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. 2025 Jun 12;14(12):4189.
doi: 10.3390/jcm14124189.

Induction or Adjuvant Chemotherapy in Patients with Locally Advanced Nasopharyngeal Cancer Receiving Chemoradiotherapy? A Turkish Oncology Group Study

Serhat Sekmek  1 , Aysel Oguz  2 , Melek Karakurt Eryilmaz  2 , Murat Araz  2 , Sedat Biter  3 , Mehmet Mutlu Kıdı  3 , Ertugrul Bayram  3 , Efe Cem Erdat  4 , Arzu Yasar  4 , Rumeysa Colak  5 , Mesut Yilmaz  5 , Gizem Bakir Kahveci  6 , Didem Divriklioglu  6 , Elvin Chalabiyev  7 , Sercan Aksoy  7 , Sema Nur Ozsan Celebi  1 , Hakan Kosku  1 , Mesut Yılmaz  8 , Ilhan Hacibekiroglu  8 , Haydar Temizyurek  9 , Kubra Canaslan  10 , Gorkem Turhan  11 , Ahmet Kadıoglu  12 , Seda Jeral  13 , Mehmetcan Atak  14 , Huseyin Atacan  15 , Anil Ozbay  16 , Tugay Atasever  17 , Mustafa Seyyar  18 , Pervin Can Sanci  19 , Bahadir Koylu  20 , Nargiz Majidova  21 , Erkan Arpaci  22 , Muhammed Bulent Akinci  1 , Dogan Uncu  1 , Gokhan Ucar  1
Affiliations

Induction or Adjuvant Chemotherapy in Patients with Locally Advanced Nasopharyngeal Cancer Receiving Chemoradiotherapy? A Turkish Oncology Group Study

Serhat Sekmek et al. J Clin Med. .

Abstract

Background/Objectives: In this retrospective study, we aimed to compare the efficacy, survival, and toxicity results of induction (IC) or adjuvant (AC) treatment with chemoradiotherapy (CRT) in locally advanced nasopharyngeal cancer (NPC). Methods: A total of 405 patients from 22 different centres in Turkey, belonging to the Turkish Oncology Group (TOG), was included. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoints were safety and toxicity. Results: The median age of the patients included in the study was 49 (18.2-91.5) years. In total, 298 (73.6%) of the patients were male. Of the 405 patients, 258 (63.7%) received IC and 147 (36.3%) received AC treatment. When OS and PFS analyses were performed in terms of age, gender, T and N stages, pathological features, and treatments received, no effect of any variable on prognosis was observed. For the overall group, the median estimated OS was 137.3 months (the Kaplan-Meier statistical method could not reach the 95% confidence interval [CI]). For the IC group, the median estimated survival was 137.3 months (95% CI: 111.4-163.3), whereas the Kaplan-Meier statistical method could not estimate survival for the AC group. No statistically significant difference was observed between IC and AC groups in terms of OS (p = 0.209) or PFS (p = 0.248). Grade 3-4 side effects were observed in 12% of patients in the IC group and 29.9% of patients in the AC group. Treatment was discontinued due to toxicity in 5 patients (1.9%) in the IC group and 18 patients (12.2%) in the AC group. Conclusion: No difference in OS or PFS was observed between AC and IC treatments. More grade 3-4 side effects were observed in the AC-treated group and early discontinuation rate was higher.

Keywords: adjuvant; chemotherapy; induction; nasopharyngeal cancer.

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Conflict of interest statement

None of the authors has any significant direct or indirect commercial or financial incentives associated with the publication of the article.

Figures

Figure 1
Figure 1
Overall survival rates of induction and adjuvant groups.
Figure 2
Figure 2
Progression-free survival rates of induction and adjuvant groups.
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