Effect of the number of cycles of induction chemotherapy on survival outcomes in patients with locally advanced nasopharyngeal carcinoma
Objective:To evaluate the efficacy of different cycles of induction chemotherapy(IC)in patients with locoregionally advanced nasopharyngeal carcinoma(LA-NPC).Methods:We retrospectively an-alyzed LA-NPC patients treated with IC combined with concurrent chemoradiotherapy(CCRT)in Re-min Hospital of Wuhan University from January 2016 to August 2021.They were divided into the IC<3 group and IC≥3 group according to IC cycles.T-tests and χ2-tests were used to analyze the dif-ferences between groups,Kaplan-Meier and log-rank tests were adopted to compare the survival out-comes,univariate and multivariate Cox regression models were adopted to identify potential indepen-dent predictors,and subgroup analyses were used to investigate whether complementary adjuvant che-motherapy(AC)could improve the efficacy of IC combined with CCRT for LA-NPC.Results:A to-tal of 138 patients with LA-NPC were included(92 in the IC<3 group and 46 in the IC≥3 group).The median follow-up time was 31.2 months,and the 1-and 3-year distant metastasis-free survival(DMFS)rates were significantly higher in the IC<3 group than in the IC≥3 group(86.9%vs 74.6%and 86.9%vs 64.5%,respectively,P<0.01).Subgroup analysis showed that sequential AC after IC combined with CCRT further improved patients'DMFS in the IC<3 group(1 year:94.4%vs 75.0%;3 years:91.6%vs 70.0%,P<0.01).Multifactorial analysis showed that the IC cycle was an independent factor for DMFS.Conclusion:IC cycle is an independent prognostic factor for LA-NPC,and receiving<3 cycles IC reduces the incidence of distant metastases as compared with≥3 cycles IC;sequential AC further improves patients'DMFS when they receive<3 cycles IC com-bined with CCRT.
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