299P - Weekly versus triweekly concurrent chemoradiation for nasopharyngeal cancer

Background

Nasopharyngeal cancer is the most common head and neck cancer in Indonesia with prevalence of 28.4% among all adult head and neck cancer. Radiotherapy and chemotherapy are the main modalities for nasopharyngeal cancer treatment, With proper treatment, patients with nasopharyngeal cancer would have 5-year survival rate of above 80%, even in locally advanced nasopharyngeal cancer. However toxicity associated with nasopharyngeal cancer treatment is quite burdensome for the patients especially toxicity in terms of hematology, mucositis, nausea, and vomiting. Due to the burdening toxicity of chemoradiation treatment for the patients, several chemotherapy schedules were attempted. We aimed to search and elucidate high quality evidence available to date to answer our clinical question, whether triweekly or weekly concurrent chemoradiation is better for nasopharyngeal cancer treatment in terms of survival.

Methods

Literature searching was conducted on 3 databases: PubMed, EBSCOhost, and Scopus using keyword “Nasopharyngeal Cancer”, “Weekly Chemotherapy”, “Triweekly Chemotherapy”, “Overall Survival” and its synonyms using both MeSH and non-MeSH terms. Critical Appraisal for selected studies was done by 3 different person, using CEBM Critical Appraisals Tools.

Results

Six studies were selected to be relevant after elaborate search, which was then critically apprasied and found to be valid. Results from all those 6 studies found that weekly vs. triweekly chemoradiation regimen leads to similar survival outcome in nasopharyngeal cancer patients. Overall Survival (OS) rates from those 6 studies showed comparable result among both regimens (3-Year OS, 91% vs 90.8%; 5-year OS, 89% vs. 91%, 85.6% vs 90%, 78.9% vs 85.2%) and, all OS rate outcomes didn’t reach significant difference for all 6 studies.

Conclusions

Weekly and triweekly chemoradiation regimens for nasopharyngeal cancer were shown to be similar in terms of overall survival. The choice of weekly or triweekly chemoradiation for nasopharyngeal cancer patient should tailored according to institutional condition and capability.

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.