Induction plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy in elderly patients with locoregionally advanced nasopharyngeal carcinoma.

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  • Author(s): Chen L;Chen L; Li K; Li K; Li Q; Li Q; Li Q; Ji P; Ji P; Huang C; Huang C; Tang L; Tang L
  • Source:
    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Nov; Vol. 200, pp. 110497. Date of Electronic Publication: 2024 Aug 25.
  • Publication Type:
    Journal Article; Comparative Study
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8407192 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0887 (Electronic) Linking ISSN: 01678140 NLM ISO Abbreviation: Radiother Oncol Subsets: MEDLINE
    • Publication Information:
      Publication: Limerick : Elsevier Scientific Publishers
      Original Publication: Amsterdam : Elsevier Science Publishers, c1983-
    • Subject Terms:
      Chemoradiotherapy*/adverse effects ; Nasopharyngeal Carcinoma*/therapy ; Nasopharyngeal Carcinoma*/mortality ; Nasopharyngeal Carcinoma*/pathology ; Nasopharyngeal Neoplasms*/therapy ; Nasopharyngeal Neoplasms*/mortality ; Nasopharyngeal Neoplasms*/pathology ; Induction Chemotherapy*; Humans ; Male ; Female ; Aged ; Retrospective Studies ; Survival Rate ; Kaplan-Meier Estimate ; Neoplasm Staging
    • Abstract:
      Background: The effectiveness and safety of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in elderly patients with locoregionally advanced nasopharyngeal carcinomas (LANPCs) remain subjects of debate. This study evaluated the efficacy of IC+CCRT compared to CCRT alone in elderly LANPC patients.
      Materials and Methods: This retrospective, single-center study analyzed 335 elderly patients diagnosed with stage III or IVa NPC who received CCRT with or without IC between 2010 and 2016. Kaplan-Meier analysis and log-rank tests were used to estimate and compare survival rates. Multivariate analysis using Cox proportional hazards regression model was conducted to assess prognostic risk factors. Toxicities were compared using the χ 2 test.
      Results: The median follow-up duration was 69.3 months (interquartile range: 42.7-72.6). Baseline clinical characteristics were well-balanced between groups. No significant differences were observed between IC+CCRT and CCRT for any survival-related endpoints, including overall survival (hazard ratio [HR] = 1.26, 95 % confidence interval [CI]: 0.89-1.77, p = 0.188), locoregional relapse-free survival (HR=1.03, 95 % CI: 0.56-1.91, p = 0.913), distant metastasis-free survival (HR=1.39, 95 % CI: 0.90-2.16, p = 0.139), and failure-free survival (HR = 1.25, 95 % CI: 0.85-1.83, p = 0.255). However, the incidence and severity of acute and late toxicities were significantly higher in the IC+CCRT group compared to the CCRT group.
      Conclusion: In elderly LANPC patients, the addition of IC to CCRT did not improve survival outcomes, but was associated with significant toxicities.
      Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
      (Copyright © 2024 Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Concurrent chemoradiotherapy; Elderly patients; Induction chemotherapy; Nasopharyngeal carcinoma; Prognosis
    • Publication Date:
      Date Created: 20240827 Date Completed: 20240928 Latest Revision: 20240928
    • Publication Date:
      20240929
    • Accession Number:
      10.1016/j.radonc.2024.110497
    • Accession Number:
      39191301