Role of intensity-modulated radiation therapy combined with chemotherapy in patients with stage T1-2N1M0 nasopharyngeal carcinoma:a retrospective study
Li Peijing1,2, Jin Ting2, Chen Yuanyuan3, Chen Ming1,2, Tian Ye1
1Department of Radiotherapy&Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy&Oncology, Soochow University; Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China; 2Department of Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Zhejiang Key Laboratory of Radiation Oncology, Hangzhou 321400, China; 3Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, ChinaLi Peijing and Jin Ting contributed equally to this article
Abstract：Objective To evaluate the efficacy of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for treating patients with T1-2N1M0 nasopharyngeal carcinoma (NPC). Methods 343 patients diagnosed with T1-2N1M0 NPC in Zhejiang Cancer Hospital and Sun Yat-sen University Cancer Center from January 2008 to December 2016 were recruited in this study. All patients received IMRT and divided into the radiotherapy (RT) and chemoradiotherapy (CRT) groups. Patients in the CRT group were further assigned into the concurrent chemoradiotherapy (CCRT), induction chemotherapy+ CCRT (IC+CCRT) and CCRT+ adjuvant chemotherapy (AC) groups. Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) were estimated by Kaplan-Meier method. Multivariate prognostic analysis was performed by Cox models. Results The median follow-up time for surviving patients (303/343) was 91(range:49-138) months. The 5-year OS, CSS, PFS, LRFFS, and DMFS rates in the CRT group were not superior to those of the RT group (93.7%:93.9%,93.7%:93.9%,89.0%:87.7%,93.8%:92.8%,93.8%:91.2%, all P>0.05). No significant difference was found in treatment outcomes of patients with T1N1 or T2N1 NPC between two groups (all P>0.05). In multivariable analyses, only age was an independent prognostic factor for OS, PFS, CSS and DMFS, and negative correlation was found between them. No survival benefits were achieved in the CCRT, IC+CCRT, CCRT+AC and RT groups, and no significant differences were found in clinical efficacy among the three combined (all P>0.05). Conclusions IMRT alone yields comparable clinical efficacy to CRT in treating patients with T1-2N1M0 NPC. However, whether CT can be eliminated in the T1-2N1M0 population still needs further confirmation by prospective, randomized and controlled clinical trials.
Li Peijing,Jin Ting,Chen Yuanyuan et al. Role of intensity-modulated radiation therapy combined with chemotherapy in patients with stage T1-2N1M0 nasopharyngeal carcinoma:a retrospective study[J]. Chinese Journal of Radiation Oncology, 2021, 30(12): 1227-1232.
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