1. Concurrent chemoradiotherapy with or without cetuximab for stage II to IVb nasopharyngeal carcinoma: a case-control study.
- Author
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Yang Li, Qiu-Yan Chen, Lin-Quan Tang, Li-Ting Liu, Shan-Shan Guo, Ling Guo, Hao-Yuan Mo, Ming-Yuan Chen, Xiang Guo, Ka-Jia Cao, Chao-Nan Qian, Mu-Shen Zeng, Jin-Xin Bei, Jian-Yong Shao, Ying Sun, Jing Tan, Shuai Chen, Jun Ma, Chong Zhao, and Hai-Qiang Mai
- Subjects
CHEMORADIOTHERAPY ,CETUXIMAB ,CARCINOMA ,RADIOTHERAPY ,EPSTEIN-Barr virus ,CANCER diagnosis ,CANCER-related mortality ,CANCER treatment ,ANTINEOPLASTIC agents ,DIAGNOSTIC imaging ,LONGITUDINAL method ,TUMOR classification ,NASOPHARYNX tumors ,TREATMENT effectiveness ,CASE-control method ,KAPLAN-Meier estimator ,DIAGNOSIS ,TUMOR treatment - Abstract
Background: This study aimed to evaluate the long-term outcome and toxicities in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated by concurrent chemoradiotherapy (CCRT) with/without adding cetuximab.Methods: A total of 62 patients treated with CCRT plus cetuximab were matched with 124 patients treated with CCRT alone by age, sex, pathological type, T category, N category, disease stage, radiotherapy (RT) technique, Epstein-Barr virus (EBV) DNA levels, and Eastern Cooperative Oncology Group (ECOG). Overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were assessed using the Kaplan-Meier method and log-rank test. Treatment toxicities were clarified and compared between two groups.Results: A total of 186 well-balanced stage II to IV NPC patients were retrospectively analyzed (median follow-up, 76 months). Compared to CCRT alone, adding cetuximab resulted in more grade 3 to 4 radiation mucositis (51.6% vs. 23.4%; P < 0.001). No differences were found between the CCRT + cetuximab group and the CCRT group in 5-year OS (89.7% vs. 90.7%, P = 0.386), 3-year PFS (83.9% vs. 88.7%, P = 0.115), the 3-year LRFS (95.0% vs. 96.7%, P = 0.695), and the 3-year DMFS (88.4% vs 91.9%, P = 0.068). Advanced disease stage was the independent prognostic factor predicting poorer OS and PFS.Conclusion: Adding cetuximab to CCRT did not significantly improve benefits in survival in stage II to IV NPC and exacerbated acute mucositis and acneiform rash. Further investigations are warranted. [ABSTRACT FROM AUTHOR]- Published
- 2017
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