Abstract
BackgroundThis study aimed to assess the effectiveness and cost-effectiveness of nimotuzumab in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).MethodsLA-NPC patients treated between October 2013 and December 2016 were retrospectively reviewed. A well-balanced cohort of patients who received nimotuzumab in addition to standard treatment (n = 50) and patients who did not receive nimotuzumab (n = 100) was selected using propensity score-matching method (1:2 ratio) for the cost-effectiveness analysis.ResultsCompared with concurrent chemoradiotherapy (CCRT) alone, addition of nimotuzumab to CCRT significantly improved the 3-year overall survival (OS) (98.00% vs. 91.00%, P = 0.032). On multivariate analysis, nimotuzumab (hazard ratio = 0.124, 95% confidence interval: 0.017–0.902, P = 0.039) showed prognostic significance for OS. No serious treatment-related adverse events were observed in the nimotuzumab group (P > 0.05). Cost-effectiveness analysis revealed that addition of nimotuzumab increased the average treatment costs by $14,364.63. The additional cost for every one percent increase in OS rate was $ 2,052.09.ConclusionAddition of nimotuzumab to CCRT for LA-NPC confers significant survival benefits; however, it is not cost-effective.
Highlights
Nasopharyngeal carcinoma (NPC) is a highly aggressive malignant tumor derived from nasopharyngeal epithelial cells
The inclusion criteria were: (1) stage III-IV disease in accordance to the American Joint Committee on Cancer (AJCC) staging system (7th edition, 2010); (2) confirmed by pathology; (3) positive Epidermal growth factor receptor (EGFR) expression; (4) Karnofsky performance score (KPS) ≥ 80; (5) treatment regimen: induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) with or without nimotuzumab; (6) radical intensity-modulated radiotherapy (IMRT)
Treatment Chemotherapy IC followed by CCRT was recommended for patients with stage III–IV disease at our institution during the study reference period
Summary
Nasopharyngeal carcinoma (NPC) is a highly aggressive malignant tumor derived from nasopharyngeal epithelial cells. Up to 70% of newly diagnosed patients with nasopharyngeal cancer have locoregionally advanced disease [3] with an unfavorable prognosis. Platinum-based concurrent chemoradiotherapy (CCRT) with or without induction chemotherapy (IC) is the standard treatment for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) [4]. Application of intensity-modulated radiotherapy (IMRT) has helped improved locoregional control and survival [5, 6]. Approximately 20% of patients with locoregionally advanced disease tend to develop recurrent disease and/ or metastasis [7]. This study aimed to assess the effectiveness and cost-effectiveness of nimotuzumab in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC)
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