Efficacy of Concurrent Chemotherapy for Intermediate Risk NPC in the Intensity-Modulated Radiotherapy Era: a Propensity-Matched Analysis.
Efficacy of Concurrent Chemotherapy for Intermediate Risk NPC in the Intensity-Modulated Radiotherapy Era: a Propensity-Matched Analysis.
复制标题
调强放疗时代同步化疗对中危鼻咽癌的疗效：倾向匹配分析
DOI：
10.1038/srep17378
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发表时间：
2015-11-27
影响因子：
4.6
通讯作者：
Ma J
中科院分区：
文献类型：
--
作者：
Zhang F;Zhang Y;Li WF;Liu X;Guo R;Sun Y;Lin AH;Chen L;Ma J
本研究旨在评价额外同步化疗对中度风险患者的疗效对440例中危鼻咽癌患者进行调强放疗（IMRT），其中单纯调强放疗组128例放疗组（RT组）312例，调强放疗加同步化疗组（CRT组）312例。进行倾向评分匹配，以创建在宿主和肿瘤因素方面同等匹配的RT和CRT队列。CRT组的急性毒性反应明显高于RT组。对440名患者的多变量分析未能证明同时化疗是FFS、LR-FFS和D-FFS的独立预后因素。在匹配良好的RT队列和CRT队列之间，所有生存终点均无显著差异（FFS：92.8%vs91.2%，P = 0.801; LR-FFS：95.2%vs94.4%，P = 0.755; D-FFS：96.4%vs96.3%，P = 0.803; OS：98.2%vs98.9%，P = 0.276）。我们的研究结果表明，对于接受调强放射治疗的中危鼻咽癌患者，额外的同步化疗没有提供任何显着的生存益处，但明显更严重的急性毒性。然而，前瞻性随机试验是必要的，以最终确认我们的研究结果。
This study is to evaluate the efficacy of additional concurrent chemotherapy for intermediate risk (stage II and T3N0M0) NPC patients treated with intensity-modulated radiotherapy (IMRT).440 patients with intermediate risk NPC were studied retrospectively, including 128 patients treated with IMRT alone [radiotherapy group (RT group)] and 312 paitents treated with IMRT plus concurrent chemotherapy [chemoradiotherapy group (CRT group)]. Propensity score matching was carried out to create RT and CRT cohorts equally matched for host and tumor factor. Significantly more severe acute toxicities were observed in the CRT group than in the RT group. Multivariate analyses of 440 patients failed to demonstrate concurrent chemotherapy as an independent prognostic factor for FFS, LR-FFS and D-FFS. Between the well-matched RT cohort and the CRT cohort, no significant difference was demonstrated in all survival endpoints (FFS: 92.8% versus 91.2%,P= 0.801; LR-FFS: 95.2% versus 94.4%,P= 0.755; D-FFS: 96.4% versus 96.3%,P= 0.803; OS: 98.2% versus 98.9%,P= 0.276). Our results demonstrated that for patients with intermediate risk NPC treated with IMRT, additional concurrent chemotherapy did not provide any significant survival benefit but significantly more severe acute toxicities. However, prospective randomized trials are warranted for the ultimate confirm of our findings.