Department of Radiation Oncology, xijing Hospital, Fourth Military Medical University, Xi'an, Shanxi, China.
Department of Health Statistics, Faculty of Preventative Medicine, Fourth Military Medical University, Xi'an, Shanxi, China.
Sci Rep. 2018 Sep 6;8(1):13318. doi: 10.1038/s41598-018-31050-z.
Given the potentially distinctive histological variations in northwest of China, the aim of current study was to compare the efficacy of induction chemotherapy plus concurrent chemoradiotherapy (IC + CCRT) with concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients with different histological types. A total of 301 patients were included in this study. Patients were classified in two cohorts according to the 2005 WHO World Health Organization histological classification: WHO type IIa group and WHO type IIb group. The Kaplan-Meier method was used to detect the efficacy between IC + CCRT and CCRT in two WHO types cohorts. Propensity score matching method was adopted to balance the baseline covariate and eliminate potential selection bias. On propensity matched analyses, IC + CCRT was found to produce better 3-year DMFS and OS than CCRT in WHO type IIa cohort (DMFS, 76.2% vs. 42.2%, p = 0.029; OS, 78.3% vs. 65.5%, p = 0.027). For WHO type IIb cohort, IC + CCRT was associated with a better 3-year OS (87.4% vs. 77.9%, p = 0.029) and a trend of better 3-year DMFS (85.9% vs. 76%, p = 0.162) compared with CCRT. IC + CCRT was benefit for advanced stage nasopharyngeal carcinoma with different nonkeratinizing carcinoma subtypes.
鉴于中国西北地区潜在的独特组织学变化，本研究旨在比较诱导化疗联合同期放化疗（IC+CCRT）与同期放化疗（CCRT）在不同组织学类型的鼻咽癌（NPC）患者中的疗效。共有 301 例患者纳入本研究。根据 2005 年世界卫生组织（WHO）的组织学分类，患者分为两组：WHO Ⅱa 型组和 WHO Ⅱb 型组。采用 Kaplan-Meier 法检测两组患者 IC+CCRT 和 CCRT 的疗效。采用倾向评分匹配法平衡基线协变量，消除潜在的选择偏倚。在倾向评分匹配分析中，IC+CCRT 可使 WHO Ⅱa 型组患者的 3 年无远处转移生存率（DMFS）和总生存率（OS）明显优于 CCRT（DMFS：76.2%比 42.2%，p=0.029；OS：78.3%比 65.5%，p=0.027）。对于 WHO Ⅱb 型组，与 CCRT 相比，IC+CCRT 可使患者的 3 年 OS（87.4%比 77.9%，p=0.029）和 3 年 DMFS（85.9%比 76%，p=0.162）明显改善。与 CCRT 相比，IC+CCRT 对不同非角化型癌亚型的晚期鼻咽癌患者更有益。
