Abstract 298P
Background
Although the acute toxicities during induction TPF in head and neck cancers are well known, there has been little studied about the long term complications including of outcomes in nasopharyngeal cancer (NPC). The purpose of this study is to evaluate the long term complications and survival outcomes in patients with locally advanced NPC treated with induction TPF followed by CRT.
Methods
From 2004 to 2016, 244 patients were diagnosed as NPC. Among them, 104 patients who completed the 3 cycles of TPF (docetaxel 75 mg/m2 and cisplatin 75/m2 day 1, plus fluorouracil 1000 mg/m2 days 1–4, every 3 wks) followed by CRT were evaluated. During CRT, cisplatin was given as either a weekly or 3 weeks regimen and RT was performed at 65–70 Gy. After completing TPF and CRT, follow up imaging and regular examination was checked by ENT specialist.
Results
The median follow-up duration was 60 months (range, 13-135). 5Y OS rate and 3Y PFS rate were 88.9±3.7% (95%CI 81.65-96.15) and 80.4±4.5 (95%CI 71.58-89.22). PFS was significantly associated with TNM (p = 0.001), especially N stage (N3, 3Y-PFS 42.9%, p = 0.001). The response after induction chemotherapy and postop CRT were significantly associated with PFS and OS. ENT complications such as hearing impairment, chronic infection, ear drum perforation were shown in 31 patients (30%) and renal impairment (Clcr≤60) was developed in 30 patients (30%). The incidence of both complications was significantly associated with age (>65 years, ENT Cx, p = 0.011, renal Cx, 0.032). However, age was not attenuate response rate or survival. The decreased Clcr before starting RT was associated with long term renal complication, and cumulative cisplatin dose did not affect treatment outcome. In addition, both ENT and renal toxicities were not associated with the radiation dose or cumulative cisplatin dose.
Conclusions
TPF followed by CCRT is an effective treatment scheme for advanced NPC. However, long term complications in ENT and decreased renal function were considerable, especially in elderly. Therefore, careful observation and management are required for high risk patients and optimal cisplatin adjustment could be prevent renal complication without affecting the treatment outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
133P - Prognostic and predictive factors from the phase III CELESTIAL trial of cabozantinib (C) versus placebo (P) in previously treated advanced hepatocellular carcinoma (aHCC)
Presenter: Thomas Yau
Session: Poster display session
Resources:
Abstract
134P - Identification, development and validation of a circulating miRNA-based diagnostic signature for early detection of gastric cancer
Presenter: Daisuke Izumi
Session: Poster display session
Resources:
Abstract
135P - The promising key genes associated with tumour microenvironment and prognosis of hepatocellular carcinoma
Presenter: Jing Fang
Session: Poster display session
Resources:
Abstract
136P - Helicobacter pylori-positive gastric diffuse large B-cell lymphoma: A subset with distinct prognostic features
Presenter: Yuan Cheng
Session: Poster display session
Resources:
Abstract
137P - Significant benefit of pyrotinib combined with SHR6390 in patients with multiline-resistant HER2-positive advanced gastric cancer
Presenter: Zuhua Chen
Session: Poster display session
Resources:
Abstract
138P - Incidence of supracarinal lymph node positivity in operated cases of total esophagectomy: Short term results from a tertiary cancer centre
Presenter: Akhil Palod
Session: Poster display session
Resources:
Abstract
139P - Prognostic usefulness of advanced lung cancer inflammation index in locally-advanced pancreatic carcinoma patients treated with radical chemoradiotherapy
Presenter: Ayberk Besen
Session: Poster display session
Resources:
Abstract
140P - Pancreaticoduodenectomy versus combined neoadjuvant chemotherapy and pancreaticoduodenectomy: Survival patterns among patients with stage II & III periampullary carcinoma
Presenter: Mai Abdelkader
Session: Poster display session
Resources:
Abstract
141P - A 13-gene signature of DNA repair predicts prognosis in gastric cancer patients
Presenter: Jinjia Chang
Session: Poster display session
Resources:
Abstract
142P - Relation between Interleukin -4 (590C/T) gene polymorphism and hepatocellular carcinoma risk in HBV and HCV patients
Presenter: Suzy Gohar
Session: Poster display session
Resources:
Abstract