Wu Kun-Peng, Li Qing-Qing, Luo Xu-Qiang, Wang Xiao-Xi, Lai Yan-Zhen, Tian Dan, Yang Hong-Cheng, Wei Xue-Ling, Wang Lan-Ying, Li Qiu-Ming, Zhu Dao, Chen Si-Jie, Li Yang-Si
Department of Oncology, Heyuan People's Hospital, Guangdong Provincial People's Hospital Heyuan Hospital, Heyuan, Guangdong, China.
Heyuan Key Laboratory of Molecular Diagnosis & Disease Prevention and Treatment, Doctors Station of Guangdong Province, Heyuan People's Hospital, Heyuan, Guangdong, China.
Ann Med. 2025 Dec;57(1):2453091. doi: 10.1080/07853890.2025.2453091. Epub 2025 Jan 21.
Chemoimmunotherapy is the first-line therapy for patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) and is currently the main induction treatment option for patients with locoregionally advanced NPC. However, it remains unclear whether combining immunotherapy with standard induction chemotherapy enhances its efficacy. This study aimed to evaluate the efficacy, toxicity, and survival outcomes of induction chemoimmunotherapy in patients with locoregionally advanced NPC.
This study analyzed 50 patients with stage IVa NPC between January 2020 and December 2023 in our hospital. Among them, 23 received induction chemoimmunotherapy, and 27 received induction chemotherapy. All patients underwent standard platinum-based concurrent intensity-modulated radiation therapy. We compared tumor response and toxicity during induction treatment and concurrent chemoradiotherapy (CCRT) between the two groups.
The objective and complete response rates were significantly higher in the induction chemoimmunotherapy group compared to the induction chemotherapy group (95.7% vs 77.8%, and 39.1% vs 22.2%, respectively). All patients completed radical CCRT. Median follow-up was 24 months. Patients who received induction chemoimmunotherapy had longer event-free survival (EFS) compared to those who received induction chemotherapy ( = 0.029, Hazard Ratio and 95%confidence interval [CI]: 0.24 [0.07-0.85]). The 24-month EFS was higher in the induction chemoimmunotherapy group compared with the chemotherapy group (24-month EFS rates and 95%CI: 88.9% [95%CI: 68.3%-100%] vs 62.6% [95%CI: 43.1%-82.1%]). No significant differences in adverse events were observed between the two groups during induction treatment and CCRT.
Adding immunotherapy to induction chemotherapy may be an effective and safe choice for treating patients with stage IVa NPC.
化学免疫疗法是复发或转移性鼻咽癌（NPC）患者的一线治疗方法，目前是局部晚期NPC患者的主要诱导治疗选择。然而，免疫疗法与标准诱导化疗联合是否能提高其疗效仍不清楚。本研究旨在评估诱导化学免疫疗法对局部晚期NPC患者的疗效、毒性和生存结果。
本研究分析了2020年1月至2023年12月在我院的50例IVa期NPC患者。其中，23例接受诱导化学免疫疗法，27例接受诱导化疗。所有患者均接受标准铂类同步调强放疗。我们比较了两组在诱导治疗和同步放化疗（CCRT）期间的肿瘤反应和毒性。
诱导化学免疫疗法组的客观缓解率和完全缓解率显著高于诱导化疗组（分别为95.7%对77.8%，39.1%对22.2%）。所有患者均完成了根治性CCRT。中位随访时间为24个月。接受诱导化学免疫疗法的患者与接受诱导化疗的患者相比，无事件生存期（EFS）更长（=0.029，风险比和95%置信区间[CI]：0.24[0.07-0.85]）。诱导化学免疫疗法组的24个月EFS高于化疗组（24个月EFS率和95%CI：88.9%[95%CI：68.3%-100%]对62.6%[95%CI：43.1%-82.1%]）。两组在诱导治疗和CCRT期间的不良事件无显著差异。
在诱导化疗中加入免疫疗法可能是治疗IVa期NPC患者的有效且安全的选择。
