Open AccessEffect of induction chemotherapy with cisplatin, fluorouracil, with or without taxane on locoregionally advanced nasopharyngeal carcinoma: a retrospective, propensity score‐matched analysis
Author(s) -
Liu GuoYing,
Lv Xing,
Wu YiShan,
Mao MinJie,
Ye YanFang,
Yu YaHui,
Liang Hu,
Yang Jing,
Ke LiangRu,
Qiu WenZe,
Huang XinJun,
Li WangZhong,
Guo Xiang,
Xiang YanQun,
Xia WeiXiong
Publication year - 2018
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-018-0283-2
Subject(s) - propensity score matching , medicine , nasopharyngeal carcinoma , hazard ratio , oncology , taxane , fluorouracil , induction chemotherapy , confidence interval , cisplatin , retrospective cohort study , chemotherapy , radiation therapy , cancer , breast cancer
Background Available data in the literature comparing different induction chemotherapy (IC) regimens on locoregionally advanced nasopharyngeal carcinoma (NPC) are scarce. The purpose of the present study was to evaluate the outcomes of locoregionally advanced NPC patients who were treated with taxane, cisplatin and 5‐fluorouracil (TPF) or cisplatin and 5‐fluorouracil (PF) as IC followed by concurrent chemoradiotherapy (CCRT). Methods In total, 1879 patients with locoregionally advanced NPC treated with IC and CCRT from a prospectively maintained database were included in the present observational study. We compared overall survival (OS), disease‐specific survival (DSS), distant metastasis‐free survival (DMFS), and locoregional relapse‐free survival, using the propensity score method. Results In total, 1256 patients received TPF or PF as IC backbone. The TPF group showed significantly better OS (hazard ratio [HR], 0.660; 95% confidence interval [CI] 0.442–0.986; P = 0.042), DSS (HR, 0.624; 95% CI 0.411–0.947; P = 0.027) and DMFS (HR, 0.589; 95% CI 0.406–0.855; P = 0.005) compared with the PF group in multivariable analyses. Propensity score matching identified 294 patients in each cohort and confirmed that TPF was associated with significantly improved 5‐year OS (88.1% vs. 80.7%; P = 0.042), DSS (88.5% vs. 80.7%; P = 0.021) and DMFS (87.9% vs. 78.6%; P = 0.012) rates compared with the PF group. There were no significant differences in locoregional relapse‐free survival before or after matching. Conclusions In our study, IC with the TPF regimen combined with CCRT showed improved long‐term survival for the patients with locoregionally advanced NPC compared with the PF regimen. However, a prospective randomized clinical trial to validate these findings is necessary.