Clinical effects of IMRT combined with EGFR monoclonal antibody, concurrent chemoradiotherapy,and IMRT alone in nasopharyngeal carcinoma patients:a retrospective case-control study

Abstract

Objective To compare the treatment outcomes and toxicities in nasopharyngeal carcinoma patients who receive intensity-modulated radiotherapy (IMRT) combined with epidermal growth factor receptor (EGFR) monoclonal antibody,IMRT with concurrent chemotherapy,and IMRT alone.Methods Sixty-eight previously untreated patients with stage Ⅱ-Ⅳb nasopharyngeal carcinoma (NPC) who received IMRT combined with cetuximab or nimotuzumab from January 2008 to September 2012 were included in BRT group; the BRT group was matched with 136 patients treated with concurrent chemoradiotherapy (CCRT) and 136 patients treated with IMRT alone at a ratio of 1:2 using SAS software.The Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis.Prognostic factors were analyzed by the Cox model.Results The sample sizes of the BRT group,IMRT group,and CCRT group were 14,69,47,respectively.The 3-year overall survival (OS),disease-free survival (DFS),locoregional control (LRC),and distant metastasis-free survival (DMFS) of all patients were 91.2％,80.2％,93.1％,and 87.2％,respectively.The 3-year OS rates of BRT group,IMRT group,and CCRT group were 91.9％,92.1％,and 89.9％,respectively (P=0.379) ;the 3-year DFS rates of BRT group,IMRT group,and CCRT group were 82.1％,77.9％,and 81.6％,respectively (P =0.594) ;the 3-year LRC rates of BRT group,IMRT group,and CCRT group were 98.2％,90.6％,and 93.0％,respectively (P =0.249);the 3-year DMFS rates of BRT group,IMRT group,and CCRT group were 85.2％,85.2％,and 90.3％,respectively (P =0.383).Multivariate prognostic analysis showed that T stage and concurrent use of EGFR monoclonal antibody were influential factors for LRC (P =0.034 and 0.032).Conclusions IMRT alone yields a good treatment outcome in NPC patients.Although there were no significant differences in OS between the three groups,the BRT group showed an increasing trend in LRC. Key words: Nasopharyngeal neoplasms/radiotherapy; Nasopharyngeal neoplasms/chemotherapy; Nasopharyngeal neoplasms/targeted molecular therapy; Prognosis