Treatment of advanced nasopharyngeal cancer using low- or high-dose concurrent chemoradiotherapy with intensity-modulated radiotherapy: A propensity score-matched, nationwide, population-based cohort study.

Abstract

BACKGROUND:

No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC.

METHODS:

In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups.

RESULTS:

We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group.

CONCLUSION:

LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.

• Authors: Tsung-Ming Chen, Kuan-Chou Lin, Kevin Sheng-Po Yuan, Chia-Lun Chang, Jyh-Ming Chow, Szu-Yuan Wu
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 129 Issue 1 Pg. 23-29 (10 2018) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 29277447 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2017 Elsevier B.V. All rights reserved.

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage)
• Case-Control Studies
• Chemoradiotherapy (methods, mortality)
• Chemotherapy, Adjuvant
• Cisplatin (administration & dosage)
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Nasopharyngeal Carcinoma (therapy)
• Nasopharyngeal Neoplasms (mortality, therapy)
• Propensity Score
• Proportional Hazards Models
• Radiotherapy, Intensity-Modulated (methods, mortality)
• Research Design
• Retrospective Studies
• Taiwan (epidemiology)
• Treatment Outcome
• Young Adult