Chemotherapy use and survival in stage II nasopharyngeal carcinoma

Pan, Xin-Bin; Huang, Shan; Chen, Kaihua; Zhu, Xiaodong

doi:10.18632/oncotarget.21751

Cited by 12 publications

(11 citation statements)

References 42 publications

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“…Luo et al19 reported that the 3-year OS rate was worse in T2N1 patients than in T1N1 and T2N0 patients (74.5 vs 100.0%, respectively; p =0.01). However, other studies have found that the survival rates were not different between the T1N1, T2N0, and T2N1 subgroups 3,21–23. The prognosis of the three subgroups remains controversial.…”

Section: Discussionmentioning

confidence: 94%

Neutrophil-to-lymphocyte ratio predicts the prognosis of stage II nasopharyngeal carcinoma

Pan

Huang

Zhu

2019

CMAR

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PurposeTo assess the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in stage II nasopharyngeal carcinoma (NPC).MethodsStage II (2010 UICC/AJCC staging system) NPC patients treated between January 2007 and December 2014 were retrospectively analyzed. The NLR was calculated from peripheral blood cell counts before treatment. The optimal cut-off value of NLR was determined by receiver operating characteristic curve analysis. Survival rates were compared according to the NLR value. Multivariable Cox regression analyses were performed to assess the association between the NLR and overall survival (OS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS).ResultsTwo hundred and fifty-one stage II NPC patients were included in this study. The NLR was correlated with T stage (r=0.158, p=0.012). An NLR ≥2.92 was associated with poor 5-year OS (84.3% vs 97.4%, p=0.001) and LRFS (91.4% vs 98.4%, p=0.003). An NLR ≥2.82 was associated with poor 5-year DMFS (92.6% vs 98.2%, p=0.033). The multivariate Cox regression analysis showed that an NLR ≥2.92 was an independent prognostic biomarker in stage II NPC.ConclusionThe NLR is an independent prognostic factor in stage II NPC.

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Section: Discussionmentioning

confidence: 94%

Neutrophil-to-lymphocyte ratio predicts the prognosis of stage II nasopharyngeal carcinoma

Pan

Huang

Zhu

2019

CMAR

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“…The characteristics of the patients included in the 14 eligible studies 17‐30 are shown in Table 1. A total of 4086 participants were involved in this meta‐analysis, of whom 2014 received CCRT with additional chemotherapy and 2072 received CCRT alone.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies 17‐20,23‐25,27,28,30 investigated IC + CCRT, which included 1431 participants. Moreover, four trials 21,22,26,29 explored CCRT + AC in 583 patients. Eleven studies 18‐20,22‐29 involved 1:1 PSM analysis, Two studies 21,30 involved 1:2 PSM analysis, and 2:1 PSM analysis was conducted in only one study 17 .…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, four trials 21,22,26,29 explored CCRT + AC in 583 patients. Eleven studies 18‐20,22‐29 involved 1:1 PSM analysis, Two studies 21,30 involved 1:2 PSM analysis, and 2:1 PSM analysis was conducted in only one study 17 . Most patients were male (72%, 2929/4086), and more than 73% (2990/4086) of the patients were younger than 50 years of age.…”

Section: Resultsmentioning

confidence: 99%

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Concurrent chemoradiotherapy with additional chemotherapy for nasopharyngeal carcinoma: A pooled analysis of propensity score‐matching studies

Zhang

et al. 2021

Head & Neck

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Objective To determine the benefits of adding induction chemotherapy (IC) and adjuvant chemotherapy (AC) to concurrent chemoradiotherapy (CCRT) for nasopharyngeal carcinoma (NPC) based on propensity score‐matching (PSM) studies. Methods Eligible PSM studies were searched in the PubMed, Web of Science, and Embase databases from inception to September 1, 2020. The primary endpoints included overall survival (OS), distant metastasis‐free survival (DMFS), and locoregional recurrence‐free survival (LRFS). Results A total of 14 trials consisting of 4086 participants were included. Significant benefits were observed between IC + CCRT and CCRT for OS (hazard ratio [HR], 0.76; 95% confidence interval [CI]: 0.64–0.91) and DMFS (HR, 0.77; 95% CI: 0.64–0.94) with the exception of LRFS (HR, 1.14; 95% CI: 0.90–1.43). However, CCRT + AC did not achieve significant improvements. Conclusions IC with CCRT yields significant survival benefits in terms of OS and DMFS, whereas CCRT with AC fails to achieve any additional benefit in all endpoints.

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“…Nevertheless, some researchers have attempted to assess the efficacy of AC in patients with stage II NPC. Pan et al 26 reviewed 251 stage II (according to the 2010 UICC/AJCC staging system) NPC patients treated with IMRT using the PS matching method. The Kaplan-Meier survival curves showed no significant difference in OS (P=0.200), LRFS (P=0.204), or DMFS (P=0.064) in patients treated with RT alone, CCRT, or CCRT + AC.…”

Section: Adjuvant or Induction Chemotherapy Combined With Imrt For Stmentioning

confidence: 99%

Management of Chemotherapy for Stage II Nasopharyngeal Carcinoma in the Intensity-Modulated Radiotherapy Era: A Review

Wu¹,

Zhao²,

Li³

et al. 2020

CMAR

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Nasopharyngeal carcinoma is an endemic disease with a high prevalence in Southeast Asia, Mediterranean countries, and Northern Africa. With substantial advances in screening and diagnosis, increasingly more early-stage (stage I~II) patients are being diagnosed. The undebated treatment modality for stage I patients is radiotherapy alone. However, controversies exist for patients with stage II disease, mostly revolving around the management of chemotherapy. However, the use of intensity-modulated radiotherapy for the treatment of nasopharyngeal carcinoma has increased recently, which has drastically improved survival outcomes. Thus, many oncologists have considered omitting chemotherapy for stage II patients in the intensity-modulated radiotherapy era. Unfortunately, prospective studies comparing concurrent radio-chemotherapy with intensity-modulated radiotherapy alone are limited. Notably, stage II nasopharyngeal carcinoma consists of three subgroups, among which stage T2N1M0 disease is unique and potentially warrants additional treatment including chemotherapy. Additionally, molecular biology techniques are advancing at an incredible speed. Instead of adopting a one-size-fits-all recommendation, exploring potential predictive biomarkers to select patients who are likely to derive benefit from chemotherapy is a better choice. In this review, we summarize the data from studies and reviews regarding chemotherapy for stage II nasopharyngeal carcinoma in the intensitymodulated radiotherapy era and discuss chemotherapy utility. Eventually, we conclude that IMRT alone may be sufficient for stage II nasopharyngeal carcinoma, but this needs to be verified by prospective studies in the near future, the evidence collected thus far suggests that concurrent chemo-radiotherapy without induction or adjuvant chemotherapy is yet to be necessary for patients with stage II disease.

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Chemotherapy use and survival in stage II nasopharyngeal carcinoma

Cited by 12 publications

References 42 publications

<p>Neutrophil-to-lymphocyte ratio predicts the prognosis of stage II nasopharyngeal carcinoma</p>

<p>Neutrophil-to-lymphocyte ratio predicts the prognosis of stage II nasopharyngeal carcinoma</p>

Concurrent chemoradiotherapy with additional chemotherapy for nasopharyngeal carcinoma: A pooled analysis of propensity score‐matching studies

<p>Management of Chemotherapy for Stage II Nasopharyngeal Carcinoma in the Intensity-Modulated Radiotherapy Era: A Review</p>

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