Feasibility and efficiency of double-agent versus single-agent concurrent chemoradiotherapy in patients with nasopharyngeal carcinoma

Qin, Guanjie; Rai, Raju; Zhang, Rongjun; Su, Yixin; Zhang, Bin; Pan, Yuefei; Xiong, Ranhua; Xie, Yuan; Yang, Haojie; Kong, Xiangyun; Luo, Zan; Ruan, Xiaolan; Mo, Yunyan; Aftab, Omer; Shahisanjeev,; Jazib,; Jiang, Wei

doi:10.1016/j.oraloncology.2020.104704

Cited by 1 publication

(4 citation statements)

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“…6 In a combined analysis of six randomized trials in NPC, concurrent TP (paclitaxel + cisplatin) was associated with a significantly higher CR (OR = 2.60, 95% CI: 0.37-18.17, p < 0.05) and a significantly lower incidence of grade 3 and grade 4 gastrointestinal injury (OR = 0.38, 95% CI: 0.16-0.93, p < 0.05) than was PF (cisplatin + 5-FU). 5 However, Qin et al 7 found that concurrent double-agent chemotherapy did not provide survival benefits and was associated with higher hematological toxicities than a single-agent regimen. Collectively, these findings support that concurrent dual-agent chemotherapy may be a potential treatment option for high-risk LANPC patients.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of grade 3 and grade 4 leukopenia and neutropenia was significantly higher in the DACC group (41.5% and 31.7%, respectively), consistent with previous reports. 7,32 In the future, considering that the incidence of disease recurrence is the highest within 2 years after chemoradiotherapy, strategies for providing additional benefits for high-risk patients with large tumor volumes after IC need to be explored.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of grade 3 and grade 4 leukopenia and neutropenia was significantly higher in the DACC group (41.5% and 31.7%, respectively), consistent with previous reports. 7 , 32 …”

Section: Discussionmentioning

confidence: 99%

“… 6 Moreover, a recent study comparing concurrent dual-agent chemotherapy (conventional paclitaxel/5-FU plus cisplatin) and single-agent (cisplatin alone) chemotherapy has shown that the dual-agent regimen was not effective in prolonging survival and had greater hematologic toxicities. 7 Whether double-agent concurrent chemotherapy (DACC) could provide additional survival benefits and the optimal DACC regimens and patient subsets warrants investigation.…”

Section: Introductionmentioning

confidence: 99%

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Concurrent chemotherapy using taxane plus cisplatin versus cisplatin alone in high-risk nasopharyngeal carcinoma patients with suboptimal response to induction chemotherapy

Zhang

Chen

et al. 2023

Ther Adv Med Oncol

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Background: Detectable Epstein–Barr virus (EBV) DNA levels and unsatisfactory tumor response to induction chemotherapy (IC) could be used to guide the risk-adapted treatment strategy of locoregionally advanced nasopharyngeal carcinoma (LANPC) before concurrent chemoradiotherapy. We aim to compare the efficacy and safety of concurrent chemotherapy using taxane plus cisplatin [double-agent concurrent chemotherapy (DACC) group] with those of cisplatin alone [single-agent concurrent chemotherapy (SACC) group] in high-risk LANPC. Methods: Overall, 197 LANPC patients with detectable EBV DNA or stable disease (SD) after IC were retrospectively included. Potential confounders between the DACC and SACC groups were adjusted by propensity score matching. Short-term efficacy and long-term survival were assessed in the two groups. Results: Although the objective response rate of the DACC group was marginally higher than that of the SACC group, the difference was not significant (92.7% versus 85.3%, p = 0.38). Concerning long-term survival, DACC did not show superiority to SACC after patient matching: 3-year progression-free survival: 87.8% versus 81.7%, p = 0.80; overall survival: 97.6% versus 97.3%, p = 0.48; distant metastasis-free survival: 87.8% versus 90.5%, p = 0.64, and; locoregional relapse-free survival: 92.3% versus 86.9%, p = 0.77. The incidence of grade 1–4 hematological toxicities was significantly higher in the DACC group. Conclusion: Due to the small sample size, we do not have sufficient evidence that concurrent chemotherapy using taxane plus cisplatin provides additional survival benefits in LANPC patients with an unfavorable response (detectable EBV DNA levels or SD) after IC. But concurrent taxane and cisplatin chemotherapy is associated with a higher rate of hematologic adverse events. Further clinical trials will be required to establish evidence and identify more effective treatment modalities for high-risk LANPC patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The incidence of grade 3 and grade 4 leukopenia and neutropenia was significantly higher in the DACC group (41.5% and 31.7%, respectively), consistent with previous reports. 7 , 32 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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