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REVIEW article

Front. Oncol.
Sec. Head and Neck Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1475176
This article is part of the Research Topic Neoadjuvant Therapy in HNSCC View all 3 articles

Long-term outcomes of induction chemotherapy followed by concurrent chemoradiotherapy and adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: A retrospective study

Provisionally accepted
Xiaoyan Zhao Xiaoyan Zhao 1Ling Tian Ling Tian 1Yun Chen Yun Chen 2Qing Yang Qing Yang 1Tao Xie Tao Xie 1Modong Chen Modong Chen 1Jinhui Rao Jinhui Rao 1Meng Yang Meng Yang 1Ning Huang Ning Huang 3*Yanxin Ren Yanxin Ren 1*
  • 1 1. Department of Head and Neck Surgery , Third affiliated hospital of Kunming medical university, Kunming, China
  • 2 2. Department of Pathology , Third affiliated hospital of Kunming medical university，Kunming, Kunming, China
  • 3 Department of Pharmacology, Kunming Medical University, Kunming, Yunnan Province, Kunming, China

The final, formatted version of the article will be published soon.

    The optimal treatment strategy for locally advanced NPC (stage III and IVA, LA-NPC) involves various combinations of induction chemotherapy (IC), concurrent chemoradiotherapy (CCRT), and adjuvant chemotherapy (AC), each with distinct advantages. This one institutional study aims to retrospectively analysis the efficacy and clinical outcomes of IC with CCRT (IC+CCRT), CCRT with AC (CCRT+AC), and the comprehensive approach of IC followed by CCRT and subsequently AC (IC+CCRT+AC) in the management of LA-NPC.A total of 352 LA-NPC patients were included: 173 accepted IC+CCRT, 60 received CCRT+AC, and 119 underwent IC+CCRT+AC. The primary endpoints including overall survival (OS) and progression-free survival (PFS), were assessed using the Kaplan-Meier method and log-rank test.The median follow-up was 61.2 months (1-216 months). There was no significant difference in 5-year OS and PFS between IC group and no IC group, extending the observation time to 90 months, the OS and PFS were significantly better in IC group than no IC group (OS: 76% vs. 70%,P<0.05; PFS: 76% vs. 71%, P<0.05). Patients with 1, 2, or 3 cycles of IC had higher 5-year OS and PFS than those with more than 3 cycles (1-4 cycles IC OS: 89% vs. 87% vs. 88% vs. 79%, P<0.05; 1-4 cycles IC PFS: 87% vs. 85% vs. 85% vs. 70%, P<0.05). NP regimen demonstrated higher OS and PFS than TP, PF, and TPF regimens (OS: 95% vs. 82% vs. 85% vs. 71%, P<0.05; PFS: 93% vs. 83% vs. 81% vs. 80%, P<0.05). The 5-year OS and PFS were significantly better in AC group than no AC group (OS: 82% vs. 72%, P<0.05; PFS: 81% vs. 69%, P<0.05). In the AC group, there was no differential effect of chemotherapy cycles and chemotherapy regimens on patients' OS and PFS. In the ThNh group, patients receiving IC+CCRT+AC had higher OS and PFS compared to those receiving IC+CCRT, with no significant difference in the rest (OS: 85% VS 66% P<0.05; PFS: 78% VS 62%, P<0.05).CCRT combined with IC or AC could benefit LA-NPC patients. The IC+CCRT +AC regimen was most beneficial for NPC patients with later T and N stages.

    Keywords: nasopharyngeal carcinoma, adjuvant chemotherapy (AC), Induction chemotherapy (IC), Overall survival (OS), progression-free survival (PFS)

    Received: 03 Aug 2024; Accepted: 16 Oct 2024.

    Copyright: © 2024 Zhao, Tian, Chen, Yang, Xie, Chen, Rao, Yang, Huang and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ning Huang, Department of Pharmacology, Kunming Medical University, Kunming, Yunnan Province, Kunming, China
    Yanxin Ren, 1. Department of Head and Neck Surgery , Third affiliated hospital of Kunming medical university, Kunming, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.