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Neoadjuvant or Adjuvant Chemotherapy Plus Concurrent CRT Versus Concurrent CRT Alone in the Treatment of Nasopharyngeal Carcinoma: A Study Based on EBV DNA.
Liu, Li-Ting; Chen, Qiu-Yan; Tang, Lin-Quan; Guo, Shan-Shan; Guo, Ling; Mo, Hao-Yuan; Li, Yang; Tang, Qing-Nan; Sun, Xue-Song; Liang, Yu-Jing; Zhao, Chong; Guo, Xiang; Qian, Chao-Nan; Zeng, Mu-Sheng; Bei, Jin-Xin; Hong, Ming-Huang; Shao, Jian-Yong; Sun, Ying; Ma, Jun; Mai, Hai-Qiang.
Afiliación
  • Liu LT; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Chen QY; Department of Nasopharyngeal Carcinoma.
  • Tang LQ; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Guo SS; Department of Nasopharyngeal Carcinoma.
  • Guo L; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Mo HY; Department of Nasopharyngeal Carcinoma.
  • Li Y; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Tang QN; Department of Nasopharyngeal Carcinoma.
  • Sun XS; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Liang YJ; Department of Nasopharyngeal Carcinoma.
  • Zhao C; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Guo X; Department of Nasopharyngeal Carcinoma.
  • Qian CN; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Zeng MS; Department of Nasopharyngeal Carcinoma.
  • Bei JX; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Hong MH; Department of Nasopharyngeal Carcinoma.
  • Shao JY; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Sun Y; Department of Nasopharyngeal Carcinoma.
  • Ma J; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine.
  • Mai HQ; Department of Nasopharyngeal Carcinoma.
J Natl Compr Canc Netw ; 17(6): 703-710, 2019 06 01.
Article en En | MEDLINE | ID: mdl-31200353
BACKGROUND: The goal of this study was to explore the value of adding neoadjuvant chemotherapy (NACT) or adjuvant chemotherapy (ACT) to concurrent chemoradiotherapy (CCRT) in patients with nasopharyngeal carcinoma (NPC) with different risks of treatment failure. PATIENTS AND METHODS: A total of 2,263 eligible patients with stage III-IVb NPC treated with CCRT ± NACT or ACT were included in this retrospective study. Distant metastasis-free survival (DMFS), overall survival, and progression-free survival were calculated using the Kaplan-Meier method and differences were compared using the log-rank test. RESULTS: Patients in the low-risk group (stage N0-1 disease and Epstein-Barr virus [EBV] DNA <4,000 copies/mL) who received NACT followed by CCRT achieved significantly better 5-year DMFS than those treated with CCRT alone (96.2% vs 91.3%; P= .008). Multivariate analyses also demonstrated that additional NACT was the only independent prognostic factor for DMFS (hazard ratio, 0.42; 95% CI, 0.22-0.80; P=.009). In both the intermediate-risk group (stage N0-1 disease and EBV DNA ≥4,000 copies/mL and stage N2-3 disease and EBV DNA <4,000 copies/mL) and the high-risk group (stage N2-3 disease and EBV DNA ≥4,000 copies/mL), comparison of NACT or ACT + CCRT versus CCRT alone indicated no significantly better survival for all end points. CONCLUSIONS: The addition of NACT to CCRT could reduce distant failure in patients with low risk of treatment failure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Neoplasias Nasofaríngeas / Herpesvirus Humano 4 / Infecciones por Virus de Epstein-Barr / Terapia Neoadyuvante / Carcinoma Nasofaríngeo Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Natl Compr Canc Netw Asunto de la revista: NEOPLASIAS Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Neoplasias Nasofaríngeas / Herpesvirus Humano 4 / Infecciones por Virus de Epstein-Barr / Terapia Neoadyuvante / Carcinoma Nasofaríngeo Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Natl Compr Canc Netw Asunto de la revista: NEOPLASIAS Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos