Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 6/2017

01-06-2017 | Original Article

Induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective cohort study

Authors: Jianyuan Zhang, Shaojun Chen, Guisheng Li, Weihua Zhang, Tingting Qin, Ping Yin, Haixin Huang, Hongwei Jiang

Published in: Cancer Chemotherapy and Pharmacology | Issue 6/2017

Login to get access

Abstract

Purpose

To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC).

Methods

We reviewed data of locoregionally advanced NPC patients who underwent 2 different treatment plans, 1 with induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) and the other with only concurrent chemoradiotherapy (CCRT). All patients received cisplatin 80 mg/m2 3 weeks one cycle concurrently with intensity-modulated radiation therapy, and three IC protocols were included for the IC + CCRT group.

Results

Data of 262 patients treated from May 2011 to November 2014 were found eligible for our study. With a median follow-up of 29.02 months, no significant differences were detected between the two groups on the 2-year overall survival or OS rates (96.63 vs. 92.86%, P = 0.169), 2-year distant metastasis-free survival or DMFS rates (91.57 vs. 86.90%, P = 0.246) and 3-year DMFS rates (90.45 vs. 82.14%, P = 0.093). However, they were statistically different on 2-year locoregional failure-free survival or LFFS rates (94.94 vs. 86.90%, P = 0.020), 3-year OS rates (95.51 vs. 82.14%, P = 0.002) and 3-year LFFS rates (93.82 vs. 79.76%, P = 0.001). The most common severe (grade 3–4) adverse events we recorded were Nausea/vomiting (36.52 vs. 33.33%), leukopenia (14.04 vs. 4.76%), thrombocytopenia (3.93 vs. 3.57%) and hepatic toxicity (3.37 vs. 2.38%).

Conclusion

Compared with CCRT, the treatment plan IC + CCRT produced significantly encouraging outcomes in locoregionally advanced NPC patients on local progression-free survival and 3-year overall survival position, but might raise the risk of certain adverse reactions.
Appendix
Available only for authorised users
Literature
1.
Chang ET, Adami HO (2006) The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev 15(10):1765–1777CrossRefPubMed
2.
3.
Lin HX, Hua YJ, Chen QY, Luo DH, Sun R, Qiu F, Mo HY, Mai HQ, Guo X, Xian LJ, Hong MH, Guo L (2013) Randomized study of sinusoidal chronomodulated versus flat intermittent induction chemotherapy with cisplatin and 5-fluorouracil followed by traditional radiotherapy for locoregionally advanced nasopharyngeal carcinoma. Chin J Cancer 32(9):502–511CrossRefPubMedPubMedCentral
4.
Teo P, Yu P, Lee WY, Leung SF, Kwan WH, Yu KH, Choi P, Johnson PJ (1996) Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography. Int J Radiat Oncol Biol Phys 36(2):291–304CrossRefPubMed
5.
Lee FK, Yip CW, Cheung FC, Leung AK, Chau RM, Ngan RK (2014) Dosimetric difference amongst 3 techniques: TomoTherapy, sliding-window intensity-modulated radiotherapy (IMRT), and RapidArc radiotherapy in the treatment of late-stage nasopharyngeal carcinoma (NPC). Med Dosim 39(1):44–49CrossRefPubMed
6.
Xia P, Fu KK, Wong GW, Akazawa C, Verhey LJ (2000) Comparison of treatment plans involving intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 48(2):329–337CrossRefPubMed
7.
Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, Forastiere AA, Adams G, Sakr WA, Schuller DE, Ensley JF (1998) Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 16(4):1310–1317CrossRefPubMed
8.
Lin JC, Jan JS, Hsu CY, Liang WM, Jiang RS, Wang WY (2003) Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol 21(4):631–637CrossRefPubMed
9.
Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, Siu L, Sze WM, Leung TW, Sham JS, Ngan RK, Law SC, Yau TK, Au JS, O’Sullivan B, Pang ES, O SK, Au GK, Lau JT, Hong Kong Nasopharyngeal Cancer Study G (2005) Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol 23(28):6966–6975CrossRefPubMed
10.
Chen L, Hu CS, Chen XZ, Hu GQ, Cheng ZB, Sun Y, Li WX, Chen YY, Xie FY, Liang SB, Chen Y, Xu TT, Li B, Long GX, Wang SY, Zheng BM, Guo Y, Sun Y, Mao YP, Tang LL, Chen YM, Liu MZ, Ma J (2012) Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial. Lancet Oncol 13(2):163–171CrossRefPubMed
11.
Loong HH, Ma BB, Leung SF, Mo F, Hui EP, Kam MK, Chan SL, Yu BK, Chan AT (2012) Prognostic significance of the total dose of cisplatin administered during concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. Radiother Oncol 104(3):300–304CrossRefPubMed
12.
Da Costa Miranda V, de Souza Fede AB, Dos Anjos CH, da Silva JR, Sanchez FB, da Silva Bessa LR, de Paula Carvalho J, Filho EA, de Freitas D, Del Pilar Estevez Diz M (2014) Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients unsuitable for primary surgery: Safety and effectiveness. Gynecol Oncol 132(2):287–291CrossRefPubMed
13.
Fountzilas G, Ciuleanu E, Bobos M, Kalogera-Fountzila A, Eleftheraki AG, Karayannopoulou G, Zaramboukas T, Nikolaou A, Markou K, Resiga L, Dionysopoulos D, Samantas E, Athanassiou H, Misailidou D, Skarlos D, Ciuleanu T (2012) Induction chemotherapy followed by concomitant radiotherapy and weekly cisplatin versus the same concomitant chemoradiotherapy in patients with nasopharyngeal carcinoma: a randomized phase II study conducted by the Hellenic Cooperative Oncology Group (HeCOG) with biomarker evaluation. Ann Oncol 23(2):427–435CrossRefPubMed
14.
Ou D, Blanchard P, El Khoury C, De Felice F, Even C, Levy A, Nguyen F, Janot F, Gorphe P, Deutsch E, Temam S, Tao Y (2016) Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy or chemoradiotherapy alone in locally advanced non-endemic nasopharyngeal carcinoma. Oral Oncol 62:114–121CrossRefPubMed
15.
Liang ZG, Zhu XD, Tan AH, Jiang YM, Qu S, Su F, Xu GZ (2013) Induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy with or without adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: meta-analysis of 1,096 patients from 11 randomized controlled trials. Asian Pac J Cancer Prev 14(1):515–521CrossRefPubMed
16.
Chen YP, Guo R, Liu N, Liu X, Mao YP, Tang LL, Zhou GQ, Lin AH, Sun Y, Ma J (2015) Efficacy of the additional neoadjuvant chemotherapy to concurrent chemoradiotherapy for patients with locoregionally advanced nasopharyngeal carcinoma: a Bayesian Network meta-analysis of randomized controlled trials. J Cancer 6(9):883–892CrossRefPubMedPubMedCentral
17.
Song Y, Wang W, Tao G, Zhou X (2015) Survival benefit of induction chemotherapy in treatment for locally advanced nasopharyngeal carcinoma—a time-to-event meta-analysis. Oral Oncol 51(8):764–769CrossRefPubMed
18.
Austin PC (2014) A comparison of 12 algorithms for matching on the propensity score. Stat Med 33(6):1057–1069CrossRefPubMed
19.
Sher DJ, Thotakura V, Balboni TA, Norris CM, Haddad RI, Posner MR, Lorch J, Goguen LA, Annino DJ, Tishler RB (2012) Treatment of oropharyngeal squamous cell carcinoma with IMRT: patterns of failure after concurrent chemoradiotherapy and sequential therapy. Ann Oncol 23(9):2391–2398CrossRefPubMed
20.
Chan AT, Leung SF, Ngan RK, Teo PM, Lau WH, Kwan WH, Hui EP, Yiu HY, Yeo W, Cheung FY, Yu KH, Chiu KW, Chan DT, Mok TS, Yau S, Yuen KT, Mo FK, Lai MM, Ma BB, Kam MK, Leung TW, Johnson PJ, Choi PH, Zee BC (2005) Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst 97(7):536–539CrossRefPubMed
21.
Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, Chua ET, Yang E, Lee KM, Fong KW, Tan HS, Lee KS, Loong S, Sethi V, Chua EJ, Machin D (2005) Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol 23(27):6730–6738CrossRefPubMed
22.
Huncharek M, Kupelnick B (2002) Combined chemoradiation versus radiation therapy alone in locally advanced nasopharyngeal carcinoma: results of a meta-analysis of 1528 patients from six randomized trials. Am J Clin Oncol 25(3):219–223CrossRefPubMed
23.
Al-Sarraf M, Pajak TF, Cooper JS, Mohiuddin M, Herskovic A, Ager PJ (1990) Chemo-radiotherapy in patients with locally advanced nasopharyngeal carcinoma: a radiation therapy oncology group study. J Clin Oncol 8(8):1342–1351CrossRefPubMed
24.
Pignon JP, le Maitre A, Maillard E, Bourhis J, Group M-NC (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92(1):4–14CrossRefPubMed
25.
Hui EP, Ma BB, Leung SF, King AD, Mo F, Kam MK, Yu BK, Chiu SK, Kwan WH, Ho R, Chan I, Ahuja AT, Zee BC, Chan AT (2009) Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol 27(2):242–249CrossRefPubMed
26.
Tan T, Lim WT, Fong KW, Cheah SL, Soong YL, Ang MK, Ng QS, Tan D, Ong WS, Tan SH, Yip C, Quah D, Soo KC, Wee J (2015) Concurrent chemo-radiation with or without induction gemcitabine, Carboplatin, and Paclitaxel: a randomized, phase 2/3 trial in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 91(5):952–960CrossRefPubMed
Metadata
Title
Induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a retrospective cohort study
Authors
Jianyuan Zhang
Shaojun Chen
Guisheng Li
Weihua Zhang
Tingting Qin
Ping Yin
Haixin Huang
Hongwei Jiang
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 6/2017
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-017-3297-6

Other articles of this Issue 6/2017

Cancer Chemotherapy and Pharmacology 6/2017 Go to the issue

Original Article

The incidence and risk factors of febrile neutropenia in chemotherapy-naïve lung cancer patients receiving etoposide plus platinum

Original Article

Phase II study of S-1 plus bevacizumab combination therapy for patients previously treated for non-squamous non-small cell lung cancer

Review Article

Neurotoxicity after high-dose methotrexate (MTX) is adequately explained by insufficient folinic acid rescue

Original Article

CYT-Rx20 inhibits ovarian cancer cells in vitro and in vivo through oxidative stress-induced DNA damage and cell apoptosis

Original Article

UGT1A1 polymorphisms with irinotecan-induced toxicities and treatment outcome in Asians with Lung Cancer: a meta-analysis

Short Communication

Pharmacodynamic effects in the cerebrospinal fluid of rats after intravenous administration of different asparaginase formulations
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits