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
304P - Survival outcomes and survival predictors in recurrent and metastatic head and neck squamous cell cancer (R/M-HNSCC) patients treated with chemotherapy (CT) plus cetuximab as first-line therapy in a real-world study
Presenter: Filipa Pontes
Session: Poster display session
Resources:
Abstract
305P - A retrospective study to evaluate patient characteristics for recurrent head and neck cancer after definitive treatment
Presenter: Tetsuro Wakasugi
Session: Poster display session
Resources:
Abstract
306P - Efficacy and safety of apatinib in heavily pretreated metastatic adenocarcinoma of the head and neck
Presenter: Lin Gui
Session: Poster display session
Resources:
Abstract
307P - Lacrimal gland tumours: Clinical and epidemiological patterns in the United States
Presenter: Mahmoud KhalafAllah
Session: Poster display session
Resources:
Abstract
308P - Dental prophylaxis and 5-fluorouracil related oral mucositis in head and neck cancer patients: A population-based cohort study
Presenter: Yi-Fang Huang
Session: Poster display session
Resources:
Abstract
309P - Evaluation of a pharmacist-led opioid de-escalation (PLODE) program after chemoradiotherapy completion in head and neck cancer patients
Presenter: Ai Horinouchi
Session: Poster display session
Resources:
Abstract
310P - Laser and PDT for the oral leukoplakia
Presenter: Sadykov Rasul
Session: Poster display session
Resources:
Abstract
311P - Incidence of thyroid carcinoma in the Philippines: A retrospective study from a tertiary university hospital
Presenter: Priscilla Caguioa
Session: Poster display session
Resources:
Abstract
312P - Oral health disparities among privileged and underprivileged tribes of south India - A study on precancerous oral lesions prevalence
Presenter: Shanavas Palliyal
Session: Poster display session
Resources:
Abstract
313P - Immunotherapy application for advanced cancers: One institution experiences since 2016 to 2019
Presenter: Jo Pai Chen
Session: Poster display session
Resources:
Abstract