Systemic chemotherapy and sequential locoregional radiotherapy in initially metastatic nasopharyngeal carcinoma: Retrospective analysis with 821 cases

Head Neck. 2020 Aug;42(8):1970-1980. doi: 10.1002/hed.26130. Epub 2020 Mar 10.

Abstract

Background: We designed this retrospective study to explore the best treatment modality for patients with initially metastatic nasopharyngeal carcinoma (NPC).

Methods: From 2008 to 2017, 821 patients were enrolled. Treatment modalities and prognostic factors were analyzed.

Results: Compared with chemotherapy alone and radiotherapy-based treatment, systemic chemotherapy-sequential locoregional radiotherapy to the nasopharyngeal primary tumor site were associated with a significantly increased 3-year overall survival (OS) rate (40.3%, 11.7%, and 22.9%, P < .001). The overall response rate of the paclitaxel combined with platinum and fluorouracil (TPF) regimen as first-line chemotherapy was higher than that of the paclitaxel plus platinum (TP) regimen (78.2% vs 70.0%, P = .038). A better OS was achieved in the TPF group compared to doublet drug regimens (3-year OS, 35.7% vs 25.3%, P < .001).

Conclusions: Systemic chemotherapy-sequential locoregional radiotherapy may prolong OS and progression-free survival for selected patients with initially metastatic NPC.

Keywords: chemotherapy; local treatment; metastatic; nasopharyngeal carcinoma; radiotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemoradiotherapy
  • Cisplatin / therapeutic use
  • Disease-Free Survival
  • Fluorouracil / therapeutic use
  • Humans
  • Nasopharyngeal Carcinoma / therapy
  • Nasopharyngeal Neoplasms* / drug therapy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Cisplatin
  • Fluorouracil