Induction chemotherapy plus CCRT may improve survival in nasopharyngeal carcinoma

Induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) appears promising in its capacity to increase overall survival (OS) among patients with T3-4N0-1 nasopharyngeal carcinoma (NPC) compared with CCRT alone, suggests a recent study in China.

A team of investigators carried out this multicentre retrospective study to examine the value of adding IC to CCRT for T3-4N0-1 NPC from Northwest China. They extracted data from three hospitals between 1 May 2010 and 30 August 2018 and estimated endpoints using the Kaplan‒Meier method.

The log-rank test was used to compare survival curves, and initial propensity matching was conducted with a 1:1 match of IC plus CCRT to CCRT alone. OS was the primary endpoint of the study.

One hundred eight patients with staging T3-4N0-1 were enrolled in this study, with a median follow-up of 50 months (range, 6 to 118 months).

IC followed by CCRT did not result in significant improvements in OS relative to CCRT alone in the whole cohort (89.5 percent vs 77.6 percent; hazard ratio [HR], 0.41, 95 percent confidence interval [CI], 0.16‒1.04; p=0.100), but it significantly improved OS when a well-balanced propensity score-matched cohort was analysed.

The adjusted 4-year OS for IC plus CCRT was 89.5 percent and for CCRT alone 71.1 percent (HR, 0.30, 95 percent CI, 0.11‒0.80; p=0.027). Additionally, no significant between-group differences were observed in terms of adverse effects.

“However, prospective studies with a large sample are warranted to confirm the results,” the investigators said.