Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: A pooled data analysis of two phase III trials
Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: A pooled data analysis of two phase III trials
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DOI：
10.1200/jco.2005.12.081
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发表时间：
2005-02-20
影响因子：
45.3
通讯作者：
Min, HQ
中科院分区：
文献类型：
--
作者：
Chua, DTT;Ma, J;Min, HQ
目的比较鼻咽癌（NPC）诱导化疗加放疗（CRT）与单纯放疗（RT）的远期疗效。共纳入784例患者进行分析，两组患者数量相同。诱导化疗包括2 - 3个周期的顺铂、博莱霉素和氟尿嘧啶，或顺铂和表阿霉素。鼻咽和颈部采用兆伏级放疗（中位剂量，70戈伊）。存活患者的中位随访时间为67个月。分析的基础上意向treat.Results诱导化疗的RT与复发率下降14.3%，癌症相关死亡率下降12.9%，在5年。CRT和RT组的5年无复发生存率分别为50.9%和42.7%（P = 0.014），CRT和RT组的5年疾病特异性生存率分别为63.5%和58.1%（P = 0.029）。CRT和RT组的5年总生存率分别为61.9%和58.1%（P = 0.092）。诱导化疗后5年局部区域失败和远处转移的发生率分别降低了18.3%和13.3%。两组之间的治疗失败模式没有显着差异。结论在RT中加入以顺铂为基础的诱导化疗与晚期NPC的复发和疾病特异性生存率的改善有适度但显着的降低相关。然而，总生存率没有改善。(C)2005年，美国临床肿瘤学会。
Purpose To evaluate the long-term outcome in patients with nasopharyngeal carcinoma (NPC) treated with induction chemotherapy and radiotherapy (CRT) versus radiotherapy alone (RT).Patients and Methods The data from two phase III studies comparing CRT with RT in NPC were updated and pooled together for analysis. A total of 784 patients were included for analysis, with an equal number of patients in both arms. Induction chemotherapy consisted of two to three cycles of cisplatin, bleomycin, and fluorouracil, or cisplatin and epirubicin. RT was given to the nasopharynx and neck using megavoltage radiation (median dose, 70 Gy). The median follow-up time for surviving patients was 67 months. Analysis was based on intention to treat.Results The addition of induction chemotherapy to RT was associated with a decrease in relapse by 14.3% and cancer-related deaths by 12.9% at 5 years. The 5-year relapse-free survival rate was 50.9% and 42.7% in the CRT and RT arm, respectively (P =.014), and the 5-year disease-specific survival rate was 63.5% and 58.1% in the CRT and RT arm, respectively (P =.029). The 5-year overall survival rate was 61.9% and 58.1% in CRT and RT arm, respectively (P =.092). The incidence of locoregional failure and distant metastases was reduced by 18.3% and 13.3% at 5 years, respectively, with induction chemotherapy. There was no significant difference in the treatment failure patterns between the two arms.Conclusion The addition of cisplatin-based induction chemotherapy to RT was associated with a modest but significant decrease in relapse and improvement in disease-specific survival in advanced-stage NPC. However, there was no improvement in overall survival. (C) 2005 by American Society of Clinical Oncology.