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Radiotherapy with neoadjuvant chemotherapy versus concurrent chemoradiotherapy for ascending-type nasopharyngeal carcinoma:a retrospective comparison of toxicity and prognosis

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Chinese Journal of Cancer 2017年第4期36卷 176-183页

作者： Ji-Jin Yao Xiao-Li Yu Fan Zhang Ji-Jin Yao Xiao-Li Yu Fan Zhang Wang-Jian Zhang Guan-Qun Zhou Ling-Long Tang Yan-Ping Mao Lei Chen Jun Ma Ying Sun Department of Radiation Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Sun Yat-sen University Cancer Center Department of Radiation Oncology The Fifth Affiliated Hospital of Sun Yat-sen University Department of Radiation Oncology Sun Yat-sen Memorial Hospital Sun Yat-sen University Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine School of Public Health Sun Yat-sen University

Background:In the era of intensity?modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NACT)in treating ascending?type nasopharyngeal carcinoma(NPC)is under?*** study was to compare the efficacy of NACT followed by IMRT(NACT+RT)with the efficacy of concurrent chemoradiotherapy(CCRT)on ascending?type ***:Clinical data of 214 patients with ascending?type NPC treated with NACT+RT or CCRT between Decem?ber 2009 and July 2011 were *** the 214 patients,98 were treated with NACT followed by IMRT,and 116 were treated with *** survival rates were assessed using Kaplan–Meier analysis,and the survival curves were compared using a log?rank ***:The 4?year overall survival,locoregional failure?free survival,distant failure?free survival,and failure?free sur?vival rates were not significantly different between the two groups(all P>0.05).However,patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT+RT group during radiotherapy,includ?ing leukopenia(30.2%vs.15.3%,P=0.016),neutropenia(25.9%vs.11.2%,P=0.011),and mucositis(57.8%vs.40.8%,P=0.028).After radiotherapy,patients in the CCRT group exhibited significantly higher rates of xerostomia(21.6%***:The treatment outcomes of the NACT+RT and CCRT groups were similar;however,CCRT led to higher rates of acute and late ***+RT may therefore be a better treatment strategy for ascending?type NPC.

关键词： Nasopharyngeal carcinoma ascending-type Intensity-modulated radiotherapy Neoadjuvant chemotherapy Concurrent chemoradiotherapy

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