Predictive factors of chemotherapy use in stage II nasopharyngeal carcinoma

Abstract

Identification of predictive factors of chemotherapy use and assessment of the roles of these factors in prognosis will aid therapeutic decision-making in stage II nasopharyngeal carcinoma (NPC). Using logistic regression, we retrospectively assessed factors predicting chemotherapy use in 251 stage II (2010 UICC/AJCC staging system) NPC patients. Five-year overall survival (OS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed based on the predictive factors. Logistic regression found that N1 stage was an independent factor predicting chemotherapy use in stage II NPC patients. However, 5-year OS (96.5% vs 94.9%, P = .564), LRFS (98.2% vs 96.9%, P = .652), and DMFS (95.9% vs 97.6%, P = .560) did not differ between N0 and N1 stage patients. Moreover, addition of chemotherapy use did not improve treatment outcomes in N1 stage compared with radiotherapy alone. N1 stage predicted chemotherapy use in stage II NPC patients. But, the addition of chemotherapy did not provide a survival benefit.

Survival outcome and prognostic factors of patients with nasopharyngeal cancer in Yogyakarta, Indonesia: A hospital-based retrospective study

“…with early disease demonstrated much better survival (94.5%-96.5%) [47,48]. The predicted rate for 5-year survival for our present cohort (35%) matched only the survival rate of patients in the US four decades ago, between 1973-1979 [21].…”

Radiation Oncology Alternative Payment Model and Large Urban Academic Centers: Future Implications for Patients and Providers

“…[29][30][31] Advanced stage is also associated with a higher likelihood of requiring concurrent chemoradiation as opposed to radiation alone for multiple cancer types, demanding extra resources and time and necessitating more complex treatment to minimize toxicities. 32 Under the RO-APM, management of stage IV patients in need of synchronous treatment to multiple sites will result in significant financial losses. For example, if an oligometastatic patient undergoes RT to multiple distinct sites (eg, primary tumor and metastasis, or concurrent brain and bone metastases) within a 90-day RO-APM episode, the provider will receive the bundled payment only for the diagnosis with the highest charge.…”

“…29-31 Advanced stage is also associated with a higher likelihood of requiring concurrent chemoradiation as opposed to radiation alone for multiple cancer types, demanding extra resources and time and necessitating more complex treatment to minimize toxicities. 32…”