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Zhong Q, Luo D, Li X, Du Q, Liang Q, Liu W, Li J, Zhu X. The efficacy of induction chemotherapy or adjuvant chemotherapy added to concurrent chemoradiotherapy in T3-4N0-1M0 nasopharyngeal carcinoma: a propensity score-matched analysis. Cancer Biol Ther 2023; 24:2274121. [PMID: 37965924 PMCID: PMC10653744 DOI: 10.1080/15384047.2023.2274121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/19/2023] [Indexed: 11/16/2023] Open
Abstract
This research aimed to assess the effectiveness of combining induction chemotherapy (IC) or adjuvant chemotherapy (AC) with concurrent chemoradiotherapy (CCRT) in patients with T3-4N0-1M0 nasopharyngeal carcinoma (NPC). Before propensity score matching(PSM),we retrospectively collected 457 patients with T3-4N0-1M0 NPC treated with CCRT with or without IC/AC. PSM method selected 285 patients from two cohort(148 in CCRT±IC/AC group,137 in CCRT group). The 3-year overall survival(OS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) were estimated. The median follow-up was 41.03 months(range 2.13-94.67 months). No significant differences in 3 year-OS,LRFS and DMFS between CCRT±IC/AC group and CCRT group.Univariate analysis have shown that induction chemotherapy was significantly associated with 3 year LRFS(hazard ratio[HR] 0.214, 95%confidence interval[CI] 0.053-0.861,P = .030).Overall stage(HR 0.260, CI 0.078-0.870, P = .029) and T classification (HR 0.260, CI 0.078-0.870, P = .029)were significantly associated with OS.Multivariate analysis demonstrated no independent factors were related to 3-year OS,LRFS and DMFS. Subgroup analyses revealed that no significant survival differences in the two groups in patients with T3N1.In terms of T4N1 disease, patients received CCRT±IC/AC had lower 3-year DMFS than those treated with CCRT(90.4% vs 98.7%, P = .015). Adding IC or AC to CCRT did not significantly improve the prognosis of T3-4N0-1M0 NPC patients. Patients with T4N1M0 treated with CCRT had better DMFS than those received CCRT±IC/AC.However,more investigations should be confirmed the results.
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Affiliation(s)
- Qiulu Zhong
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Danjing Luo
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiangde Li
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qinghua Du
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qianfu Liang
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenqi Liu
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jian Li
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaodong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
- Department of Radiation Oncology, Wuming Hospital of Guangxi Medical University, Nanning, China
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Zang J, Li Y, Liu Q, Zhu Y, Luo S, Li X, Wang J, Hou B, Su N, Zhao L, Shi M. Therapeutic Evaluation of Induction Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma With Low-risk N Stage : A Multicenter Retrospective Study From Nonendemic Region of China. Am J Clin Oncol 2023; 46:206-212. [PMID: 36879390 DOI: 10.1097/coc.0000000000000995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVES The role of induction chemotherapy (IC) remains ambiguous in a patient with T3-4N0-1 nasopharyngeal carcinoma (NPC) according to data from the endemic area of China. Here, we conducted a multicenter retrospective study to investigate the value of adding IC to concurrent chemoradiotherapy (CCRT) for T3-4N0-1 NPC from Northwest China. METHODS Data were extracted in 3 hospitals from Northwest China between May 1, 2010 and August 30, 2018. The Kaplan-Meier method was used to estimate the endpoints. Survival curves were compared using the log-rank test. Initial propensity matching was conducted with a 1:1 match of IC + CCRT to CCRT. The primary endpoint of this study was overall survival (OS). RESULTS A total of 108 patients with staging T3-4N0-1 were included in this study. The median follow-up time was 50 months (range: 6 to 118 months). IC followed by CCRT did not significantly improve OS compared with CCRT in the whole cohort (89.5% vs 77.6%, hazard ratio: 0.41, 95% CI: 0.16-1.04, P = 0.100). But significantly better OS was found when a well-balanced propensity score-matched cohort was analyzed. Adjusted 4-year OS was 89.5% for IC followed by CCRT versus 71.1% for CCRT (hazard ratio: 0.30, 95% CI: 0.11-0.80, P = 0.027). No significant differences were detected in side effects between the two groups. CONCLUSION This study suggested IC followed by CCRT had the potential to further improve OS in patients with T3-4N0-1M0 NPC from Northwest China compared with CCRT. However, prospective studies with a large sample are warranted to confirm the results.
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Affiliation(s)
- Jian Zang
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Yan Li
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Qiufang Liu
- Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital
| | - Yong Zhu
- Department of Radiation Oncology, Baoji Central Hospital, Xi'an, China
| | - Shanquan Luo
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Xiaohua Li
- Department of Radiation Oncology, Baoji Central Hospital, Xi'an, China
| | - Jianhua Wang
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Bingxin Hou
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Ning Su
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Lina Zhao
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
| | - Mei Shi
- Department of Radiation Oncology, Xijing Hospital, The Fourth Military University, Xi'an
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Li P, Zhang Q, Luo D, Jiang F, Jin Q, Hua Y, Jin T, Chen X. Explore the Value of Adding Induction Chemotherapy to Concurrent Chemoradiotherapy in T3-4N0M0 Nasopharyngeal Carcinoma Patients: A Retrospective Study. Cancer Manag Res 2021; 13:7067-7076. [PMID: 34526821 PMCID: PMC8437383 DOI: 10.2147/cmar.s321471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 12/09/2022] Open
Abstract
Purpose Patients with T3-4N0M0 nasopharyngeal carcinoma (NPC) are a unique subgroup of locoregional advanced NPC, which generally have a better prognosis than others and are often excluded in most randomized controlled clinical trials focusing on locoregional advanced NPC. The management of this population is still controversial. This study aims to evaluate the outcomes of T3-4N0M0 NPC patients treated with sequential induction chemotherapy and concurrent chemoradiotherapy (IC+CCRT) or chemoradiotherapy (CCRT) alone. Patients and Methods We included 362 patients diagnosed with T3-4N0M0 NPC from two hospitals between December 2005 and December 2014. All patients were received IC + CCRT (n=146) or CCRT (n=216). Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were retrospectively estimated. Results The median follow-up was 95 (range: 11-168) months. Univariable analyses have shown that 5-year LRFFS, DFS and OS in the IC+CCRT group and the CCRT group were 87.4% vs 93.4% (P = 0.035), 80.4% vs 87.0% (P = 0.047) and 86.3% vs 93.0% (P = 0.040). Multivariate analyses demonstrated that only the T stage was the independent prognostic factor for LRFFS, DFS, and OS in the entire group analysis. Subgroup analysis revealed that patients with T3 tumors who received IC+CCRT had significantly lower LRFFS, DFS, and OS than those treated with CCRT. For T4 patients, the outcomes had no significant difference between the two groups. Conclusion This retrospective study showed that T3N0M0 patients who received CCRT had better prognosis than those treated with IC+CCRT. In terms of T4N0M0 disease, treatment outcomes are similar in both treatment groups. However, these results require further confirmation of large sample size, prospectively, randomized controlled trials.
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Affiliation(s)
- Peijing Li
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310000, People's Republic of China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, People's Republic of China
| | - Qun Zhang
- Department of Radiation Oncology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510060, People's Republic of China
| | - Donghua Luo
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Feng Jiang
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310000, People's Republic of China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, People's Republic of China
| | - Qifeng Jin
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310000, People's Republic of China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, People's Republic of China
| | - Yonghong Hua
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310000, People's Republic of China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, People's Republic of China
| | - Ting Jin
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310000, People's Republic of China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, People's Republic of China
| | - Xiaozhong Chen
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310000, People's Republic of China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, People's Republic of China
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Wakatsuki M, Kato S, Ohno T, Banu PA, Hoang NC, Yadamsuren E, Supriana N, Cao J, Devi CB, Calaguas MJ, Chansilpa Y, Cho CK, Adylkhanov T, Okonogi N, Nakano T, Tsujii H. Multi-institutional Observational Study of Prophylactic Extended-Field Concurrent Chemoradiation Therapy Using Weekly Cisplatin for Patients With Pelvic Node-Positive Cervical Cancer in East and Southeast Asia. Int J Radiat Oncol Biol Phys 2019; 105:183-189. [DOI: 10.1016/j.ijrobp.2019.04.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/18/2019] [Accepted: 04/27/2019] [Indexed: 02/02/2023]
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Mizuno H, Fukuda S, Fukumura A, Nakamura YK, Jianping C, Cho CK, Supriana N, Dung TA, Calaguas MJ, Devi CB, Chansilpa Y, Banu PA, Riaz M, Esentayeva S, Kato S, Karasawa K, Tsujii H. Multicentre dose audit for clinical trials of radiation therapy in Asia. JOURNAL OF RADIATION RESEARCH 2017; 58:372-377. [PMID: 27864507 PMCID: PMC5440882 DOI: 10.1093/jrr/rrw108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/16/2016] [Accepted: 10/11/2016] [Indexed: 06/06/2023]
Abstract
A dose audit of 16 facilities in 11 countries has been performed within the framework of the Forum for Nuclear Cooperation in Asia (FNCA) quality assurance program. The quality of radiation dosimetry varies because of the large variation in radiation therapy among the participating countries. One of the most important aspects of international multicentre clinical trials is uniformity of absolute dose between centres. The National Institute of Radiological Sciences (NIRS) in Japan has conducted a dose audit of participating countries since 2006 by using radiophotoluminescent glass dosimeters (RGDs). RGDs have been successfully applied to a domestic postal dose audit in Japan. The authors used the same audit system to perform a dose audit of the FNCA countries. The average and standard deviation of the relative deviation between the measured and intended dose among 46 beams was 0.4% and 1.5% (k = 1), respectively. This is an excellent level of uniformity for the multicountry data. However, of the 46 beams measured, a single beam exceeded the permitted tolerance level of ±5%. We investigated the cause for this and solved the problem. This event highlights the importance of external audits in radiation therapy.
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Affiliation(s)
- Hideyuki Mizuno
- Department of Radiation Measurement and Dose Assessment,National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Shigekazu Fukuda
- Department of Radiation Measurement and Dose Assessment,National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Akifumi Fukumura
- Department of Radiation Measurement and Dose Assessment,National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Yuzuru-Kutsutani Nakamura
- Department of Radiation Measurement and Dose Assessment,National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | | | - Chul-Koo Cho
- Korea Institute of Radiological & Medical Sciences (KIRAMS), Korea
| | | | | | | | | | | | | | - Masooma Riaz
- Institute of Nuclear Medicine and Oncology, Pakistan
| | | | - Shingo Kato
- Saitama Medical University International Medical Centre, Japan
| | | | - Hirohiko Tsujii
- Department of Radiation Measurement and Dose Assessment,National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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