Radiotherapy with neoadjuvant chemotherapy versus concurrent chemoradiotherapy for ascending-type nasopharyngeal carcinoma: a retrospective comparison of toxicity and prognosis.

Abstract

BACKGROUND:

In the era of intensity-modulated radiotherapy (IMRT), the role of neoadjuvant chemotherapy (NACT) in treating ascending-type nasopharyngeal carcinoma (NPC) is under-evaluated. This study was to compare the efficacy of NACT followed by IMRT (NACT + RT) with the efficacy of concurrent chemoradiotherapy (CCRT) on ascending-type NPC.

METHODS:

Clinical data of 214 patients with ascending-type NPC treated with NACT + RT or CCRT between December 2009 and July 2011 were analyzed. Of the 214 patients, 98 were treated with NACT followed by IMRT, and 116 were treated with CCRT. The survival rates were assessed using Kaplan-Meier analysis, and the survival curves were compared using a log-rank test.

RESULTS:

The 4-year overall survival, locoregional failure-free survival, distant failure-free survival, and failure-free survival rates were not significantly different between the two groups (all P > 0.05). However, patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT + RT group during radiotherapy, including leukopenia (30.2% vs. 15.3%, P = 0.016), neutropenia (25.9% vs. 11.2%, P = 0.011), and mucositis (57.8% vs. 40.8%, P = 0.028). After radiotherapy, patients in the CCRT group exhibited significantly higher rates of xerostomia (21.6% vs. 10.2%, P = 0.041) and hearing loss (17.2% vs. 6.1%, P = 0.023).

CONCLUSIONS:

The treatment outcomes of the NACT + RT and CCRT groups were similar; however, CCRT led to higher rates of acute and late toxicities. NACT + RT may therefore be a better treatment strategy for ascending-type NPC.

• Authors: Ji-Jin Yao, Xiao-Li Yu, Fan Zhang, Wang-Jian Zhang, Guan-Qun Zhou, Ling-Long Tang, Yan-Ping Mao, Lei Chen, Jun Ma, Ying Sun
• Journal: Chinese journal of cancer (Chin J Cancer) Vol. 36 Issue 1 Pg. 26 (Mar 06 2017) ISSN: 1944-446X [Electronic] England
• PMID: 28264724 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Taxoids
• Docetaxel
• Cisplatin
• Fluorouracil

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (adverse effects, therapeutic use)
• Carcinoma (radiotherapy, therapy)
• Chemoradiotherapy (adverse effects)
• Cisplatin (adverse effects, therapeutic use)
• Docetaxel
• Female
• Fluorouracil (adverse effects, therapeutic use)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Nasopharyngeal Carcinoma
• Nasopharyngeal Neoplasms (radiotherapy, therapy)
• Neoadjuvant Therapy (adverse effects)
• Prognosis
• Taxoids (adverse effects, therapeutic use)
• Treatment Outcome
• Young Adult