Concurrent chemoradiotherapy with or without cetuximab for stage II to IVb nasopharyngeal carcinoma: a case–control study

BMC Cancer

Research Article

Mu-Shen Zeng¹  Jin-Xin Bei¹  Shuai Chen¹  Jing Tan¹  Jian-Yong Shao²  Ka-Jia Cao³  Hai-Qiang Mai³  Qiu-Yan Chen³  Hao-Yuan Mo³  Yang Li³  Lin-Quan Tang³  Chao-Nan Qian³  Ming-Yuan Chen³  Xiang Guo³  Shan-Shan Guo³  Ling Guo³  Chong Zhao³  Li-Ting Liu³  Ying Sun⁴  Jun Ma⁴ 

[1] State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China;State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China;Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China;State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China;Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, 510060, Guangzhou, People’s Republic of China;State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine,Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China;Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, People’s Republic of China;

关键词: Cetuximab;    Intensity-modulated radiotherapy;    Nasopharyngeal carcinoma;    Cisplatin;    Concurrent chemotherapy;    Clinical outcome;   

DOI  :  10.1186/s12885-017-3552-6

 received in 2017-02-13, accepted in 2017-08-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis 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.MethodsA 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.ResultsA 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.ConclusionAdding 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.

【 授权许可】

CC BY   
© The Author(s). 2017