Long-term efficacy and adverse reactions of IMRT combined with Endostar versus IMRT combined with chemotherapy for locally advanced nasopharyngeal carcinoma: a retrospective study

Background: This study aimed to analyze the long-term efficacy and late adverse reactions of intensity-modulated radiation therapy (IMRT) combined with recombinant human endostatin (Endostar) versus IMRT combined with concurrent chemotherapy (CCT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC).

Methods: This was a retrospective analysis of twenty-three NPC stage III-IVA patients treated with IMRT + Endostar or IMRT + CCT. Patients in the IMRT + Endostar group (n=10) received a total of 2 cycles of Endostar, while patients in the IMRT + CCT group (n=13) received a total of 3 cycles of concurrent cisplatin chemotherapy.

Results: The 5-year overall survival rates (OS) for the IMRT + Endostar group and the IMRT + CCT group were 90.0% and 61.5% P=0.123), respectively. Local relapse-free survival (LRFS) rates were 90.0% and 76.9% (P=0.396), distant metastasis-free survival (DMFS) rates were 90.0% and 61.5% (P=0.129), and progression-free survival (PFS) rates were 90.0% and 53.8% (P=0.074) for the IMRT + Endostar group and the IMRT + CCT group. The incidence of grades 0, 1, and 2 xerostomia was 70.0%, 20.0%, and 10.0%, respectively, in the IMRT + Endostar group, and 15.4%, 76.9%, and 7.7% in the IMRT + CCT group, showing significant differences between the 2 groups (P=0.020). For the IMRT + Endostar group, the incidence of grades 0, 1, and 2 mouth-opening difficulty was 100.0%, 0%, and 0%, respectively, while for the IMRT + CCT group, the incidence was 53.8%, 38.5%, and 7.7%, with significant differences between the two groups (P=0.044). For the IMRT + Endostar group, the incidence of grades 0, 1, and 2 cervical and facial soft tissue fibrosis was 40.0%, 60.0%, and 0%, respectively, while for the IMRT + CCT group, the incidence was 0%, 76.9%, and 23.1%, showing significant differences between the two groups (P=0.027).

Conclusions: The difference in long-term efficacy between the IMRT + Endostar group and IMRT + CCT group was not significant for locally advanced NPC, but the IMRT + Endostar group had better efficacy and less severe late side effects. Further research involving a larger sample size and longer follow-up period are needed.