Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov;144(11):2231-2243.
doi: 10.1007/s00432-018-2721-6. Epub 2018 Aug 14.

Platinum-based concurrent chemotherapy remains the optimal regimen for nasopharyngeal carcinoma: a large institutional-based cohort study from an endemic area

Yahui Yu  1   2   3 , Hu Liang  1   2 , Xing Lv  1   2 , Liangru Ke  1   2 , Wenze Qiu  1   2 , Xinjun Huang  1   2 , Guoying Liu  1   2 , Wangzhong Li  1   2 , Xiang Guo  4   5 , Yanqun Xiang  6   7 , Weixiong Xia  8   9
Affiliations

Platinum-based concurrent chemotherapy remains the optimal regimen for nasopharyngeal carcinoma: a large institutional-based cohort study from an endemic area

Yahui Yu et al. J Cancer Res Clin Oncol. 2018 Nov.

Abstract

Purpose: To retrospectively investigate the optimal regimen of concurrent chemotherapy for nasopharyngeal carcinoma (NPC) by comparing clinical outcomes of patients who received platinum-based and non-platinum-based concurrent chemoradiotherapy (CCRT) regimens.

Methods: Based on a prospectively maintained database from 1998 to 2013 in an endemic area, a total of 4608 newly diagnosed, biopsy-proven, and non-disseminated NPC patients were identified and allocated into three cohorts based on concurrent chemotherapy regimens: cisplatin-based (CP) chemotherapy cohort, other platinum-based (OP) chemotherapy cohort, and non-platinum-based (NP) chemotherapy cohort. Overall survival (OS) and disease-free survival (DFS) were estimated using the Cox proportional hazards model and propensity score analysis of treatment using an inverse probability weighting model (PSA/IPTW). Finally, sensitivity analysis estimated the effects of potential unmeasured confounders.

Results: The median follow-up time was 68.5 months (range 2-194 months). The multivariate Cox model showed that NP regimens were significantly related with worse survival compared with CP or OP regimens (OS: HR 1.51, 95% CI 1.16-2.00, P = 0.002; HR 1.68, 95% CI 1.24-2.27, P = 0.001; DFS: HR 1.31, 95% CI 1.03-1.66, P = 0.031; HR 1.50, 95% CI 1.14-1.97, P = 0.004, respectively). Meanwhile, no significant survival difference was found between OP and CP regimens. The PSA/IPTW method, CCRT-specific and III-IVB NPC cohort subgroup analysis showed similar results. Sensitivity analysis confirmed the robustness of our results.

Conclusions: Platinum-based concurrent chemotherapy, including both CP and OP regimens, yields better survival benefits for non-metastatic NPC patients than the NP regimen and remains the optimal regimen for these patients.

Keywords: Cisplatin-based regimen; Concurrent chemoradiotherapy; Nasopharyngeal carcinoma; Propensity score analysis; Sensitivity analysis; Survival analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram. CP group cisplatin-based chemotherapy group, OP group other platinum-based chemotherapy group, NP group non-platinum chemotherapy group
Fig. 2
Fig. 2
Kaplan–Meier survival curves for the three groups in the entire cohort. a Overall survival, b disease-free survival. CP group cisplatin-based chemotherapy group, OP group other platinum-based chemotherapy group, NP group, non-platinum chemotherapy group, CI confidence interval, HR hazard ratio
Fig. 3
Fig. 3
Forest plots for overall survival and disease-free survival with hazard ratios and P value by multivariate Cox proportional hazard model and IPTW/PSA in the entire cohort and in the CCRT-specific cohort. CP group cisplatin-based chemotherapy group, OP group other platinum-based chemotherapy group, NP group non-platinum chemotherapy group, CI confidence interval, HR hazard ratio, IPTW/PSA propensity score analysis of treatment using inverse probability weighting model
Fig. 4
Fig. 4
Kaplan–Meier survival curves for the three groups in the CCRT-specific cohort. a Overall survival, b disease-free survival. CP group cisplatin-based chemotherapy group, OP group other platinum-based chemotherapy group, NP group non-platinum chemotherapy group, CI confidence interval, HR hazard ratio
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Adelstein D et al (2017) NCCN guidelines insights: head and neck cancers, version 2.2017. J Natl Compr Cancer Netw 15:761–770. 10.6004/jnccn.2017.0101 - PubMed
    1. Adham M et al (2012) Nasopharyngeal carcinoma in Indonesia: epidemiology, incidence, signs, and symptoms at presentation. Chin J Cancer 31:185–196. 10.5732/cjc.011.10328 - PMC - PubMed
    1. Al-Sarraf M et al (1998) Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized intergroup study 0099. J Clin Oncol 16:1310–1317 - PubMed
    1. Austin PC (2013) The performance of different propensity score methods for estimating marginal hazard ratios. Stat Med 32:2837–2849. 10.1002/sim.5705 - PMC - PubMed
    1. Blanchard P et al (2015) Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol 16:645–655. 10.1016/S1470-2045(15)70126-9 - PubMed

LinkOut - more resources