Abstract
Objective:To investigate the long-term efficacy and safety between induction chemotherapy and concurrent chemotherapy in patients with locally advanced nasopharyngeal carcinoma.Method:From January 2006 to January 2011, 190 patients with nasopharyngeal carcinoma were enrolled in the study. Among them, 92 patients received induction chemotherapy and radiotherapy who were classified as the study group, while 98 cases received concurrent radiotherapy and chemotherapy plus adjuvant chemotherapy who were classified as the control group. The general data, overall survival rate, progression free survival rate, acute and chronic adverse reactions were compared between the two groups, and the prognostic factors of local advanced nasopharyngeal carcinoma were analyzed.Result:The 5 year progression free survival (70.7%, 67.3%, P= 0.591) and overall survival (78.3%, 78.6%, P= 0.635) did not differ significantly between the two groups. There was no significant difference in recurrence or metastasis rate between the two groups (29.3%, 35.7%, P= 0.435). The incidence of grade Ⅲ-Ⅳ leukopenia and nausea and vomiting was significantly lower in the study group than that in the control group (P< 0.05), while there was no significant difference in the incidence of late adverse reactions between the two groups (P 0.05). Multivariate analysis showed that age (P= 0.000) and N stage (P= 0.003) were independent prognostic factors for overall survival in patients with locally advanced nasopharyngeal carcinoma.Conclusion:The effect of induction chemotherapy combined with radiotherapy and chemoradiotherapy plus adjuvant chemotherapy was equivalent to locally advanced nasopharyngeal carcinoma, however, the acute adverse reaction rate of induction chemotherapy+radiotherapy was lower. Therefore, induction chemotherapy+radiotherapy may be more effective and safe treatment for patients with local advanced nasopharyngeal carcinoma.
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