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Article Abstract
Background: The optimal timing of combined chemotherapy with radiotherapy for locally advanced nasopharyngeal carcinoma (LA-NPC) is undetermined.
Objective: This study aimed to compare the therapeutic efficacy of neoadjuvant chemotherapy (NACT) followed by radiotherapy (RT) and concurrent chemoradiotherapy (CCRT).
Methods: Five hundred and thirty-eight patients diagnosed with LA-NPC and treated with NACT + RT or CCRT alone were enrolled in the study. Restricted cubic spline regression (RCS) was used to determine the relationship between age and the hazard Ratio of death. A Kaplan-Meier analysis was performed to evaluate overall survival (OS) related to NACT + RT or CCRT alone. Cox proportional hazards models were used to adjust for potential confounding factors.
Results: Compared with the CCRT alone regimen, the NACT + RT regimen showed a significantly better OS rate with a 62% decreased risk of death in a subgroup of patients aged ⩾ 45 years (hazard ratio, HR: 0.38; 95% confidence interval, CI: 0.24-0.61). In patients aged < 45 years, the risk of death was significantly increased when NACT + RT was chosen compared with CCRT (HR: 4.10; 95% CI: 2.09-8.07).
Conclusions: Age is a significant biomarker when selecting NACT + RT or CCRT alone in patients with locally advanced NPC.
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| http://dx.doi.org/10.3233/CBM-210357 | DOI Listing |
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- Nasopharyngeal carcinoma (NPC) affects patients with bulky tumors and extensive lymph node involvement, often leading to poor prognosis, and this study focuses on evaluating the effectiveness and side effects of neoadjuvant chemotherapy followed by chemoradiotherapy for treating advanced cases of NPC.
- In this prospective study, patients aged 16-65 with stage III-IVA NPC were treated with either a combination of docetaxel, cisplatin, and fluorouracil or gemcitabine and cisplatin, with their treatment responses and haematological toxicity monitored post-therapy.
- Results showed that the group receiving gemcitabine and cisplatin had a higher complete response rate (71.9%) and lower partial