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ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 |
doi: 10.3389/fphar.2024.1394754
Concurrent chemoradiotherapy with S-1 versus platinum in the treatment of locoregionally advanced nasopharyngeal carcinoma: a multicenter, retrospective, propensity score-matched analysis
Provisionally accepted
Chenbin Bian
1,2
Zhuangzhuang Zheng
1,2
Jing Su
1,2
Sitong Chang
1,2
Huiyuan Yu
1,2
Jindian Bao
1,2
Qin Zhao
1,2*
Xin Jiang
1,2*- 1 Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, the First Hospital of Jilin University, Changchun, 130021, China., Changchun, Hebei Province, China
- 2 NHC Key Laboratory of Radiobiology, School of Public Health of Jilin University, Changchun, 130021, China., Changchun, Hebei Province, China
Literature data are scarce on concurrent chemoradiotherapy (CCRT) with S-1 for locally advanced nasopharyngeal carcinoma (LANPC) treatment. This study compared the efficacy and safety of the S-1 versus platinum-based CCRT in LANPC treatment.This study enrolled 547 patients newly diagnosed with LANPC who underwent CCRT with S-1 or platinum at three institutions. Propensity score matching in a 1:1 ratio balancing baseline features was performed. Survival and adverse effects were compared between groups.Of 160 patients in the cohort, 100 eligible were propensity score matched. Matched dataset analyses showed a higher 5-year overall survival rate (87.1% vs. 84.7%, P = 0.833), progression-free survival (79.6% vs. 75.5%, P = 0.669), locoregional recurrence-free survival (87.0% vs. 84.7%, P = 0.518), and distant metastasis-free survival (84.8% vs. 83.0%, P = 0.780) in the S-1 group than in the platinum-based CCRT group, although not statistically significant. Objective response rate (98.0% vs. 88.0%, P = 0.117) was significantly higher in the S-1 than in the platinum-based regimen, although it was not statistically reflected. Compared with platinum-based, those undergoing S-1-based chemotherapy demonstrated a higher incidence of grade 3 mucositis (20.0% vs. 2.0%, P = 0.016) in the S-1 group and a lower incidence of leukopenia (44.0% vs. 68.0%, P = 0.033), neutropenia (28.0% vs. 52.0%, P = 0.032), anemia (22.0% vs. 44.0%, P = 0.040), nephrotoxicity (4.0% vs. 20.0%, P = 0.028), and nausea/vomiting (30.0% vs. 56.0%, P = 0.019).The results suggest that S-1 can be used as a concurrent chemotherapy regimen during radiotherapy for patients with LANPC, since it presents a noninferior survival benefit compared with platinum and shows tolerable adverse effects.
Keywords: concurrent chemoradiotherapy, S-1, Platinum, nasopharyngeal carcinoma, Propensity score matching, prognosis, Toxicity
Received: 02 Mar 2024; Accepted: 28 Oct 2024.
Copyright: © 2024 Bian, Zheng, Su, Chang, Yu, Bao, Zhao and Jiang. 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:
Qin Zhao, Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, the First Hospital of Jilin University, Changchun, 130021, China., Changchun, Hebei Province, China
Xin Jiang, Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, the First Hospital of Jilin University, Changchun, 130021, China., Changchun, Hebei Province, China
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