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. 2019 Jan 17;14(1):9.
doi: 10.1186/s13014-019-1213-4.

The prolonged interval between induction chemotherapy and radiotherapy is associated with poor prognosis in patients with nasopharyngeal carcinoma

Liang Peng  1 , Jin-Qi Liu  1 , Cheng Xu  1 , Xiao-Dan Huang  1 , Ling-Long Tang  1 , Yu-Pei Chen  1 , Ying Sun  1 , Jun Ma  2
Affiliations

The prolonged interval between induction chemotherapy and radiotherapy is associated with poor prognosis in patients with nasopharyngeal carcinoma

Liang Peng et al. Radiat Oncol. .

Abstract

Objectives: Induction chemotherapy (IC) now is gaining recognition for the treatment of nasopharyngeal carcinoma (NPC). The current study was conducted to examine the association between prognosis and the interval between IC and radiotherapy (RT) in NPC patients.

Methods: Patients with newly diagnosed, non-metastatic NPC who were treated with IC followed by RT from 2009 to 2012 were identified from an inpatient database. Overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and locoregional recurrence-free survival (LRFS) were compared between those with interval ≤ 30 and > 30 days by Kaplan-Meier and log-rank analyses; Cox modeling was used for multivariable analysis.

Results: A total of 668 patients met inclusion criteria with median follow-up of 64.4 months. Patients were categorized by interval: 608 patients with interval ≤ 30 days, and 60 with interval > 30 days. The 5-year OS, DFS, DMFS and LRFS rates were 86.6, 78.2, 88.0 and 89.8% for patients with interval ≤ 30 days, respectively, and 69.2, 64.5, 71.2 and 85.1% for patients with interval > 30 days, respectively. The prolonged interval was a risk factor for OS, DFS and DMFS with adjusted hazard ratios (95% confidence intervals) were 2.44 (1.48-4.01), 1.99 (1.27-3.11) and 2.62 (1.54-4.47), respectively.

Conclusions: Prolonged interval > 30 days was associated with a significantly higher risk of distant metastasis and death in NPC patients. Efforts should be made to avoid prolonged interval between IC and RT to minimize the risk of treatment failure.

Keywords: Induction chemotherapy; Interval; Nasopharyngeal carcinoma; Prognosis; Radiotherapy.

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Conflict of interest statement

Ethics approval and consent to participate

The clinical research ethics committee of Sun Yat-sen University Cancer Center approved this study. As this was a retrospective analysis of routine data, we were granted a waiver for written consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The OS curves based on the interval categorized into five groups. OS, overall survival
Fig. 2
Fig. 2
The OS (a), DFS (b), DMFS(c), and LRFS (d) curves based on the interval categorized into two groups. OS, overall survival; DFS, disease-free survival; DMFS, distant metastasis-free survival; LRFS, locoregional recurrence-free survival
See this image and copyright information in PMC

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