Concurrent chemoradiotherapy with weekly docetaxel versus cisplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma: A propensity score-matched analysis

Jun Fang Liao, Qun Zhang, Xiao Jing Du, Mei Lan, Shan Liu, Yun Fei Xia, Xiu Yu Cai, Wei Luo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy (CCRT) were reported in head and neck cancer. In addition, the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma (NPC) was verified. However, CCRT with docetaxel for locoregionally advanced NPC are not well studied. This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC. Methods: Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel (15 mg/m2) or tri-weekly cisplatin (80-100 mg/m2) were reviewed. Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics. Adverse events and survival were compared between the two groups. Results: A total of 962 patients were included as the whole cohort, and 448 patients were matched and were regarded as the matched cohort. The median follow-up duration was 48 months for the whole cohort. The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole (hazard ratio [HR] = 0.37, 95% confidence interval [CI] 0.19-0.72, P = 0.030) and matched cohorts (HR = 0.33, 95% CI 0.14-0.79, P = 0.023). However, no significant differences were observed in overall survival, local recurrence-free survival, and distant metastasis-free survival between the two groups in both cohorts. Significantly higher rates of grade 3 radiodermatitis (6.7% vs. 1.8%, P = 0.001), mucositis (74.5% vs. 37.9%, P < 0.001), and leucopenia (2.2% vs. 11.6%, P < 0.001) were observed in the docetaxel group, but any grade of renal injury (1.8% vs. 15.1%, P < 0.001), vomiting (18.8% vs. 88.3%, P < 0.001), and ALT elevation (19.2% vs. 31.3%, P = 0.027) were more common in the cisplatin group. Conclusions: CCRT with weekly low-dose docetaxel is an effective and tolerable therapeutic regimen for locally advanced NPC. It provides a survival benefit mainly by improving the control of regional lymph node metastases, especially for patients with low pretreatment EBV DNA levels.

Original languageEnglish (US)
Article number40
JournalCancer Communications
Volume39
Issue number1
DOIs
StatePublished - Jun 27 2019

Fingerprint

docetaxel
Propensity Score
Chemoradiotherapy
Cisplatin
Survival
Therapeutics
Radiodermatitis
Confidence Intervals
Neoplasm Metastasis
Recurrence
Mucositis
Leukopenia
Head and Neck Neoplasms
Nasopharyngeal carcinoma
Human Herpesvirus 4
Fluorouracil
Vomiting
Survival Rate
Lymph Nodes

Keywords

  • Cisplatin
  • Concurrent chemoradiotherapy
  • Distant metastasis-free survival
  • Docetaxel
  • Intensity-modulated radiotherapy
  • Locoregional recurrence-free survival
  • Nasopharyngeal carcinoma
  • Nodal recurrence-free survival
  • Overall survival
  • Propensity score matching

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Concurrent chemoradiotherapy with weekly docetaxel versus cisplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma : A propensity score-matched analysis. / Liao, Jun Fang; Zhang, Qun; Du, Xiao Jing; Lan, Mei; Liu, Shan; Xia, Yun Fei; Cai, Xiu Yu; Luo, Wei.

In: Cancer Communications, Vol. 39, No. 1, 40, 27.06.2019.

Research output: Contribution to journalArticle

@article{af66783f9f2d4b6ab5962a52623f2ea3,
title = "Concurrent chemoradiotherapy with weekly docetaxel versus cisplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma: A propensity score-matched analysis",
abstract = "Background: Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy (CCRT) were reported in head and neck cancer. In addition, the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma (NPC) was verified. However, CCRT with docetaxel for locoregionally advanced NPC are not well studied. This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC. Methods: Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel (15 mg/m2) or tri-weekly cisplatin (80-100 mg/m2) were reviewed. Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics. Adverse events and survival were compared between the two groups. Results: A total of 962 patients were included as the whole cohort, and 448 patients were matched and were regarded as the matched cohort. The median follow-up duration was 48 months for the whole cohort. The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole (hazard ratio [HR] = 0.37, 95{\%} confidence interval [CI] 0.19-0.72, P = 0.030) and matched cohorts (HR = 0.33, 95{\%} CI 0.14-0.79, P = 0.023). However, no significant differences were observed in overall survival, local recurrence-free survival, and distant metastasis-free survival between the two groups in both cohorts. Significantly higher rates of grade 3 radiodermatitis (6.7{\%} vs. 1.8{\%}, P = 0.001), mucositis (74.5{\%} vs. 37.9{\%}, P < 0.001), and leucopenia (2.2{\%} vs. 11.6{\%}, P < 0.001) were observed in the docetaxel group, but any grade of renal injury (1.8{\%} vs. 15.1{\%}, P < 0.001), vomiting (18.8{\%} vs. 88.3{\%}, P < 0.001), and ALT elevation (19.2{\%} vs. 31.3{\%}, P = 0.027) were more common in the cisplatin group. Conclusions: CCRT with weekly low-dose docetaxel is an effective and tolerable therapeutic regimen for locally advanced NPC. It provides a survival benefit mainly by improving the control of regional lymph node metastases, especially for patients with low pretreatment EBV DNA levels.",
keywords = "Cisplatin, Concurrent chemoradiotherapy, Distant metastasis-free survival, Docetaxel, Intensity-modulated radiotherapy, Locoregional recurrence-free survival, Nasopharyngeal carcinoma, Nodal recurrence-free survival, Overall survival, Propensity score matching",
author = "Liao, {Jun Fang} and Qun Zhang and Du, {Xiao Jing} and Mei Lan and Shan Liu and Xia, {Yun Fei} and Cai, {Xiu Yu} and Wei Luo",
year = "2019",
month = "6",
day = "27",
doi = "10.1186/s40880-019-0380-x",
language = "English (US)",
volume = "39",
journal = "Cancer Communications",
issn = "1000-467X",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Concurrent chemoradiotherapy with weekly docetaxel versus cisplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma

T2 - A propensity score-matched analysis

AU - Liao, Jun Fang

AU - Zhang, Qun

AU - Du, Xiao Jing

AU - Lan, Mei

AU - Liu, Shan

AU - Xia, Yun Fei

AU - Cai, Xiu Yu

AU - Luo, Wei

PY - 2019/6/27

Y1 - 2019/6/27

N2 - Background: Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy (CCRT) were reported in head and neck cancer. In addition, the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma (NPC) was verified. However, CCRT with docetaxel for locoregionally advanced NPC are not well studied. This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC. Methods: Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel (15 mg/m2) or tri-weekly cisplatin (80-100 mg/m2) were reviewed. Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics. Adverse events and survival were compared between the two groups. Results: A total of 962 patients were included as the whole cohort, and 448 patients were matched and were regarded as the matched cohort. The median follow-up duration was 48 months for the whole cohort. The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole (hazard ratio [HR] = 0.37, 95% confidence interval [CI] 0.19-0.72, P = 0.030) and matched cohorts (HR = 0.33, 95% CI 0.14-0.79, P = 0.023). However, no significant differences were observed in overall survival, local recurrence-free survival, and distant metastasis-free survival between the two groups in both cohorts. Significantly higher rates of grade 3 radiodermatitis (6.7% vs. 1.8%, P = 0.001), mucositis (74.5% vs. 37.9%, P < 0.001), and leucopenia (2.2% vs. 11.6%, P < 0.001) were observed in the docetaxel group, but any grade of renal injury (1.8% vs. 15.1%, P < 0.001), vomiting (18.8% vs. 88.3%, P < 0.001), and ALT elevation (19.2% vs. 31.3%, P = 0.027) were more common in the cisplatin group. Conclusions: CCRT with weekly low-dose docetaxel is an effective and tolerable therapeutic regimen for locally advanced NPC. It provides a survival benefit mainly by improving the control of regional lymph node metastases, especially for patients with low pretreatment EBV DNA levels.

AB - Background: Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy (CCRT) were reported in head and neck cancer. In addition, the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma (NPC) was verified. However, CCRT with docetaxel for locoregionally advanced NPC are not well studied. This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC. Methods: Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel (15 mg/m2) or tri-weekly cisplatin (80-100 mg/m2) were reviewed. Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics. Adverse events and survival were compared between the two groups. Results: A total of 962 patients were included as the whole cohort, and 448 patients were matched and were regarded as the matched cohort. The median follow-up duration was 48 months for the whole cohort. The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole (hazard ratio [HR] = 0.37, 95% confidence interval [CI] 0.19-0.72, P = 0.030) and matched cohorts (HR = 0.33, 95% CI 0.14-0.79, P = 0.023). However, no significant differences were observed in overall survival, local recurrence-free survival, and distant metastasis-free survival between the two groups in both cohorts. Significantly higher rates of grade 3 radiodermatitis (6.7% vs. 1.8%, P = 0.001), mucositis (74.5% vs. 37.9%, P < 0.001), and leucopenia (2.2% vs. 11.6%, P < 0.001) were observed in the docetaxel group, but any grade of renal injury (1.8% vs. 15.1%, P < 0.001), vomiting (18.8% vs. 88.3%, P < 0.001), and ALT elevation (19.2% vs. 31.3%, P = 0.027) were more common in the cisplatin group. Conclusions: CCRT with weekly low-dose docetaxel is an effective and tolerable therapeutic regimen for locally advanced NPC. It provides a survival benefit mainly by improving the control of regional lymph node metastases, especially for patients with low pretreatment EBV DNA levels.

KW - Cisplatin

KW - Concurrent chemoradiotherapy

KW - Distant metastasis-free survival

KW - Docetaxel

KW - Intensity-modulated radiotherapy

KW - Locoregional recurrence-free survival

KW - Nasopharyngeal carcinoma

KW - Nodal recurrence-free survival

KW - Overall survival

KW - Propensity score matching

UR - http://www.scopus.com/inward/record.url?scp=85068434815&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068434815&partnerID=8YFLogxK

U2 - 10.1186/s40880-019-0380-x

DO - 10.1186/s40880-019-0380-x

M3 - Article

C2 - 31248459

AN - SCOPUS:85068434815

VL - 39

JO - Cancer Communications

JF - Cancer Communications

SN - 1000-467X

IS - 1

M1 - 40

ER -