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The role of chemotherapy in the treatment of stage II nasopharyngeal carcinoma: Retrospective analysis of the national cancer database
- Source :
- Cancer Medicine, Vol 8, Iss 4, Pp 1500-1507 (2019), Cancer Medicine
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- The standard of care treatment for locally advanced nasopharyngeal carcinoma (NPC) includes both chemotherapy and definitive radiation. However, there are limited data on the optimal management of stage II NPC. We performed a retrospective analysis of the National Cancer Database to analyze the treatment patterns and role of chemotherapy in patients with stage II NPC. We identified 611 patients diagnosed with T1‐2, N0‐1, M0 NPC, from 2004 to 2013. Five‐year survival was calculated using Kaplan Meier (KM) analysis. Multivariable analysis and propensity matched analysis were performed to analyze the impact of chemotherapy on overall survival. Of the 611 patients, 527 underwent concurrent chemoradiation (CCRT) and 84 received radiation only. Unadjusted KM analysis showed improved 5‐year survival in the CCRT group compared to radiation only (80.5% vs 65.7%; P = 0.0021). Multivariable analysis also showed improved survival with the addition of chemotherapy (Hazard ratio [HR] 0.59; 95 CI 0.39‐0.89; P = 0.0124). Propensity matched analysis confirmed a significant clinical benefit from the addition of chemotherapy to radiation. Age ≥ 65 years (HR 2.41; 95% CI 1.71‐3.4; P = 1 (HR 2.82; 95% CI 1.49‐5.31; P = 0.0014) and positive lymph node status (HR 1.6; 95% CI 1.04‐2.46; P = 0.0340) were associated with worse survival. In this retrospective analysis, patients with stage II NPC had improved survival with CCRT compared to definitive radiation only. Elderly patients with comorbidities had worse outcomes.
- Subjects :
- 0301 basic medicine
Male
Cancer Research
Databases, Factual
medicine.medical_treatment
computer.software_genre
0302 clinical medicine
Retrospective analysis
Original Research
Database
Hazard ratio
Age Factors
Chemoradiotherapy
Middle Aged
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Lymphatic Metastasis
Female
stage II
overall survival
Antineoplastic Agents
Stage ii
lcsh:RC254-282
concurrent chemoradiotherapy
03 medical and health sciences
Drug Therapy
medicine
Humans
Radiology, Nuclear Medicine and imaging
radiotherapy
Aged
Neoplasm Staging
Retrospective Studies
Chemotherapy
business.industry
nasopharyngeal carcinoma
Cancer
Clinical Cancer Research
Nasopharyngeal Neoplasms
medicine.disease
Survival Analysis
Radiation therapy
030104 developmental biology
Nasopharyngeal carcinoma
Propensity score matching
business
computer
Subjects
Details
- Language :
- English
- ISSN :
- 20457634
- Volume :
- 8
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Cancer Medicine
- Accession number :
- edsair.doi.dedup.....cee3f67ebe0396c0c5ed19178d588cb4