Cancer Res Treat.  2016 Jul;48(3):917-927. 10.4143/crt.2015.265.

The Role of Neoadjuvant Chemotherapy in the Treatment of Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Study (KROG 11-06) Using Propensity Score Matching Analysis

Affiliations
  • 1Department of Radiation Oncology, Gyeongsang National University Hospital and Gyeongsang National University School of Medicine, Jinju, Korea.
  • 2Department of Radiation Oncology, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Otolaryngology-Head and Neck Surgery, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 6Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
  • 7Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Seoul, Korea.
  • 8Department of Radiation Oncology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 9Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
  • 10Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
  • 11Department of Radiation Oncology, Pusan National University School of Medicine, Busan, Korea.
  • 12Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, Korea.
  • 13Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
  • 14Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. yeonkim7@catholic.ac.kr

Abstract

PURPOSE
We compared the treatment results and toxicity in nasopharyngeal carcinoma (NPC) patients treated with concurrent chemotherapy (CCRT) alone (the CRT arm) or neoadjuvant chemotherapy followed by CCRT (the NCT arm).
MATERIALS AND METHODS
A multi-institutional retrospective study was conducted to review NPC patterns of care and treatment outcome. Data of 568 NPC patients treated by CCRT alone or by neoadjuvant chemotherapy followed by CCRT were collected from 15 institutions. Patients in both treatment arms were matched using the propensity score matching method, and the clinical outcomes were analyzed.
RESULTS
After matching, 300 patients (150 patients in each group) were selected for analysis. Higher 5-year locoregional failure-free survival was observed in the CRT arm (85% vs. 72%, p=0.014). No significant differences in distant failure-free survival (DFFS), disease-free survival (DFS), and overall survival were observed between groups. In subgroup analysis, the NCT arm showed superior DFFS and DFS in stage IV patients younger than 60 years. No significant difference in compliance and toxicity was observed between groups, except the radiation therapy duration was slightly shorter in the CRT arm (50.0 days vs. 53.9 days, p=0.018).
CONCLUSION
This study did not show the superiority of NCT followed by CCRT over CCRT alone. Because NCT could increase the risk of locoregional recurrences, it can only be considered in selected young patients with advanced stage IV disease. The role of NCT remains to be defined and should not be viewed as the standard of care.

Keyword

Nasopharyngeal neoplasms; Chemoradiotherapy; Induction chemotherapy; Radiotherapy; Republic of Korea

MeSH Terms

Arm
Chemoradiotherapy
Compliance
Disease-Free Survival
Drug Therapy*
Humans
Induction Chemotherapy
Methods
Nasopharyngeal Neoplasms
Propensity Score*
Radiotherapy
Recurrence
Republic of Korea
Retrospective Studies*
Standard of Care
Treatment Outcome
Full Text Links
  • CRT
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error