Abstract 2049
Background
In current clinical trials and practice, patients with R and M1 NPC are considered the same entity and typically received similar systemic treatments. However, natural history, treatment outcomes and tolerability of systemic chemotherapy between both groups remains unknown.
Methods
R and M1 NPC patients were identified. Patient characteristics, treatment modalities, tolerability, and survival outcome were retrospectively abstracted. Tolerability of chemotherapy was defined by dose reduction, hospitalization, delayed, and/or termination of chemotherapy.
Results
A total of 144 NPC patients (R = 98, M1=46) were analyzed. In R patients, locoregional recurrence and distant metastasis were observed in 30% and 66%, respectively. In R group, median time to recurrence was 16.6 months. Median OS of M1 patients was not difference from R group (12.3 vs 11.8 months; p = 0.09). However, patients with M1 had shorter OS when compared with locoregional group (12.3 vs 26.7 months; p = 0.01). Patients who received doublet had longer OS than single agent chemotherapy in both groups. There was no different in OS between 1st line cisplatin- and carboplatin-based chemotherapy in R group (34.2 vs 19.3 months; p = 0.15), but significant difference in M1 patients (14.7 vs 12.3 months; p = 0.05). Tolerability to systemic chemotherapy were comparable among R and M1 NPC patients.Table: 1114P
| Characteristic | Metastasis at diagnosis N = 46 (%) | Recurrence N = 98(%) | P-value |
|---|---|---|---|
| Baseline Patient Characteristics | |||
| -Median age (range) | 56(29-75) | 50(19-79) | 0.17 |
| -male | 34 (73.9) | 75 (76.5) | 0.73 |
| -smoker | 21(45.7) | 42(42.9) | 0.84 |
| ECOG 0-1 >2 | 41 (89.1) 3 (6.5) | 95 (96.9) 2 (2.0) | 0.18 |
| chemotherapy | |||
| 1st line | 33 (71.7) | 66(67.3) | 0.60 |
| 2nd line | 15 (32.6) | 28 (28.6) | 0.62 |
| > =3rd line | 7 (15.2) | 11 (11.2) | 0.50 |
| doublet single | 32(69.6) 0 | 53(54.1) 11 (11.2) | 0.01 |
| cisplatin carboplatin | 22(47.8) 10(21.7) | 12(12.2) 41(41.8) | <0.01 |
Conclusions
There was no different in tolerability and survival of R and M1 NPC patients. Physicians should expect similar outcomes of R and M1 NPC patients who received systemic chemotherapy.
Clinical trial identification
Legal entity responsible for the study
Ramathibodi Hospital.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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