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
| Characteristics | All (n = 675) | Adjuvant chemotherapy (n = 595) | Active surveillance (n = 80) | p-value |
|---|---|---|---|---|
| Age (mean±SD) | 49.52269 ± 11.91209 | 48.96639 ± 11.63714 | 53.425 ±13.4473 | 0.002 |
| Male (%) | 465 (69) | 416 (69.92) | 49 (61.25) | 0.116 |
| BMI kg/m2 (mean±SD) | 23.26 ±4.08 | 23.25 ±4.10 | 23.35 ± 4.00 | 0.824 |
| Smoking Status Non-smoking Previous Current Missing | 419 135 100 29 | 367 120 84 26 | 49 13 15 3 | 0.454 |
| T stage T1-T2 T3-T4 | 359 316 | 309 286 | 50 30 | 0.075 |
| N stage N0 N1-N2 N3, N3a, N3b | 75 516 73 | 62 463 60 | 13 53 13 | 0.054 |
| Stage at diagnosis Stage 1 Stage 2 Stage 3 Stage 4 Stage 4a Stage 4b | 4 117 306 33 137 78 | 3 100 275 32 120 65 | 1 17 31 1 17 13 | 0.255 |
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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