The long-term survival of the doublet regimen of concurrent chemoradiation therapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective study.
The long-term survival of the doublet regimen of concurrent chemoradiation therapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective study.
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对局部晚期鼻咽癌的并发化学放疗治疗的双重疗法的长期生存：一项回顾性研究。
DOI：
10.1186/s13014-022-02158-4
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发表时间：
2022-11-17
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这项研究介绍了创新的策略，即同步放化疗的双重方案，以确保局部晚期鼻咽癌的更长生存期。我们回顾了2013年1月至2018年12月在我们中心接受紫杉烷联合铂类同期放化疗的104例局部晚期鼻咽癌患者。统计分析采用Kaplan-Meier法(SPSS23.0)。不同组间比较采用Wilcoxon秩和检验。最终，104名患者被选入这项研究，其中分别有18名和86名患者同时接受单纯放化疗或同时接受放化疗加辅助化疗。无进展生存的中位随访时间为53.0个月(IQR 48.5~57.5)。联合化疗对局部晚期鼻咽癌的3年无进展生存率(PFS)、总生存率(OS)、局部无复发生存率(LRRFS)和无远处转移生存率(DMFS)分别为85.9%、96.0%、96.0%和90.8%。此外，我们还对亚组进行了分析，发现III期与IV期的3年生存率分别为97.8%与75.5%(P = 0.000)、100%与92.5%(P = 0.004)、100%与92.4%(P = 0.015)和97.8%与82.8%(P = 0.002)。同期化疗期间，急性化疗3级或4级不良反应发生率仅为18.3%。白细胞减少是最常见的急性化疗不良事件(10例(9.6%))，其次是中性粒细胞减少(8例(7.6%))。紫杉烷+铂同步放化疗的双重方案可提高局部晚期鼻咽癌患者的长期生存率，特别是局部控制率，值得进一步前瞻性评估。
This study introduces innovative strategies, the doublet regimen of concurrent chemoradiotherapy, to ensure longer survival for locoregionally advanced nasopharyngeal carcinoma. We retrospectively reviewed 104 locoregionally advanced nasopharyngeal carcinoma patients who underwent taxane combined platinum-based concurrent chemoradiotherapy in our center between January 2013 and December 2018. All statistical analyses were performed using the Kaplan–Meier method (SPSS 23.0). Different groups were compared with the Wilcoxon rank-sum test. Ultimately, 104 patients were selected for this study, including 18 and 86 who received either concurrent chemoradiation therapy alone or concurrent chemoradiation therapy plus adjuvant chemotherapy, respectively. The median follow-up time for progression free survival was 53.0 months (IQR 48.5–57.5). The 3-years progression-free survival (PFS), overall survival (OS), local–regional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS) rates of the doublet regimen of concurrent chemotherapy for locoregionally advanced nasopharyngeal carcinoma were 85.9%, 96.0%, 96.0% and 90.8%, respectively. Additionally, we analyzed the subgroups and found that the 3-years PFS, OS, LRRFS and DMFS rates for stage III versus stage IVa were 97.8% versus 75.5% (P = 0.000), 100% versus 92.5% (P = 0.004), 100% versus 92.4% (P = 0.015) and 97.8% versus 82.8% (P = 0.002), respectively. During concurrent chemotherapy, acute chemotherapy adverse events of grade 3 or 4 was only 18.3%. Leukopenia was the most common acute chemotherapy adverse event (in 10 patients [9.6%]), followed by neutropenia (in 8 patients [7.6%]). The doublet regimen of taxane plus platinum concurrent chemoradiotherapy resulted in improved long-term survival of locoregionally advanced nasopharyngeal carcinoma patients, especially for local control rate and warrants further prospective evaluation.
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