Real-world data on the efficacy and toxicity of induction chemotherapy in locally advanced nasopharyngeal carcinoma in a non-endemic population.

IF 1.2 Q4 ONCOLOGY

ecancermedicalscience Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI:10.3332/ecancer.2025.1832

Cassio Murilo Hidalgo Filho, Gabriel Berlingieri Polho, Otavio Augusto Moreira, Matheus de Oliveira Andrade, Vinicius Cruz Parrela, Yumi Ricucci Shinkado, Amanda Acioli de Almeida Robatto, Felippe Lazar Neto, Ana Julia Freitas, Aurelio Teixeira Souza, Gilberto de Castro Junior, Milena Perez Mak

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Abstract

Background: Induction chemotherapy (ICT) is critical for managing locally advanced nasopharyngeal carcinoma (LA-NPC), but real-world data on its efficacy and toxicity are limited.

Methods: This retrospective study included LA-NPC patients treated with ICT from 2012 to 2022. We evaluated radiological response rates, overall survival (OS), treatment-related toxicities and complete response (CR) rates.

Results: Among 217 patients, 119 met the inclusion criteria and were included in the final analysis. CR rates were similar across ICT regimens (docetaxel, cisplatin and 5-fluorouracil 68.0%; cisplatin and gemcitabine 57.1%; cisplatin and 5-fluorouracil 58.0%; others 50%, p = 0.72). Serious adverse events (SAEs) occurred in 22%, with 69.7% experiencing weight loss and 31.9% requiring enteral tube placement. Poor OS was linked to Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥2 hazard ratios (HR 2.8, p = 0.004) and residual disease (RD) (HR 7.4, p = 0.001). Stage IV (Odds Ratio [OR] 3.77, p = 0.005) and ECOG-PS ≥ 2 (OR 4.69, p = 0.006) were associated with RD.

Conclusion: ICT regimens had similar CR rates. Poor ECOG-PS and stage IV predicted RD. Managing toxicities is crucial for better outcomes.

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