The prolonged interval between induction chemotherapy and radiotherapy is associated with poor prognosis in patients with nasopharyngeal carcinoma

ObjectivesInduction chemotherapy (IC) now is gaining recognition for the treatment of nasopharyngeal carcinoma (NPC). The current study was conducted to examine the association between prognosis and the interval between IC and radiotherapy (RT) in NPC patients.MethodsPatients with newly diagnosed, non-metastatic NPC who were treated with IC followed by RT from 2009 to 2012 were identified from an inpatient database. Overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and locoregional recurrence-free survival (LRFS) were compared between those with interval30 and>30days by Kaplan-Meier and log-rank analyses; Cox modeling was used for multivariable analysis.ResultsA total of 668 patients met inclusion criteria with median follow-up of 64.4months. Patients were categorized by interval: 608 patients with interval30days, and 60 with interval>30days. The 5-year OS, DFS, DMFS and LRFS rates were 86.6, 78.2, 88.0 and 89.8% for patients with interval30days, respectively, and 69.2, 64.5, 71.2 and 85.1% for patients with interval>30days, respectively. The prolonged interval was a risk factor for OS, DFS and DMFS with adjusted hazard ratios (95% confidence intervals) were 2.44 (1.48-4.01), 1.99 (1.27-3.11) and 2.62 (1.54-4.47), respectively.ConclusionsProlonged interval>30days was associated with a significantly higher risk of distant metastasis and death in NPC patients. Efforts should be made to avoid prolonged interval between IC and RT to minimize the risk of treatment failure.