Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study.
Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study.
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调强放疗时代顺铂累积剂量对儿童鼻咽癌新辅助化疗反应的影响：一项真实世界研究
DOI：
10.1186/s12935-021-02281-4
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发表时间：
2021-11-12
影响因子：
5.8
通讯作者：
Xia LP
中科院分区：
文献类型：
--
作者：
Jin YN;Qiang MY;Liu MM;Cheng ZB;Zhang WJ;Ryan I;Marks T;Yao JJ;Xia LP
背景我们旨在全面探讨新辅助化疗（NAC）后不同肿瘤反应的局部晚期鼻咽癌（CA-LANPC）同步放化疗（CC-CCD）期间顺铂的最佳累积剂量。方法对接受NAC后接受顺铂为主的同步放化疗的CA-LANPC患者进行回顾性分析。经过两到四个周期的 NAC 后，根据实体瘤疗效评估标准 (RECIST) 1.1 对患者的肿瘤疗效进行评估。多变量 Cox 比例风险模型用于预后。采用递归分区分析（RPA）对参与者进行分类并预测无病生存期（DFS）。结果纳入了 132 名 NAC 后反应良好的患者。 CC-CCD 中位数为 163 mg/m2（IQR，145–194 mg/m2），选择 160 mg/m2 作为将患者分为低 CC-CCD 组和高 CC-CCD 组（< 160 与 ≥160 mg/m2）的分界点。与接受低 CC-CCD 的患者相比，接受高 CC-CCD 的患者的 5 年 DFS 显着改善（91.2% vs. 72.6%；P = 0.003）。多变量分析显示，CC-CCD、T 分期和 Epstein-Barr 病毒 (EBV) DNA 是 DFS 的独立预后因素（均 P<0.05）。通过 RPA 将患者进一步分为两个预后组：低风险组（无论 EBV DNA 是否为 T1-3 疾病，以及 EBV DNA < 4000 拷贝/mL 的 T4 疾病）和高风险组（EBV DNA ≥ 4000 拷贝/mL 的 T4 疾病）。高 CC-CCD 的高危组观察到 5 年 DFS 显着改善 (P = 0.004)。然而，低风险组的 DFS 改善相对不显着（P = 0.073）。 结论 对于 CA-LANPC 中 NAC 后的反应者，CC-CCD 是一个积极的预后因素。此外，CC-CCD≥ 160 mg/m2可以显着提高CA-LANPC高危组的DFS，但高CC-CCD对低危组的益处需要进一步研究。
BackgroundWe aimed to comprehensively investigate the optimal cumulative cisplatin dose during concurrent chemoradiotherapy (CC-CCD) for locoregionally advanced nasopharyngeal carcinoma (CA-LANPC) with different tumor responses after neoadjuvant chemotherapy (NAC).MethodsPatients with CA-LANPC who underwent NAC followed by cisplatin-based concurrent chemoradiotherapy were retrospectively analyzed. Evaluation of tumor response in patients was conducted by Response Evaluation Criteria for Solid Tumor (RECIST) 1.1 after two to four cycles NAC. Multivariate Cox proportional hazards models were used for prognosis. Recursive partitioning analysis (RPA) was conducted to classify participates and predict disease-free survival (DFS).ResultsOne hundred and thirty-two patients with favorable response after NAC were included. The median CC-CCD was 163 mg/m2(IQR, 145–194 mg/m2), and 160 mg/m2was selected as the cutoff point to group patients into low and high CC-CCD groups (< 160 vs. ≥ 160 mg/m2). There was significant improvement in 5-year DFS (91.2% vs. 72.6%; P = 0.003) for patients receiving high CC-CCD compared to those receiving low CC-CCD. Multivariate analysis revealed that CC-CCD, T stage, and Epstein–Barr virus (EBV) DNA were independent prognostic factors for DFS (P < 0.05 for all). Patients were further categorized into two prognostic groups by RPA: the low-risk group (T1-3 disease with regardless of EBV DNA, and T4 disease with EBV DNA < 4000 copy/mL), and the high-risk group (T4 disease with EBV DNA ≥ 4000 copy/mL). Significant 5-year DFS improvement was observed for the high-risk group (P = 0.004) with high CC-CCD. However, DFS improvement was relatively insignificant in the low-risk group (P = 0.073).ConclusionsCC-CCD was a positive prognostic factor for responders after NAC in CA-LANPC. Furthermore, CC-CCD ≥ 160 mg/m2could significantly improve DFS in the high-risk group with CA-LANPC, but the benefit of high CC-CCD in the low-risk group needs further study.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
DOI：
10.1016/j.ijrobp.2008.12.030
发表时间：
2009-11-15
影响因子：
7
作者：
Downing, N. Lance;Wolden, Suzanne;Le, Quynh-Thu
通讯作者：
Le, Quynh-Thu
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：
5.7
作者：
Loong, Herbert H.;Ma, Brigette B. Y.;Chan, Anthony T. C.
通讯作者：
Chan, Anthony T. C.
新辅助化疗后同步放化疗与单独同步放化疗治疗局部晚期鼻咽癌：一项 III 期多中心随机对照试验。
影响因子：
8.4
作者：
Cao, Su-Mei;Yang, Qi;Hong, Ming-Huang
通讯作者：
Hong, Ming-Huang