鼻咽癌
医学
四分位间距
放化疗
倾向得分匹配
放射治疗
肿瘤科
阶段(地层学)
不利影响
内科学
回顾性队列研究
化疗
外科
古生物学
生物
作者
Weiwei Zhang,Jizhen Lin,Gaoyuan Wang,Cheng‐Long Huang,Ling‐Long Tang,Yan‐Ping Mao,Guan Qun Zhou,Lizhi Liu,Tian Liu,Ji‐Bin Li,Jun Ma,Rui Guo
标识
DOI:10.1016/j.radonc.2024.110189
摘要
Abstract
Background and purpose
Whether concurrent chemoradiotherapy would provide survival benefits in patients with stage II and T3N0 NPC with adverse factors remains unclear in IMRT era. We aimed to assess the value of concurrent chemotherapy compared to IMRT alone in stage II and T3N0 NPC with adverse features. Materials and methods
287 patients with stage II and T3N0 NPC with adverse factors were retrospectively analyzed, including 98 patients who received IMRT alone (IMRT alone group) and 189 patients who received cisplatin-based concurrent chemotherapy (CCRT group). The possible prognostic factors were balanced using propensity score matching (PSM). Kaplan–Meier analysis was used to evaluate the survival rates, and log-rank tests were employed to compare differences between groups. Results
The median follow-up duration was 90.8 months (interquartile range = 75.6–114.7 months). The IMRT alone and the CCRT group were well matched; however, for all survival-related endpoints, there were no significant differences between them (5-year failure-free survival: 84.3% vs. 82.7%, P value = 0.68; 5-year overall survival: 87.3% vs. 90.6%, P value = 0.11; 5-year distant metastasis-free survival: 92.8% vs. 92.5%, P value = 0.97; 5-year locoregional relapse-free survival: 93.4% vs. 89.9%, P value = 0.30). The incidence of acute toxicities in the IMRT alone group was significantly lower than that in the CCRT group. Conclusion
For patients with stage II and T3N0 NPC with adverse features treated using IMRT, no improvement in survival was gained by adding concurrent chemotherapy; however, the occurrence of acute toxicities increased significantly. For those combined with non-single adverse factors, the comprehensive treatment strategy needs further exploration.
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