Prognostic value of chemotherapy in addition to concurrent chemoradiotherapy in T3-4N0-1 nasopharyngeal carcinoma: a propensity score matching study.
Prognostic value of chemotherapy in addition to concurrent chemoradiotherapy in T3-4N0-1 nasopharyngeal carcinoma: a propensity score matching study.
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T3-4N0-1鼻咽癌化疗加同步放化疗的预后价值：倾向评分匹配研究
DOI：
10.18632/oncotarget.20014
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发表时间：
2017-09-29
期刊：
影响因子：
--
通讯作者：
He X
中科院分区：
文献类型：
--
作者：
Wu LR;Yu HL;Jiang N;Jiang XS;Zong D;Wen J;Huang L;Xie P;Chen W;Wang TT;Gu DY;Yan PW;Yin L;He X
本研究的目的是评估在调强放疗（IMRT）时代，诱导化疗（IC）或辅助化疗（AC）联合同步放化疗（CCRT）对T3 - 4N0 - 1鼻咽癌（NPC）患者的作用。
我们回顾性分析了685例新诊断为T3 - 4N0 - 1鼻咽癌患者的数据。采用倾向评分匹配（PSM）方法对患者进行匹配。不同组之间的生存结果采用Kaplan - Meier法计算，并使用对数秩检验进行比较。采用Cox比例风险模型确定独立的预后因素。
从原始队列中总共选取了236对患者。单因素分析显示，CCRT联合IC/AC组与单纯CCRT组的3年总生存率（OS）（90.8%对90.3%，P = 0.820）、无远处转移生存率（DFFS）（87.3%对89.4%，P = 0.896）和无局部区域复发生存率（LRFFS）（95.4%对93.0%，P = 0.311）相当。多因素分析发现，治疗组不是OS（风险比，0.964；95%置信区间，0.620 - 1.499；P = 0.869）、DFFS（风险比，1.036；95%置信区间，0.626 - 1.714；P = 0.890）和LRFFS（风险比，0.670；95%置信区间，0.338 - 1.327；P = 0.250）的独立预后因素。根据总分期进一步进行亚组分析也得到了类似的结果。
在IMRT时代，接受CCRT治疗的T3 - 4N0 - 1鼻咽癌患者不能从额外的诱导化疗或辅助化疗中获益。
Purpose The objective of this study is to evaluate the contribution of induction (IC) or adjuvant (AC) chemotherapy additional to concurrent chemoradiotherapy (CCRT) for patients with T3-4N0-1 nasopharyngeal carcinoma (NPC) in the era of intensity-modulate radiotherapy (IMRT). Method and Materials We retrospectively reviewed the data on 685 patients with newly diagnosed T3-4N0-1 NPC. Propensity score matching (PSM) method was used to match patients. Survival outcomes between different groups were calculated by Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model was adopted to establish independent prognostic factors. Results In total, 236 pairs were selected from the primary cohort. Univariate analysis revealed 3-year overall survival (OS) (90.8% vs. 90.3%, P = 0.820), distant failure-free survival (DFFS) (87.3% vs. 89.4%, P = 0.896) and locoregional failure-free survival (LRFFS) (95.4% vs. 93.0%, P = 0.311) rates were comparable between CCRT plus IC/AC and CCRT alone groups. Multivariate analysis found that treatment group was not an independent prognostic factors for OS (HR, 0.964; 95% CI, 0.620-1.499; P = 0.869), DFFS (HR, 1.036; 95% CI, 0.626-1.714; P = 0.890) and LRFFS (HR, 0.670; 95% CI, 0.338-1.327; P = 0.250). Further subgroup analysis according to overall stage also obtained similar results. Conclusion Patients with T3-4N0-1 NPC receiving CCRT could not benefit from additional induction or adjuvant chemotherapy in the era of IMRT.
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影响因子：
45.3
作者：
Hui, Edwin P.;Ma, Brigette B.;Chan, Anthony T.
通讯作者：
Chan, Anthony T.
影响因子：
51.1
作者：
Chen, Lei;Hu, Chao-Su;Ma, Jun
通讯作者：
Ma, Jun
影响因子：
45.3
作者：
Chan, ATC;Teo, PML;Johnson, PJ
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Johnson, PJ
影响因子：
45.3
作者：
Ma, J;Mai, HQ;Mo, HY
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Mo, HY
影响因子：
4.6
作者：
Du XJ;Tang LL;Chen L;Mao YP;Guo R;Liu X;Sun Y;Zeng MS;Kang TB;Shao JY;Lin AH;Ma J
通讯作者：
Ma J