The impact of the cumulative dose of cisplatin during concurrent chemoradiotherapy on the clinical outcomes of patients with advanced-stage nasopharyngeal carcinoma in an era of intensity-modulated radiotherapy

BMC Cancer

Research Article

Mu-Sheng Zeng¹  Jin-Xin Bei¹  Jian-Yong Shao²  Hai-Qiang Mai³  Lu Zhang³  Qiu-Yan Chen³  Ming-Yuan Chen³  Shan-Shan Guo³  Ling Guo³  Dong-Hua Luo³  Chong Zhao³  Lin Wang³  Chao-Nan Qian³  Ka-Jia Cao³  Hao-Yuan Mo³  Rui Sun³  Lin-Quan Tang³  Yan-Qun Xiang³  Xiang Guo³  Xing Lv³  Li-Ting Liu³  Pei-Yu Huang³  Ying Sun⁴  Jun Ma⁴  Ming-Huang Hong⁵ 

[1] Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou, China;Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060, Guangzhou, P. R. China;Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China;Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;Good Clinical Practice Center, Sun Yat-sen University Cancer Center, Guangzhou, China;

关键词: Nasopharyngeal carcinoma;    Cumulative dose of cisplatin;    IMRT;    EBV DNA;    Survival;   

DOI  :  10.1186/s12885-015-1964-8

 received in 2015-05-03, accepted in 2015-11-30,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe impact of cumulative dose of cisplatin on clinical outcomes of nasopharyngeal carcinoma (NPC) patients who received intensity-modulated radiotherapy (IMRT) was evaluated.MethodsThis study included 491 consecutive patients with histologically confirmed NPC who were treated with concurrent chemoradiotherapy with IMRT. The patients were divided into three groups: low- (cumulative dose ≤100 mg/m2), medium- (cumulative dose >100 mg/m2 and ≤200 mg/m2), and high- (cumulative dose >200 mg/m2) dose groups. Subgroups of patients included pre-treatment levels of Epstein–Barr Virus DNA (EBV DNA) <4000 copies/ml and pre-treatment EBV DNA ≥4000 copies/ml. To test for independent significance, the Kaplan–Meier with the log–rank test and the Cox proportional hazards model were used.ResultsThe 5-year overall survival (OS) rates of the low-, medium-, and high-dose groups were 64.1 %, 91.1 %, and 89.4 %, respectively (P = 0.002). Based on multivariate analysis, patients who were in the medium- and high-dose groups had compared with the low-dose group, with an odds ratio of 0.135 (95 % CI 0.045–0.405, P < 0.001) and 0.225 (95 % CI 0.069–0.734, P = 0.013), respectively. For the low-risk patients, the cumulative dose of cisplatin significantly associated with a lower OS (P < 0.001). The medium-dose group had reduced odds of death compared with the low-dose group, with an odds ratio of 0.062 (95 % CI 0.001–0.347, P = 0.002), according to multivariate analysis.ConclusionsThe cumulative dose of cisplatin is associated with OS and distant metastasis-free survival (DMFS) among NPC patients who received IMRT.

【 授权许可】

CC BY   
© Guo et al. 2015