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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4944 - Survival benefit of adjuvant chemotherapy VS active surveillance in locally advanced nasopharyngeal carcinoma, a multicenter retrospective study

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Tumour Site

Head and Neck Cancers

Presenters

Pongwut Danchaivijitr

Citation

Annals of Oncology (2018) 29 (suppl_8): viii372-viii399. 10.1093/annonc/mdy287

Authors

P. Danchaivijitr1, A. Dechaphunkul2, C. Paoin1, J. Setakornnukul3, T. Dechaphunkul4, R. Jiratrachu5, S. Niyomnaitham6, B. Suktitipat7, C. Sookthon8, P. Pattaranutaporn9, C. Jiarpinitnun9, N. Ngamphaiboon8

Author affiliations

  • 1 Medicine, Siriraj Hospital, Mahidol University, 10700 - Bangkok/TH
  • 2 Medicine, Prince of Songkla University, Songkhla/TH
  • 3 Radiology, Siriraj Hospital, Mahidol University, 10700 - Bangkok/TH
  • 4 Otorhinolaryngology Head And Neck Surgery, Songkhlanagarind Hospital, 90110 - Songkla/TH
  • 5 Radiology, Songklanagarind Hospital, 90110 - Hat Yai/TH
  • 6 Pharmacology, Siriraj Hospital, Mahidol University, 10700 - Bangkok/TH
  • 7 Biochemistry, Siriraj Hospital, Mahidol University, 10700 - Bangkok/TH
  • 8 Medicine, Ramathibodi Hospital, 10400 - Bangkok/TH
  • 9 Radiology, Ramathibodi Hospital, 10400 - Bangkok/TH
More

Resources

Abstract 4944

Background

Adjuvant chemotherapy (AC) is not a standard of care, but commonly utilized, in locally advanced nasopharyngeal carcinoma (LA-NPC) after definitive concurrent chemoradiotherapy (CCRT). Prospective randomized studies showed unclear overall survival benefit of AC compared with active surveillance (AS).

Methods

We conducted retrospective medical record review from 2005 to 2017 from the 3 university hospitals. LA-NPC patients who underwent definitive CCRT were included. Patients who received adjuvant platinum doublet chemotherapy (AC) were compared with AS patients. The primary objectives were overall survival (OS) and disease-free survival (DFS). Toxicities were also analyzed.

Results

Patients’ demographic data as shown in the table. Median follow up was 54.4months. Median OS in AC arm was 120 months vs 49.3 months in AS arm (HR = 0.51, P < 0.001, 95% CI 0.37 - 0.70). Median DFS in AC arm was 107.1 months vs 35.4 months in AS arm (HR = 0.49, P < 0.001, 95% CI 0.36 - 0.66). Weight loss and decline of renal function were observed but not statistically significant between two groups.Table: 1073P

CharacteristicsAll (n = 675)Adjuvant chemotherapy (n = 595)Active surveillance (n = 80)p-value
Age (mean±SD)49.52269 ± 11.9120948.96639 ± 11.6371453.425 ±13.44730.002
Male (%)465 (69)416 (69.92)49 (61.25)0.116
BMI kg/m2 (mean±SD)23.26 ±4.0823.25 ±4.1023.35 ± 4.000.824
Smoking Status Non-smoking Previous Current Missing419 135 100 29367 120 84 2649 13 15 30.454
T stage T1-T2 T3-T4359 316309 28650 300.075
N stage N0 N1-N2 N3, N3a, N3b75 516 7362 463 6013 53 130.054
Stage at diagnosis Stage 1 Stage 2 Stage 3 Stage 4 Stage 4a Stage 4b4 117 306 33 137 783 100 275 32 120 651 17 31 1 17 130.255

Conclusions

AC should be considered for patients with LA-NPC who completed definitive CCRT. AC in LA-NPC should be further validated in a randomized clinical study.

Clinical trial identification

Legal entity responsible for the study

Research University Network, Thailand.

Funding

Research University Network, Thailand.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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