Comparative studies on triweekly and weekly cisplatin in locally advanced nasopharyngeal carcinoma (NPC) were all based on small sample size, and no definitive conclusion has been reached. The aim of this study was to compare the outcomes of concurrent chemoradiotherapy (CCRT) using two different schedules of cisplatin in patients with locally advanced NPC.
From January 2007 to December 2011, 1582 patients with stage II-IVb NPC, treated with CCRT alone were reviewed. Eight hundred and two patients received triweekly cisplatin (80-100 mg/m2 every three weeks, two to three cycles) and 780 patients received weekly cisplatin (30-40 mg/m2 every week, over five cycles). Clinical characteristics and treatment factors were well balanced in two groups. Overall survival (OS), disease–free survival (DFS), locoregional recurrence–free survival (LRRFS), distant metastasis-free survival (DMFS) and acute toxicity profiles were calculated.
Median follow-up time was 64 months (range, 4–194 months). For the entire cohort, the distant metastasis risk was decreased by 30% in the triweekly group than weekly group (hazard ratio [HR] = 0.70; 95% confidence interval [CI]: 0.49-0.99). Subgroup analysis revealed that triweekly cisplatin could further improve patients' 5-year DMFS (92.6% vs. 85.8%, P
Triweekly cisplatin treatment is more effective than weekly cisplatin regimen in reducing distant metastases in patients with locally advanced NPC, especially for those with N3 or stage IV diseases and who were treated with IMRT.
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This research was supported by Grants from the Natural Science Foundation of China (81402244).
All authors have declared no conflicts of interest.