In a study recently published in the journal BMC Cancer, researchers from the National Cheng Kung University Hospital in Taiwan reviewed the long-term outcomes of 128 patients with confirmed locally advanced nasopharyngeal carcinoma (LA-NPC) in Epstein-Barr virus infection endemic areas.
These patients received either neoadjuvant chemotherapy followed by radiotherapy (NACT) or concurrent chemoradiotherapy (CCRT; consisting of 3-week cycles of cisplatin or 4-week cycles of cisplatin and fluorouracil). The first failure site, disease free survival (DFS), overall survival (OS), and other prognostic factors were analyzed. Thirty-eight (30%) of the 128 patients received NACT, and those patients with advanced nodal disease and advanced clinical stage (stage IVA-IVB) were more likely to enroll in the NACT group.
When NACT to CCRT, patients who received NACT had similar 5-year DFS and OS (51.5% vs 65.1%, p = 0.28 and 71.7% vs 74.3%, p = 0.91, respectively); however, in those patients who were recurrence-free in the first 2 years after treatment, those who received NACT treatment had worse locoregional control compared with patients who received CCRT (hazard ratio =2.57, 95% CI: 1.02 to 6.47, p =0.046).
The authors concluded that although the two treatments had similar outcomes, patients treated with NACT should be followed-up closely because they are more likely to develop locoregional failure than patients receiving CCRT.
This research compared the long–term outcomes between LA–NPC patients treated with neoadjuvant chemotherapy followed by radiotherapy (NACT) and those treated with concurrent chemoradiotherapy (CCRT). For LA–NPC, both CCRT and NACT were similarly efficacious treatment strategies in terms of long–term disease control and survival probability.
Close locoregional follow–up is recommended for patients receiving NACT, because these patients are more prone to develop locoregional failure than patients receiving CCRT.