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. 2014 Oct 16;9(10):e110765.
doi: 10.1371/journal.pone.0110765. eCollection 2014.

Comparison of long-term survival and toxicity of cisplatin delivered weekly versus every three weeks concurrently with intensity-modulated radiotherapy in nasopharyngeal carcinoma

Chang-Juan Tao  1 , Li Lin  2 , Guan-Qun Zhou  2 , Ling-Long Tang  2 , Lei Chen  2 , Yan-Ping Mao  2 , Mu-Sheng Zeng  3 , Tie-Bang Kang  3 , Wei-Hua Jia  3 , Jian-Yong Shao  4 , Hai-Qiang Mai  5 , Ai-Hua Lin  6 , Jun Ma  2 , Ying Sun  2
Affiliations

Comparison of long-term survival and toxicity of cisplatin delivered weekly versus every three weeks concurrently with intensity-modulated radiotherapy in nasopharyngeal carcinoma

Chang-Juan Tao et al. PLoS One. .

Abstract

Background: We aimed to compare the long-term survival outcomes and acute toxicity of cisplatin administered weekly versus every three weeks concurrently with intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).

Methods: This was a retrospective review of 154 patients with histologically proven, non-disseminated NPC who were treated using IMRT between January 2003 and December 2007. Seventy-three patients (47.4%) received 5-7 weeks of 30-40 mg/m2 cisplatin weekly; 81 patients (52.6%) received two or three cycles of 80 mg/m2 cisplatin every three weeks. IMRT was delivered at 68 Gy/30 fractions to the nasopharyngeal gross target volume and 60-66 Gy to the involved neck area.

Results: The clinical characteristics and treatment factors of the two groups were well-balanced. The median follow-up was 74 months (range, 6-123 months), and the 5-year overall survival, disease-free survival, locoregional relapse-free survival, and distant metastasis-free survival rates were 85.2% vs. 78.9% (P = 0.318), 71.6% vs. 71.0% (P = 0.847), 93.5% vs. 92.6% (P = 0.904), and 80.9% vs. 80.1% (P = 0.925) for the group treated every three weeks and weekly, respectively. Subgroup analyses indicated no significant differences in the survival rates of the two groups among patients with early- or advanced-stage disease. The incidence of acute toxicities was similar between groups.

Conclusion: IMRT with concurrent cisplatin administered weekly or every three weeks leads to similar long-term survival outcomes and acute toxicity in NPC regardless of whether patients have early- or advanced-stage disease.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Survival curves for patients with NPC.
(A) OS, (B) DFS, (C) LRRFS, and (D) DMFS. Hazard ratios (HRs) were calculated with an unadjusted Cox proportional hazards model; P-values were calculated with the unadjusted log-rank test.
Figure 2
Figure 2. OS and DFS curves for NPC patients stratified by clinical stage.
Group 1: patients with stage II disease; Group 2: patients with stage III–IVB disease. P-values were calculated with the unadjusted log-rank test.
See this image and copyright information in PMC

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