Abstract
BackgroundThe present study compared the effectiveness and toxicity of two treatment modalities, namely radiotherapy combined with nimotuzumab (N) and chemoradiotherapy (CRT) in patients with locally recurrent nasopharyngeal carcinoma (LR-NPC).MethodsPatients with LR-NPC who were treated with radiotherapy were retrospectively enrolled from January 2015 to December 2018. The treatment included radiotherapy combined with N or platinum-based induction chemotherapy and/or concurrent chemotherapy. The comparison of survival and toxicity between the two treatment modalities was evaluated using the log-rank and chi-squared tests. Overall survival (OS) was the primary endpoint.ResultsA total of 87 patients were included, of whom 32 and 55 were divided into the N group and the CRT group, respectively. No significant differences were noted in the survival rate between the N and the CRT groups (4-year OS rates, 37.1% vs. 40.7%, respectively; P = 0.735). Mild to moderate acute complications were common during the radiation period and mainly included mucositis and xerostomia. The majority of the acute toxic reactions were tolerated well. A total of 48 patients (55.2%) demonstrated late radiation injuries of grade ≥ 3, including 12 patients (37.5%) in the N group and 36 patients (66.5%) in the CRT group. The CRT group exhibited significantly higher incidence of severe late radiation injuries compared with that of the N group (P = 0.011).ConclusionRadiotherapy combined with N did not appear to enhance treatment efficacy compared with CRT in patients with LR-NPC. However, radiotherapy combined with N may be superior to CRT due to its lower incidence of acute and late toxicities. Further studies are required to confirm the current findings.
Highlights
The present study compared the effectiveness and toxicity of two treatment modalities, namely radiotherapy combined with nimotuzumab (N) and chemoradiotherapy (CRT) in patients with locally recurrent naso‐ pharyngeal carcinoma (LR-Nasopharyngeal carcinoma (NPC))
Patient characteristics A total of 156 patients with recurrent NPC were treated at our center from January 2015 to December 2018 and 69 cases were excluded, including 19 cases with single lymph node regional recurrence, 17 cases with distant metastases, 1 case with other malignant tumors, 9 cases who did not complete treatment, cases who did not receive intensity-modulated radiation therapy (IMRT) treatment and cases who were lost to follow-up following treatment (Fig. 1)
A total of 32 (36.8%) patients received RT combined with N and were included in the N group, whereas 55 (63.2%) received CRT and were included in the CRT group
Summary
The present study compared the effectiveness and toxicity of two treatment modalities, namely radiotherapy combined with nimotuzumab (N) and chemoradiotherapy (CRT) in patients with locally recurrent naso‐ pharyngeal carcinoma (LR-NPC). Zong et al BMC Cancer (2021) 21:1274 re-irradiation, which can improve the long-term survival rate of certain patients [3]. The early recurrent form of the disease exhibits confined lesions and the 5-year survival rates with salvage surgical resection can reach 50–77.1% [4,5,6]. External radiation therapy is still the main form of treatment for this disease [2, 7]. The combination of radiation and chemotherapy may exacerbate the treatment toxicity and counteract the benefits of chemotherapy. When combined with chemotherapy, patients are less tolerant to re-irradiation. The development of more effective and less toxic treatment options is imperative
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