Role of chemoradiotherapy in intermediate prognosis nasopharyngeal carcinoma

Xu, Tianmin; Hu, Chaosu; Wang, Xiaoshen; Shen, Chunying

doi:10.1016/j.oraloncology.2011.03.008

Cited by 36 publications

(51 citation statements)

References 20 publications

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“…Xu et al [23] confirmed this conclusion by retrospectively analyzing 392 patients with T2N1M0 NPC, among whom 181 underwent conventional radiotherapy and concurrent chemotherapy (cisplatin, 100 mg/m 2 per day) on the 1st, 22nd, and 43rd days during the course of radiotherap y, 211 underwent conventional radiotherapy alone. The results showed that the 5-year OS and DFS rates were higher in the concurrent chemoradiotherapy group than in the radiotherapy alone group (80.2% vs. 76.6%, P = 0.778; 70.5% vs. 64.2%, P = 0.413), whereas the 5-year DMFS rate was lower in the concurrent chemoradiotherapy group than in the radiotherapy alone group (76.9% vs. 81.5%, P = 0.336), though they failed to reach statistical significance.…”

Section: Concurrent Chemoradiotherapymentioning

confidence: 89%

“…(1) In the investigation by Xu et al [23], the proportion of patients who underwent lymph node biopsy was significantly higher in the concurrent chemoradiotherapy group than in the radiotherapy alone group (23.2% vs. 14.2%, P = 0.02). Lymph node biopsy might enhance the risk of distant metastasis and eventually decrease the OS rate[25],[26] The role that lymph node biopsy played in enhancing the risk of distant metastasis counteracted the therapeutic gains provided by concurrent chemoradiotherapy in controlling distant metastasis.…”

Section: Concurrent Chemoradiotherapymentioning

confidence: 99%

“…Wong et al [27] performed a 3-year follow-up of 40 patients with N1 NPC who underwent IMRT and found that the 3-year DMFS rate reached 100%. However, Xu et al [23] used conventinal two-dimensional radiotherapy to treat N1 NPC and found that the 5-year DMFS rate was only 81.5%. These two studies differed in terms of enrollment time, examination tools for tumor staging (Xu et al [23] used CT, whereas Wong et al [27] used MRI), and radiotherapy dose.…”

Section: Concurrent Chemoradiotherapymentioning

confidence: 99%

“…However, Xu et al [23] used conventinal two-dimensional radiotherapy to treat N1 NPC and found that the 5-year DMFS rate was only 81.5%. These two studies differed in terms of enrollment time, examination tools for tumor staging (Xu et al [23] used CT, whereas Wong et al [27] used MRI), and radiotherapy dose. Thus, it is untenable to conclude that IMRT prolongs DMFS than does two-dimensional radiotherapy merely based upon statiscal data.…”

Section: Concurrent Chemoradiotherapymentioning

confidence: 99%

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Role of chemotherapy in stage IIb nasopharyngeal carcinoma

Pan¹,

Zhu²

2012

Chin J Cancer

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The efficacy of neoadjuvant chemotherapy and adjuvant chemotherapy on stage IIb nasopharyngeal carcinoma (NPC) remains unclear. Conventional two-dimensional radiotherapy combined with concurrent chemotherapy can improve the overall survival, progression-free survival, recurrence-free survival, and distant metastasis-free survival of patients with stage IIb NPC. Intensity-modulated radiotherapy without concurrent chemotherapy also provides good outcomes for patients with stage IIb NPC. This article summarizes the features of stage IIb NPC and reviews the role of chemotherapy in this subgroup of NPC.

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Section: Concurrent Chemoradiotherapymentioning

confidence: 89%

Section: Concurrent Chemoradiotherapymentioning

confidence: 99%

Section: Concurrent Chemoradiotherapymentioning

confidence: 99%

Section: Concurrent Chemoradiotherapymentioning

confidence: 99%

See 2 more Smart Citations

Role of chemotherapy in stage IIb nasopharyngeal carcinoma

Pan¹,

Zhu²

2012

Chin J Cancer

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show abstract

“…Besides, three-dimensional conformal radiation therapy (3D-CRT) was another developed technique, providing improved calculation, shielding, and the classic field arrangement compared with the traditional 2D technique [25]. The primary purpose of chemotherapy is to increase the disease control locally and distantly [26, 27]. And its advantageous clinical performance had been proved in a large quantity of trials.…”

Section: Discussionmentioning

confidence: 99%

Chemoradiotherapy enhanced the efficacy of radiotherapy in nasopharyngeal carcinoma patients: a network meta-analysis

Tang

et al. 2017

Oncotarget

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ObjectA Bayesian network meta-analysis (NMA) was conducted to estimate the overall survival (OS) and complete response (CR) performance in nasopharyngeal carcinoma (NPC) patients who have been given the treatment of radiotherapy, concurrent chemoradiotherapy (C), adjuvant chemotherapy (A), neoadjuvant chemotherapy (N), concurrent chemoradiotherapy with adjuvant chemotherapy (C+A), concurrent chemoradiotherapy with neoadjuvant chemotherapy (C+N) and neoadjuvant chemotherapy with adjuvant chemotherapy (N+A).MethodsLiterature search was conducted in electronic databases. Hazard ratios (HRs) accompanied their 95% confidence intervals (95%CIs) or 95% credible intervals (95%CrIs) were applied to measure the relative survival benefit between two comparators. Meanwhile odd ratios (ORs) with their 95% CIs or CrIs were given to present CR data from individual studies.RESULTSTotally 52 qualified studies with 10,081 patients were included in this NMA. In conventional meta-analysis (MA), patients with N+C exhibited an average increase of 9% in the 3-year OS in relation to those with C+A. As for the NMA results, five therapies were associated with a significantly reduced HR when compared with the control group when concerning 5-year OS. C, C+A and N+A also presented a decreased HR compared with A. There was continuity among 1-year, 3-year and 5-year OS status. Cluster analysis suggested that the three chemoradiotherapy appeared to be divided into the most compete group which is located in the upper right corner of the cluster plot.ConclusionIn view of survival rate and complete response, the NMA results revealed that C, C+A and C+N showed excellent efficacy. As a result, these 3 therapies were supposed to be considered as the first-line treatment according to this NMA.

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The role of chemotherapy in the treatment of stage II nasopharyngeal carcinoma: Retrospective analysis of the national cancer database

et al. 2019

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The standard of care treatment for locally advanced nasopharyngeal carcinoma (NPC) includes both chemotherapy and definitive radiation. However, there are limited data on the optimal management of stage II NPC. We performed a retrospective analysis of the National Cancer Database to analyze the treatment patterns and role of chemotherapy in patients with stage II NPC. We identified 611 patients diagnosed with T1‐2, N0‐1, M0 NPC, from 2004 to 2013. Five‐year survival was calculated using Kaplan Meier (KM) analysis. Multivariable analysis and propensity matched analysis were performed to analyze the impact of chemotherapy on overall survival. Of the 611 patients, 527 underwent concurrent chemoradiation (CCRT) and 84 received radiation only. Unadjusted KM analysis showed improved 5‐year survival in the CCRT group compared to radiation only (80.5% vs 65.7%; P = 0.0021). Multivariable analysis also showed improved survival with the addition of chemotherapy (Hazard ratio [HR] 0.59; 95 CI 0.39‐0.89; P = 0.0124). Propensity matched analysis confirmed a significant clinical benefit from the addition of chemotherapy to radiation. Age ≥ 65 years (HR 2.41; 95% CI 1.71‐3.4; P = <0.0001), Charlson‐Deyo comorbidity index >1 (HR 2.82; 95% CI 1.49‐5.31; P = 0.0014) and positive lymph node status (HR 1.6; 95% CI 1.04‐2.46; P = 0.0340) were associated with worse survival. In this retrospective analysis, patients with stage II NPC had improved survival with CCRT compared to definitive radiation only. Elderly patients with comorbidities had worse outcomes.

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Role of chemoradiotherapy in intermediate prognosis nasopharyngeal carcinoma

Cited by 36 publications

References 20 publications

Role of chemotherapy in stage IIb nasopharyngeal carcinoma

Role of chemotherapy in stage IIb nasopharyngeal carcinoma

Chemoradiotherapy enhanced the efficacy of radiotherapy in nasopharyngeal carcinoma patients: a network meta-analysis

The role of chemotherapy in the treatment of stage II nasopharyngeal carcinoma: Retrospective analysis of the national cancer database

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