不同诱导化疗周期及辅助化疗对局部晚期鼻咽癌患者生存结局的影响

The Effects of Different Induction Chemotherapy Cycles and Adjuvant Chemotherapy on the Survival Outcomes of Patients With Locally Advanced Nasopharyngeal Carcinoma.

作者信息

Liao Shu, Diao Yunlian, Ling Qingyuan, Xiong Zhijuan, Deng Wenxin, Zhang Ping, Zhang Congkai, Ying Ying, Zhong Xiaojun, Zhang Wei

机构信息

The Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China.

The Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

Front Oncol. 2022 Jun 20;12:845704. doi: 10.3389/fonc.2022.845704. eCollection 2022.

OBJECTIVE

This study investigated whether differences in the induction chemotherapy (IC) cycle number and adjuvant chemotherapy (AC) affect survival outcomes in patients with locally advanced nasopharyngeal carcinoma (LA-NPC).

METHODS

The survival outcomes of 386 consecutive LA-NPC patients treated between January 2015 and March 2018 were retrospectively analyzed. Univariate and multivariate analyses were used to compare treatment groups defined by IC< 3 or ≥3 IC cycles followed by radiotherapy with or without AC (i.e., IC<3+AC, IC<3+non-AC, IC≥3+AC, and IC≥3+non-AC groups).

RESULTS

The median follow-up time was 53 months (range: 2-74 months) and the median number of IC cycles was 2 (range: 1-6 cycles). The 3-year overall survival (OS) rate was significantly higher in patients with IC≥3 cycles compared to IC<3 cycles (95.7% vs. 90.3%, =0.020). Multivariate analysis indicated that the IC cycle number is an independent factor for OS (hazard ratio=0.326, =0.007). Furthermore, patients in the IC<3+AC group had a better OS rate than those in the IC<3+non-AC group (91.6% vs. 79.1%, =0.030), indicating that AC positively affected OS in patients with IC<3. However, no significant difference in the OS rate was found between IC≥3+non-AC and IC≥3+AC groups (92.1% vs. 94.6%, =0.550).

CONCLUSION

The IC cycle number appears to be an independent prognostic factor for higher OS in LA-NPC patients who received ≥3 cycles. Sequential AC after IC plus radiotherapy may improve OS in patients with IC<3 cycles.

目的

本研究调查诱导化疗（IC）周期数和辅助化疗（AC）的差异是否会影响局部晚期鼻咽癌（LA-NPC）患者的生存结局。

方法

回顾性分析2015年1月至2018年3月期间连续治疗的386例LA-NPC患者的生存结局。采用单因素和多因素分析比较由IC<3或≥3个IC周期后接受或不接受AC放疗所定义的治疗组（即IC<3+AC、IC<3+非AC、IC≥3+AC和IC≥3+非AC组）。

结果

中位随访时间为53个月（范围：2 - 74个月），IC周期的中位数为2（范围：1 - 6个周期）。IC≥3个周期的患者3年总生存率（OS）显著高于IC<3个周期的患者（95.7%对90.3%，P = 0.020）。多因素分析表明IC周期数是OS的独立因素（风险比=0.326，P = 0.007）。此外，IC<3+AC组患者的OS率高于IC<3+非AC组（91.6%对79.1%，P = 0.030），表明AC对IC<3的患者的OS有积极影响。然而，IC≥3+非AC组和IC≥3+AC组之间的OS率无显著差异（92.1%对94.6%，P = 0.550）。