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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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%, <i>p</i> = 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, <i>p</i> = 0.004) and residual disease (RD) (HR 7.4, <i>p</i> = 0.001). Stage IV (Odds Ratio [OR] 3.77, p = 0.005) and ECOG-PS ≥ 2 (OR 4.69, <i>p</i> = 0.006) were associated with RD.</p><p><strong>Conclusion: </strong>ICT regimens had similar CR rates. Poor ECOG-PS and stage IV predicted RD. Managing toxicities is crucial for better outcomes.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"19 ","pages":"1832"},"PeriodicalIF":1.2000,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959135/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-world data on the efficacy and toxicity of induction chemotherapy in locally advanced nasopharyngeal carcinoma in a non-endemic population.\",\"authors\":\"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\",\"doi\":\"10.3332/ecancer.2025.1832\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Induction chemotherapy (ICT) is critical for managing locally advanced nasopharyngeal carcinoma (LA-NPC), but real-world data on its efficacy and toxicity are limited.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%, <i>p</i> = 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, <i>p</i> = 0.004) and residual disease (RD) (HR 7.4, <i>p</i> = 0.001). Stage IV (Odds Ratio [OR] 3.77, p = 0.005) and ECOG-PS ≥ 2 (OR 4.69, <i>p</i> = 0.006) were associated with RD.</p><p><strong>Conclusion: </strong>ICT regimens had similar CR rates. Poor ECOG-PS and stage IV predicted RD. 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引用次数: 0
摘要
背景：诱导化疗（ICT）是治疗局部晚期鼻咽癌（LA-NPC）的关键，但其疗效和毒性的实际数据有限。方法：回顾性研究纳入2012 - 2022年接受ICT治疗的LA-NPC患者。我们评估了放射反应率、总生存期（OS）、治疗相关毒性和完全缓解率（CR）。结果：217例患者中，符合纳入标准的119例纳入最终分析。不同ICT方案的CR率相似(多西紫杉醇、顺铂和5-氟尿嘧啶68.0%；顺铂加吉西他滨57.1%；顺铂+ 5-氟尿嘧啶58.0%；其他50%，p = 0.72)。严重不良事件（SAEs）发生率为22%，其中69.7%出现体重减轻，31.9%需要放置肠内管。较差的OS与东部肿瘤合作组工作状态(ECOG-PS)≥2的风险比（HR 2.8, p = 0.004）和残留疾病（RD） （HR 7.4, p = 0.001）相关。IV期（比值比[OR] 3.77, p = 0.005）和ECOG-PS≥2（比值比[OR] 4.69, p = 0.006）与rd相关。结论：ICT方案的CR率相似。较差的ECOG-PS和IV期预测RD。管理毒性对于更好的结果至关重要。
Real-world data on the efficacy and toxicity of induction chemotherapy in locally advanced nasopharyngeal carcinoma in a non-endemic population.
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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