期刊
THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY
卷 12, 期 -, 页码 -出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1758835920937424
关键词
cumulative cisplatin dose; induction chemotherapy; inverse probability of treatment weighting; nasopharyngeal carcinoma; propensity score
类别
资金
- Planned Science and Technology Project of Guangdong Province [2019B020230002]
- Natural Science Foundation of Guangdong Province [2017A030312003]
- Health & Medical Collaborative Innovation Project of Guangzhou City, China [201803040003]
- Innovation Team Development Plan of the Ministry of Education [IRT_17R110]
- Overseas Expertise Introduction Project for Discipline Innovation (111 Project) [B14035]
Background: The treatment effects of cumulative cisplatin dose (CCD) during radiotherapy (RT) following induction chemotherapy (IC) have not been determined for patients with locoregionally advanced nasopharyngeal carcinoma (NPC). Methods: A total of 3460 patients with locoregionally advanced NPC who were treated with IC plus cisplatin-based concurrent chemoradiotherapy or RT alone were included in this retrospective study. Three CCD groups (0 mg/m(2) <= CCD <100 mg/m(2), 100 mg/m(2) <= CCD <200 mg/m(2), CCD > 200 mg/m(2)) were balanced through the inverse probability of treatment weighting based on propensity scores estimated by a general boosted model. The primary endpoint was overall survival (OS); the secondary endpoints were distant metastasis-free survival (DMFS) and locoregional recurrence-free survival (LRFS). Results: CCD > 200 mg/m(2)and <200 mg/m(2)exhibited similar treatment effects for OS and DMFS, and were both superior to CCD <100 mg/m(2)for OS and DMFS in patients with stage IVa NPC. The three CCD groups achieved similar treatment effects for patients with stage II-III NPC. After IC, CCD during RT appeared to exert little treatment effect on LRFS. Conclusion: The CCD during RT exerts treatment effects and improves OS by reducing the risk of distant metastasis for patients with stage IVa NPC following IC, and CCD <200 mg/m(2)(mainly 160 mg/m(2)in this group) is recommended. However, RT alone may be sufficient after IC in patients with stage II-III NPC.
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