Liu Yongliang, Li Yan, Hou Ying, Zhao Zhenan, Wang Guoquan, Gao Chunmiao, Sun Yuqing, Li Na, Jiang Yan
Department of Otolaryngolgogy, The Affiliated Hospital of Qingdao University Qingdao, Shandong, China.
Department of Otolaryngolgogy, Zibo Central Hospital Zibo, Shandong, China.
Am J Cancer Res. 2024 Jun 15;14(6):3142-3152. doi: 10.62347/WMLA4979. eCollection 2024.
This study aimed to evaluate the impact of adjuvant chemotherapy on survival rates, adverse events, and quality of life (QOL) in patients with locally advanced nasopharyngeal carcinoma (NPC). A retrospective cohort study was conducted, including patients with firstly histologically confirmed non-metastatic stage III-IVB NPC between February 2018 and February 2020, and with continuous follow-up data available, were chosen from the medical records of the affiliated hospital of Qingdao University and Zibo Central Hospital. There were 395 patients receiving concurrent chemoradiotherapy (CCRT) with adjuvant chemotherapy (adjuvant chemotherapy group) and 428 patients receiving CCRT alone (control group). The two groups were compared for treatment response, adverse events, and QOL scores. Besides, Kaplan-Meier plots, and multivariate COX analysis were conducted. The adjuvant chemotherapy group demonstrated a significantly higher overall survival and disease-free survival compared to the control group. The use of adjuvant chemotherapy was significantly correlated with improved overall survival and disease-free survival. Adjuvant chemotherapy was associated with reduced local recurrence and distant metastasis rates. However, higher rates of adverse events were observed in the adjuvant chemotherapy group. QOL scores for physical functioning, emotional functioning, and overall quality of life were higher in the adjuvant chemotherapy group. The findings of this study indicate that adjuvant chemotherapy in locally advanced NPC is associated with improved treatment response, extended overall and disease-free survivals, and better QOL, despite higher rates of adverse events.
本研究旨在评估辅助化疗对局部晚期鼻咽癌(NPC)患者生存率、不良事件及生活质量(QOL)的影响。开展了一项回顾性队列研究,从青岛大学附属医院和淄博市中心医院的病历中选取2018年2月至2020年2月期间首次经组织学确诊为非转移性III-IVB期NPC且有连续随访数据的患者。395例患者接受同步放化疗(CCRT)联合辅助化疗(辅助化疗组),428例患者仅接受CCRT(对照组)。比较两组的治疗反应、不良事件及QOL评分。此外,进行了Kaplan-Meier曲线分析和多因素COX分析。辅助化疗组的总生存率和无病生存率显著高于对照组。辅助化疗的使用与总生存率和无病生存率的提高显著相关。辅助化疗与局部复发率和远处转移率降低相关。然而,辅助化疗组观察到更高的不良事件发生率。辅助化疗组在身体功能、情绪功能及总体生活质量方面的QOL评分更高。本研究结果表明,局部晚期NPC患者接受辅助化疗虽不良事件发生率较高,但与治疗反应改善、总生存期和无病生存期延长及生活质量提高相关。