Additional induction chemotherapy to concurrent chemotherapy and intensity-modulated radiotherapy with or without nimotuzumab in first-line treatment for locoregionally advanced nasopharyngeal carcinoma: a propensity score matched analysis

Fangzheng Wang^1,2,3,*, Quanquan Sun^1,2, Chuner Jiang^4,*, Tongxin Liu^1,2, Aizawa Rihito⁵, Sakamoto Masoto³, Yuezhen Wang^1,2, Zhenfu Fu^1,2, Ming Chen^{1,2 ✉}

1. Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang Hangzhou, 310022, People's Republic of China.
2. Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Hangzhou, 310022, People's Republic of China.
3. Department of Radiology, Japanese Red Cross Fukui Hospital, Fukui, 918-8501 Japan.
4. Department of Breast Tumor Surgery, Zhejiang Cancer Hospital, Zhejiang Hangzhou, 310022, People's Republic of China.
5. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University. Kyoto, 606-8507 Japan.
^* These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.

Citation:
Wang F, Sun Q, Jiang C, Liu T, Rihito A, Masoto S, Wang Y, Fu Z, Chen M. Additional induction chemotherapy to concurrent chemotherapy and intensity-modulated radiotherapy with or without nimotuzumab in first-line treatment for locoregionally advanced nasopharyngeal carcinoma: a propensity score matched analysis. J Cancer 2018; 9(3):594-603. doi:10.7150/jca.20461. Available from https://www.jcancer.org/v09p0594.htm

Abstract

Background: The aim of this study is to assess the survival benefits of additional induction chemotherapy before concurrent chemotherapy, intensity-modulated radiotherapy and nimotuzumab in patients with locoregionally advanced nasopharyngeal carcinoma.

Methods: Clinical data from 1104 nonmetastatic nasopharyngeal carcinoma patients diagnosed between May 2008 and April 2014 were retrospectively reviewed. All patients received addition of induction chemotherapy to concurrent chemoradiotherapy with or without nimotuzumab. A propensity score matched method was used to identify paired patients according to various covariates.

Results: In total, 120 pairs were selected by propensity score matched method. At a median follow-up time of 56 months (10-99 months), the 5-year locoregional relapse-free survival, distant metastases-free survival, progression-free survival and overall survival rates in patients treated with nimotuzumab vs. without nimotuzumab were 91.6% vs. 91.1% (P= 0.957), 95.8% vs. 83.9% (P= 0.007), 87.4% vs. 81.3% (P= 0.225), 94.5% vs. 85.6% (P= 0.058), respectively. Multivariate analysis revealed that nimotuzumab was an independent prognosticator of OS and DMFS.

Conclusions: Nimotuzumab is an effective treatment option for locoregionally advanced nasopharyngeal carcinoma, and the addition of induction chemotherapy to concurrent chemoradiotherapy and nimotuzumab could obtain the best survival benefits.

Keywords: nasopharyngeal carcinoma, nimotuzumab, induction chemotherapy, concurrent chemotherapy, intensity-modulated radiotherapy, prognosis.