Optimal Total Nedaplatin Dose of Concurrent Chemotherapy in Patients with Stage III-IVA Nasopharyngeal Carcinoma

Xiaoli WANG; Ting DING; Meiping JIANG; Kuixuan ZHU; Hongwei YANG

doi:10.12259/j.issn.2095-610X.S20221213

Volume 43 Issue 12

Dec. 2022

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Article Navigation > Journal of Kunming Medical University > 2022 > 43(12): 66-74

Xiaoli WANG, Ting DING, Meiping JIANG, Kuixuan ZHU, Hongwei YANG. Optimal Total Nedaplatin Dose of Concurrent Chemotherapy in Patients with Stage III-IVA Nasopharyngeal Carcinoma[J]. Journal of Kunming Medical University, 2022, 43(12): 66-74. doi: 10.12259/j.issn.2095-610X.S20221213

Citation:

Xiaoli WANG, Ting DING, Meiping JIANG, Kuixuan ZHU, Hongwei YANG. Optimal Total Nedaplatin Dose of Concurrent Chemotherapy in Patients with Stage III-IVA Nasopharyngeal Carcinoma[J]. Journal of Kunming Medical University, 2022, 43(12): 66-74. doi: 10.12259/j.issn.2095-610X.S20221213

Citation:

Xiaoli WANG, Ting DING, Meiping JIANG, Kuixuan ZHU, Hongwei YANG. Optimal Total Nedaplatin Dose of Concurrent Chemotherapy in Patients with Stage III-IVA Nasopharyngeal Carcinoma[J]. Journal of Kunming Medical University, 2022, 43(12): 66-74. doi: 10.12259/j.issn.2095-610X.S20221213

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Optimal Total Nedaplatin Dose of Concurrent Chemotherapy in Patients with Stage III-IVA Nasopharyngeal Carcinoma

doi: 10.12259/j.issn.2095-610X.S20221213

Dept. of Radiotheray，Yunnan Cancer Hospital，Kunming Yunnan 650118，China

Received Date: 2022-10-09
Available Online: 2022-12-05
Publish Date: 2022-12-25

Abstract

Abstract

Objective To explore the most appropriate total cumulative nedaplatin dose during chemotherapy for patients at the III-IVA stage after induced chemotherapy, and to analyze the effect of the total amount of nedaplatin on the prognosis of nasopharyngeal carcinoma patients after induction chemotherapy. Methods In this study, a total of 109 patients who were first diagnosed at Yunnan Cancer Hospital from 2013 to 2018 received induction chemotherapy （IC） plus concurrent chemoradiotherapy （CCRT）. According to the CND quartile, the patients were divided into three groups: low （≤120 mg/m²）, medium （121-200 mg/m²） and high dose （ > 200 mg/m²）. According to the response after tumor induction chemotherapy, the Nedaplatin group was divided into CR/PR and SD/PD subgroups, respectively. The effects of different cumulative dose of nedaplatin on the prognosis of patients after induction chemotherapy were analyzed to obtain the optimal CND. Results The difference in survival rates between the low, medium and high dose groups of CND were not statistically significant （P > 0.05）. According to the survival analysis of CR/PR and SD/PD groups, the cumulative OS rates were 77.2% and 50.0%, the 3-year OS rates were 98.2% and 62.9%, the cumulative PFS rates were 63.2% and 45.0%, and the 3 a PFS rates were 77.2% and 54.8%, respectively. The survival rate of CR/PR group was better than that of SD/PD group （P < 0.05）. According to the low, medium and high dose of CND, the two subgroups were analyzed respectively. The cumulative OS rate of CR/PR subgroup was 93.3%, 93.8% and 60.0% （P = 0.046）, and the 3 year OS rates were 100.0%, 93.8% and 100.0% （P > 0.05）. The cumulative PFS rates were 86.7%, 78.1% and 30.0% （P = 0.007）, and the 3 year PFS rates were 93.3%, 90.6% and 60.0% （P = 0.017）. The low-dose and medium-dose groups showed significant advantages in OS rate, PFS rate and 3year PFS rate. There was no significant difference in survival rate among SD/PD subgroups （P > 0.05）. In multivariate analysis, efficacy evaluation after IC （CR/PR&SD/PD） was an independent prognostic factor for OS, 3 year OS, PFS, and 3 year PFS in patients with stage III-IVA nasopharyngeal carcinoma （P < 0.05）. Conclusion The survival benefit of CR/PR patients with stage III-IVA nasopharyngeal carcinoma after IC is much better than that of SD/PD patients. Tumor response after IC （CR/PR&SD/PD） is an independent prognostic factor for stage III-IVA nasopharyngeal carcinoma patients. In the post-IC CR/PR subgroup of patients with stage III-IVA nasopharyngeal carcinoma, the survival rate of patients receiving low and medium CND improved significantly in the higher dose group. It seems that CND does not need to exceed 200 mg/m² to achieve better survival results for these patients.
- Nasopharyngeal carcinoma,
- Induction chemotherapy,
- Simultaneous chemotherapy,
- Intensity Modulated Radiotherapy.

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References(19)

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