Abstract
Issa Mohamad
Objectives To compare outcomes and toxicity of two standard treatment approaches of advanced
nasopharyngeal carcinoma (NPC).
Methods Between 2010 and 2016, patients with NPC, stage II–IVa, treated with induction chemotherapy
(IC) (TPF), followed by concurrent chemoradiotherapy (CCRT) (induction group), or
CCRT, followed by adjuvant chemotherapy (AC) (PF) (no-induction group), were retrospectively
reviewed. CCRT included platinum-based chemotherapy with intensity-modulated radiotherapy.
Survival outcomes, the pattern of failures, toxicity, and predictors for survival
outcomes were evaluated.
Results A total of 110 patients were included, 65 in the induction group and 45 in the no-induction
group. There were no significant differences in the DFS and overall survival (OS)
at 3 years between the two groups. On multivariate analysis, performance status (1
vs. 0) predicted worse OS. The 3-year cumulative incidence rates for local, regional,
and distant failures were 58.5% (95% confidence interval [CI]: 8.4–89%), 58.00% (95%
CI: 8–88.8%), and 63.90% (95% CI: 14.1–90.2%), respectively. IC had more frequent
acute grade (G) II anemia (13 vs. 1, p < 0.01), late G II brain toxicity (4 vs. 1, p < 0.01), and late G II dysphagia (32 vs. 11, p = 0.01).
Conclusions Survival outcomes were comparable between the two groups. IC had more frequent acute
G II anemia and late G II brain and esophageal toxicities.
Keywords
nasopharyngeal carcinoma - IMRT - outcomes - toxicity - induction chemotherapy - concurrent
chemotherapy
