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. 2015 Dec 16:15:977.
doi: 10.1186/s12885-015-1964-8.

The impact of the cumulative dose of cisplatin during concurrent chemoradiotherapy on the clinical outcomes of patients with advanced-stage nasopharyngeal carcinoma in an era of intensity-modulated radiotherapy

Shan-Shan Guo  1   2 , Lin-Quan Tang  3   4 , Lu Zhang  5   6 , Qiu-Yan Chen  7   8 , Li-Ting Liu  9   10 , Ling Guo  11   12 , Hao-Yuan Mo  13   14 , Dong-Hua Luo  15   16 , Pei-Yu Huang  17   18 , Yan-Qun Xiang  19   20 , Rui Sun  21   22 , Ming-Yuan Chen  23   24 , Lin Wang  25   26 , Xing Lv  27   28 , Chong Zhao  29   30 , Xiang Guo  31   32 , Ka-Jia Cao  33   34 , Chao-Nan Qian  35   36 , Mu-Sheng Zeng  37 , Jin-Xin Bei  38 , Ming-Huang Hong  39   40 , Jian-Yong Shao  41   42 , Ying Sun  43   44 , Jun Ma  45   46 , Hai-Qiang Mai  47   48
Affiliations

The impact of the cumulative dose of cisplatin during concurrent chemoradiotherapy on the clinical outcomes of patients with advanced-stage nasopharyngeal carcinoma in an era of intensity-modulated radiotherapy

Shan-Shan Guo et al. BMC Cancer. .

Abstract

Background: The impact of cumulative dose of cisplatin on clinical outcomes of nasopharyngeal carcinoma (NPC) patients who received intensity-modulated radiotherapy (IMRT) was evaluated.

Methods: This study included 491 consecutive patients with histologically confirmed NPC who were treated with concurrent chemoradiotherapy with IMRT. The patients were divided into three groups: low- (cumulative dose≤100 mg/m2), medium- (cumulative dose>100 mg/m2 and ≤200 mg/m2), and high- (cumulative dose>200 mg/m2) dose groups. Subgroups of patients included pre-treatment levels of Epstein-Barr Virus DNA (EBV DNA)<4000 copies/ml and pre-treatment EBV DNA≥4000 copies/ml. To test for independent significance, the Kaplan-Meier with the log-rank test and the Cox proportional hazards model were used.

Results: The 5-year overall survival (OS) rates of the low-, medium-, and high-dose groups were 64.1%, 91.1%, and 89.4%, respectively (P=0.002). Based on multivariate analysis, patients who were in the medium- and high-dose groups had compared with the low-dose group, with an odds ratio of 0.135 (95% CI 0.045-0.405, P<0.001) and 0.225 (95% CI 0.069-0.734, P=0.013), respectively. For the low-risk patients, the cumulative dose of cisplatin significantly associated with a lower OS (P<0.001). The medium-dose group had reduced odds of death compared with the low-dose group, with an odds ratio of 0.062 (95% CI 0.001-0.347, P=0.002), according to multivariate analysis.

Conclusions: The cumulative dose of cisplatin is associated with OS and distant metastasis-free survival (DMFS) among NPC patients who received IMRT.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier curves of overall survival according to the cumulative dose of cisplatin in 491 patients with locally advanced nasopharyngeal carcinoma
Fig. 2
Fig. 2
Kaplan–Meier curves of distant metastasis-free survival according to the cumulative dose of cisplatin in 491 patients with locally advanced nasopharyngeal carcinoma
Fig. 3
Fig. 3
Kaplan–Meier curves of overall survival according to the cumulative dose of cisplatin in 300 low-risk patients with locally advanced nasopharyngeal carcinoma
Fig. 4
Fig. 4
Kaplan–Meier curves of distant metastasis-free survival according to the cumulative dose of cisplatin in 300 low-risk patients with locally advanced nasopharyngeal carcinoma
See this image and copyright information in PMC

References

    1. Lee AW, Lin JC, Ng WT. Current management of nasopharyngeal cancer. Semin Radiat Oncol. 2012;22(3):233–244. doi: 10.1016/j.semradonc.2012.03.008. - DOI - PubMed
    1. Tao CJ, Lin L, Zhou GQ, Tang LL, Chen L, Mao YP, et al. Comparison of long-term survival and toxicity of cisplatin delivered weekly versus every three weeks concurrently with intensity-modulated radiotherapy in nasopharyngeal carcinoma. PLoS One. 2014;9(10):e110765. doi: 10.1371/journal.pone.0110765. - DOI - PMC - PubMed
    1. Chan AT, Leung SF, Ngan RK, Teo PM, Lau WH, Kwan WH, et al. Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 2005;97(7):536–539. doi: 10.1093/jnci/dji084. - DOI - PubMed
    1. Chan AT, Teo PM, Ngan RK, Leung TW, Lau WH, Zee B, et al. Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial. J Clin Oncol. 2002;20(8):2038–2044. doi: 10.1200/JCO.2002.08.149. - DOI - PubMed
    1. Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys. 2006;64(1):47–56. doi: 10.1016/j.ijrobp.2005.06.037. - DOI - PubMed

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