Abstract 444P
Background
The role of induction chemotherapy (IC) in nasopharyngeal cancer (NPC) is well established. The most commonly used IC regimens in the real-world settings are docetaxel, cisplatin, and 5-fluorouracil (TPF); docetaxel and cisplatin (TP); gemcitabine and cisplatin (GP); and cisplatin epirubicin (AP). We aim to report the outcome of patients treated with these protocols at our institution.
Methods
This retrospective cohort study included patients with stage II-IV nasopharyngeal cancer (NPC) who received induction chemotherapy (IC) at King Fahad Medical City between January 2008 and December 2019. Clinicopathological data were analyzed. Survival analysis was estimated using the Kaplan-Meier method and compared by a log-rank test.
Results
One hundred twenty-four patients were included. Most patients had stage III disease (47%, n = 58), followed by stage IVA (42%, n = 52). The four main cohorts of IC were TP (55%, n = 68), TPF (21%, n = 26), AP (12%, n = 15), and GP (6%, n = 7), while other protocols (7%, n = 8). Following IC, 94% (n = 117) were treated with concurrent chemoradiation therapy. Local recurrence occurred in 12 patients (10%), while distant recurrence was documented in 25 patients (20%). There was no statistically significant association between the type of IC and the site of recurrence, whether local or distant, p = 0.74. The 3-year overall survival rates were 93% (TP), 87% (TPF), 85% (GP), and 83% (AP). The Kaplan-Meier method did not show a statistically significant difference between the IC cohorts, p = 0.449. The 3-year OS rates for 2 and 3 cycles were 95% and 70%, respectively, while the 3-year PFS rates for 2 and 3 cycles were 79% and 50%, respectively.
Conclusions
Our retrospective study found no significant difference in outcomes between the four IC regimens. However, a longer duration of IC may be associated with worse outcomes in locally advanced NPC. Further prospective trials are needed to define the optimal duration and regimen of IC for locally advanced NPC.
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.