NPC).Nevertheless induction chemotherapy (IC) followed by RCT is currently an attractive approach. Some trials showed a survival benefit of this therapeutic strategy. The aim of this study was to analyze complete clinical response (CCR) after IC and to assess its impact on disease control and survival.

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“…According to Wen-Fei Li and al, the addition of TPF induction chemotherapy to RCT significantly increased failure-free survival, overall survival, and distant failure-free survival rates [21].…”

Section: Discussionmentioning

confidence: 99%

Complete clinical response after induction chemotherapy followed by chemoradiotherapy in nasopharyngeal carcinoma: Impact on oncologic outcomes

Feryel¹,

Berrazaga²,

Ayadi³

et al. 2017

Otorhinolaryngol Head Neck Sur

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Objective: Concomitant chemoradiation (RCT) represents the standard of care for locally-advanced nasopharyngeal carcinoma (NPC). Nevertheless, induction chemotherapy (IC) followed by RCT could be an interesting approach. Some trials showed a survival benefit of this therapeutic strategy, but it is not the standard of care. The aim of this study was to analyze clinical response after IC and to assess its impact on disease control and survival. Materials and methods:We conducted a retrospective study from January 2008 to December 2014. Forty patients with locally advanced NPC were treated in our institute. All patients received IC with fluorouracyl-cisplatin (5 FU-CDDP) or fluorouracyl-cisplatin-Docetaxel (TPF) or Adriamycin-cisplatin (AD-CDDP). After IC, clinical response was evaluated, CCR was defined by a normal clinical and computed tomography examination. After IC, 14 patients received RCT and 22 patients received radiotherapy (RT) alone.Results: Our study included 25 men and 15 women with a median age of 41years. Tumor was classified T1 in 5% of patients, T2 in 27%, T3 in 20% and T4 in 48%. 80% of patients had involved nodes (N+). Twenty patients received 5FU-CDDP, 16 received TPF and 4 received AD-CDDP. The occurrence of leucopenia was higher in the 5FU-CDDP (p=0.02) group. Gastrointestinal toxicity was higher in the TPF group (p=0.01). Anemia and thrombopenia were similar in the three groups. After IC, 18 patients (45%) achieved CCR, 7 of them had RCT and 11 had RT alone. 21patients (52%) achieved partial clinical response (PR) and 1 patient developed metastases. The CCR was higher in (5FU-CDDP) group (p>0.3). CCR followed by RCT was associated to better local control than RT alone. However, there was no benefit in overall survival in the CCR group compared to partial clinical response (PR). Conclusion:Complete clinical response after IC followed by RCT in locally-advanced nasopharyngeal carcinoma is associated to a better local disease control without impact on survival.

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Induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma

Cited by 18 publications

References 20 publications

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

Complete Clinical Response after Induction Chemotherapy Followed by Chemoradiotherapy in Nasopharyngeal Carcinoma: Impact on Oncologic Outcomes

Complete clinical response after induction chemotherapy followed by chemoradiotherapy in nasopharyngeal carcinoma: Impact on oncologic outcomes

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