Does three cycles of neoadjuvant chemotherapy prior to concurrent chemoradiotherapy provide benefits for all childhood patients with locoregionally advanced nasopharyngeal carcinoma?
Does three cycles of neoadjuvant chemotherapy prior to concurrent chemoradiotherapy provide benefits for all childhood patients with locoregionally advanced nasopharyngeal carcinoma?
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在同步放化疗之前进行三个周期的新辅助化疗是否能为所有局部晚期鼻咽癌儿童患者带来益处？
DOI：
10.1007/s00432-021-03817-x
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Liang‑Ping Xia
中科院分区：
文献类型：
--
作者：
Ya-Nan Jin;Hui-Juan Cao;Xiao‑Hua Gong;Wang-Jian Zhang;Tia Marks;Ji‑Jin Yao;Liang‑Ping Xia
背景在同步放化疗的基础上加用新辅助化疗（NAC）是治疗儿童和青少年局部晚期鼻咽癌（CA-LANPC）的主要策略。然而，NAC周期的最佳数量仍然未知。我们的目的是优化NAC周期，并可能有助于临床决策的个别治疗CA-LANPC.Patients和methodsUsing通过一个公认的大数据信息系统，在我们的中心NPC的具体数据库，我们确定了143 CA-LANPC治疗与NAC，然后通过CCRT之间2007年9月至2018年4月。采用递归分割分析（RPA）对患者进行分类并预测无病生存期（DFS）。NAC周期（2个周期与3个周期）的临床效益进行了评估，在每个危险group.ResultsIndependent因素来自多变量分析，预测DFS的T分期（T1-3与T4）和血浆EB病毒（EBV）DNA（< 4000与≥ 4000拷贝/mL）的危险分层。因此，通过RPA，87名（61%）参与者被归类为低风险组（T1-3具有低或高EBV DNA，T4具有低EBV DNA），其他56名患者（39%）被归类为高风险组（T4具有高EBV DNA），相应的5年DFS率分别为91.9%和71.2%（p= 0.001）。在高危组中，接受3个周期NAC的患者的5年DFS比接受2个周期NAC的患者有统计学显著改善（86.7% vs 59.1%;p= 0.020），而未观察到3个周期NAC对低风险组的生存获益结论我们发现，对于CA-LANPC中的高危组，3个周期的NAC联合CCRT是改善DFS的积极预后指标。但低危患者能否从3周期NAC中获益还需进一步研究。
BackgroundAdding neoadjuvant chemotherapy (NAC) to concurrent chemoradiotherapy (CCRT) is the main strategy in treatment of children and adolescents with locoregionally advanced nasopharyngeal carcinoma (CA-LANPC). Yet, an optimal number of NAC cycles remains unknown. We aimed to optimize the NAC cycle and potentially contribute to clinical decision making for the individual treatment of CA-LANPC.Patients and methodsUtilizing an NPC-specific database through an acknowledged big-data information system at our center, we identified 143 CA-LANPC treated with NAC followed by CCRT between September 2007 through April 2018. Recursive partitioning analysis (RPA) was performed to categorize the patients and predict disease-free survival (DFS). The clinical benefits of NAC cycles (two cycles vs three cycles) were assessed in each risk group.ResultsIndependent factors derived from multivariable analysis to predict DFS were T stage (T1–3 vs T4) and plasma Epstein-Barr virus (EBV) DNA (< 4000 vs ≥ 4000 copies/mL) for risk stratification. Consequently, 87 (61%) participants were classified as low-risk group (T1–3 with low or high EBV DNA, and T4 with low EBV DNA) and the other 56 patients (39%) were classified as a high-risk group (T4 with high EBV DNA) through RPA, and corresponding 5-year DFS rates of 91.9% and 71.2%, respectively (p= 0.001). Among the high-risk group, patients receiving three cycles of NAC had statistically significant improvement in 5-year DFS over those who received two cycles of NAC (86.7% vs 59.1%;p= 0.020), while the survival benefit of three cycles NAC for low-risk groups were not observed (94.7% vs 89.7%;p= 0.652).ConclusionsWe found three cycles of NAC with CCRT was a positive prognostic indicator for improved DFS for the high-risk group among CA-LANPC. However, whether low-risk patients could benefit from three cycles NAC needs further study.
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影响因子：
--
作者：
G. Stachelek;S. Terezakis;R. Ermoian
通讯作者：
G. Stachelek;S. Terezakis;R. Ermoian
影响因子：
3.4
作者：
Ghosh-Laskar, S.;Pilar, A.;D'Cruz, A.
通讯作者：
D'Cruz, A.
DOI：
10.1016/b978-0-12-814936-2.00002-x
发表时间：
2019
期刊：
Nasopharyngeal Carcinoma
影响因子：
--
作者：
M. Lung;Wei Dai;J. Ko
通讯作者：
M. Lung;Wei Dai;J. Ko
影响因子：
2.1
作者：
Carle, Laura N.;Ko, Charles C.;Castle, James T.
通讯作者：
Castle, James T.
优化鼻咽癌诱导化疗周期数：回顾性生存分析
DOI：
10.1002/hed.26141
发表时间：
2020-08-01
影响因子：
2.9
作者：
He, Yan;Zhao, Zhihao;Peng, Xingchen
通讯作者：
Peng, Xingchen