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Li Y, Chen QY, Tang LQ, Liu LT, Guo SS, Guo L, Mo HY, Chen MY, Guo X, Cao KJ, Qian CN, Zeng MS, Bei JX, Shao JY, Sun Y, Tan J, Chen S, Ma J, Zhao C, Mai HQ. Concurrent chemoradiotherapy with or without cetuximab for stage II to IVb nasopharyngeal carcinoma: a case-control study. BMC Cancer 2017; 17:567. [PMID: 28836950 PMCID: PMC5571586 DOI: 10.1186/s12885-017-3552-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/14/2017] [Indexed: 01/12/2023] Open
Abstract
Background This study aimed to evaluate the long-term outcome and toxicities in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated by concurrent chemoradiotherapy (CCRT) with/without adding cetuximab. Methods A total of 62 patients treated with CCRT plus cetuximab were matched with 124 patients treated with CCRT alone by age, sex, pathological type, T category, N category, disease stage, radiotherapy (RT) technique, Epstein-Barr virus (EBV) DNA levels, and Eastern Cooperative Oncology Group (ECOG). Overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were assessed using the Kaplan–Meier method and log-rank test. Treatment toxicities were clarified and compared between two groups. Results A total of 186 well-balanced stage II to IV NPC patients were retrospectively analyzed (median follow-up, 76 months). Compared to CCRT alone, adding cetuximab resulted in more grade 3 to 4 radiation mucositis (51.6% vs. 23.4%; P < 0.001). No differences were found between the CCRT + cetuximab group and the CCRT group in 5-year OS (89.7% vs. 90.7%, P = 0.386), 3-year PFS (83.9% vs. 88.7%, P = 0.115), the 3-year LRFS (95.0% vs. 96.7%, P = 0.695), and the 3-year DMFS (88.4% vs 91.9%, P = 0.068). Advanced disease stage was the independent prognostic factor predicting poorer OS and PFS. Conclusion Adding cetuximab to CCRT did not significantly improve benefits in survival in stage II to IV NPC and exacerbated acute mucositis and acneiform rash. Further investigations are warranted.
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Affiliation(s)
- Yang Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Qiu-Yan Chen
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Lin-Quan Tang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Li-Ting Liu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Shan-Shan Guo
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Ling Guo
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Hao-Yuan Mo
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Ming-Yuan Chen
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Xiang Guo
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Ka-Jia Cao
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Chao-Nan Qian
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Mu-Shen Zeng
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jin-Xin Bei
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jian-Yong Shao
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Ying Sun
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Jing Tan
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Shuai Chen
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jun Ma
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Chong Zhao
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Hai-Qiang Mai
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
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