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Neoadjuvant or Adjuvant Chemotherapy Plus Concurrent CRT Versus Concurrent CRT Alone in the Treatment of Nasopharyngeal Carcinoma: A Study Based on EBV DNA

Authors :
Shan Shan Guo
Chong Zhao
Qing Nan Tang
Chao Nan Qian
Jian Yong Shao
Lin Quan Tang
Yu Jing Liang
Xiang Guo
Ying Sun
Li Ting Liu
Jun Ma
Hai Qiang Mai
Jin Xin Bei
Xue Song Sun
Ming Huang Hong
Ling Guo
Qiu Yan Chen
Mu Sheng Zeng
Yang Li
Hao Yuan Mo
Source :
Journal of the National Comprehensive Cancer Network. 17:703-710
Publication Year :
2019
Publisher :
Harborside Press, LLC, 2019.

Abstract

Background: The goal of this study was to explore the value of adding neoadjuvant chemotherapy (NACT) or adjuvant chemotherapy (ACT) to concurrent chemoradiotherapy (CCRT) in patients with nasopharyngeal carcinoma (NPC) with different risks of treatment failure. Patients and Methods: A total of 2,263 eligible patients with stage III–IVb NPC treated with CCRT ± NACT or ACT were included in this retrospective study. Distant metastasis–free survival (DMFS), overall survival, and progression-free survival were calculated using the Kaplan-Meier method and differences were compared using the log-rank test. Results: Patients in the low-risk group (stage N0–1 disease and Epstein-Barr virus [EBV] DNA P= .008). Multivariate analyses also demonstrated that additional NACT was the only independent prognostic factor for DMFS (hazard ratio, 0.42; 95% CI, 0.22–0.80; P=.009). In both the intermediate-risk group (stage N0–1 disease and EBV DNA ≥4,000 copies/mL and stage N2–3 disease and EBV DNA Conclusions: The addition of NACT to CCRT could reduce distant failure in patients with low risk of treatment failure.

Details

ISSN :
15401413 and 15401405
Volume :
17
Database :
OpenAIRE
Journal :
Journal of the National Comprehensive Cancer Network
Accession number :
edsair.doi...........44833fb1ea0fc8bb9b5b3759215bb1be