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CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0044-1787712
Original Article

Induction versus Adjuvant Chemotherapy Combined with Concurrent Chemoradiation: What Is Beneficial in Locally Advanced Nasopharyngeal Carcinoma—A 5-Year Comparative Study at a Tertiary Care Center in North India

Kaneez Fatima 
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Asifa Andleeb
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Shahida Nasreen 
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Mushtaq Ahmad Sofi
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Ulfat Ara Wani
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Malik Tariq Rasool
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Arshad Manzoor Najmi
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Shaqul Qamar
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Nazir Ahmad
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
,
Rubiya Ryhan
1   Department of Radiation Oncology, Medical Oncology, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura UT, Jammu and Kashmir, India
› Author Affiliations Funding The research was funded by Sheri Kashmir Institute of Medical Sciences.
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Abstract

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Kaneez Fatima

Background In locally advanced nasopharyngeal cancer (LANPC), concurrent chemoradiotherapy (CCRT) has been established as the current standard of care, but recently, the addition of induction chemotherapy to CCRT has presented an attractive multidisciplinary approach.

Objectives The aim of the study was to explore the clinical outcome of induction chemotherapy (IC) followed by CCRT and CCRT followed by adjuvant chemotherapy (AC) in LANPC.

Material and Methods In this propensity score–matched retrospective cohort study, we enrolled LANPC patients from October 2016 to June 2022. Study variables were evenly distributed by propensity score matching. Independent prognostic factors were identified using Cox regression analysis, and the outcome between the two chemotherapy treatment combinations was compared for patients in different subgroups.

Result A total of 80 patients were included in the study. Survival outcomes indicated that the IC followed by CCRT group (IC + CCRT) achieved a higher 5-year overall survival (OS; 90 vs. 81%, p = 0.253), failure-free survival (FFS; 80 vs. 77.50%, p = 0.17), and distant metastasis-free survival (DMFS; 88 vs. 82.50%, p = 0.314) compared with the CCRT followed by AC group (CCRT + AC), although it was not statistically significant. The stratified analysis revealed that IC followed by CCRT (IC + CCRT) was associated with significantly improved OS (hazard ratio [HR] = 0.212; 95% confidence interval [CI] = 0.014–3.16; p = 0.0026) in N2 disease. However, the superiority of CCRT followed by AC (CCRT + AC) was only observed in LRRFS (HR = 0.45; 95% CI = 0.05–0.89; p = 0.036) for the T4 subgroup.

Conclusion In patients with LANPC, especially with T3 or N2 disease, IC should be strongly considered followed by CCRT.

Keywords

chemoradiation - induction chemotherapy - locally advanced nasopharyngeal carcinoma - adjuvant chemotherapy


Publication History

Received: 08 September 2023

Accepted: 08 May 2024

Article published online:
10 June 2024

© 2024. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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