Significant survival benefit of adjuvant chemotherapy after concurrent chemoradiotherapy in locally advanced high-risk nasopharyngeal carcinoma

作者：Zhongguo Liang, Xiaoqian Chen, Guoxiang Lin, Binbin Yu, Kai-Hua Chen, Qiulu Zhong, Si-Kai Nong, Ling Li, Song Qu, Fang Su, Wei Zhao, Ye Li, Xiaodong Zhu · 发表于：Scientific Reports · 年份：2017 · DOI：10.1038/srep41449 · 被引用次数：18 · 研究领域：Head and Neck Cancer Studies、Head and Neck Surgical Oncology、Cholangiocarcinoma and Gallbladder Cancer Studies

The present study aimed to define high-risk patients who may benefit from additional adjuvant chemotherapy (AC) after concurrent chemotherapy in combination with intensity-modulated radiotherapy among patients with loco-regionally advanced nasopharyngeal carcinoma (NPC). A cohort of 511 NPC patients who received concomitant chemoradiotherapy (CCRT) with or without AC between January 2007 and December 2012 were retrospectively analysed. One hundred seventy-seven patients received CCRT alone, whereas 334 received CCRT + AC. The survival analysis showed that ages >45 years old, T3-T4 stages, N2-N3 disease and serum albumin levels ≤42 g/L were significant independent prognostic factors for overall survival (OS). Using these four risk factors, a prognostic model for OS was created as follows: (1) low-risk group: 0-1 risk factors; and (2) high-risk group: 2-4 risk factors. In the CCRT alone and CCRT + AC groups, significant differences in survival were found between the high- and low-risk groups. Patients in the high-risk group exhibited improved OS due to the addition of AC to CCRT, but no survival benefits were found in the low-risk group. In conclusion, high-risk patients may benefit from the addition of AC to CCRT regarding OS.