Abstract
We assessed the efficacy and safety of nimotuzumab plus neoadjuvant chemotherapy followed by concurrent chemoradiotherapy for Chinese patients with locoregionally advanced nasopharyngeal carcinoma. Clinical data from 210 nonmetastatic nasopharyngeal carcinoma patients diagnosed between May 2008 and April 2014 were retrospectively reviewed. All patients were initially treated with nimotuzumab plus neoadjuvant chemotherapy followed by concurrent chemoradiotherapy. Ninety-five patients received cisplatin-based adjuvant chemotherapy. The median follow-up duration was 48 months. Locoregional relapse and distant metastases occurred in 16 patients (16/210, 7.6%) and 18 patients (18/210, 8.6%), respectively. The 5-year local recurrence-free survival, regional recurrence-free survival, distant metastases-free survival, progression-free survival, and overall survival rates were 95.6%, 94.4%, 91.7%, 84.0%, and 88.7%, respectively. Univariate analysis revealed that concurrent chemotherapy regimens and clinical stage correlated with overall survival, and that adjuvant chemotherapy, N stage, clinical stage, and tumor response at the end of treatment were correlated with progression-free survival. In the multivariate analysis, concurrent chemotherapy regimens, clinical stage, and tumor response were important prognosticators. Grade 3/4 leukocytopenia was experienced by 24 patients (11.4%), and 6 patients (2.9%) developed mild liver damage during the period of neoadjuvant chemotherapy. Grade 3/4 acute mucositis was experienced by 13 patients (6.2%), and 12 patients (5.7%) experienced grade 3/4 leukocytopenia during the concurrent chemotherapy. The efficacy of nimotuzumab plus neoadjuvant chemotherapy followed by concurrent chemotherapy in locoregionally advanced nasopharyngeal carcinoma patients was encouraging and the toxicities were tolerable.
Highlights
The incidence of nasopharyngeal carcinoma (NPC) is 15 to 50 cases per 100,000 annually in Southern China, Singapore, and Malaysia that vary with age, ethnicity, and geographical origin [1]
The value of adding nimotuzumab to neoadjuvant chemotherapy (NAC) followed by Concurrent chemoradiotherapy (CCRT) in locoregionally advanced (LA) NPC patients remains unclear
We retrospectively investigated the safety and efficacy of nimotuzumab plus NAC followed by CCRT in LA NPC patients
Summary
The incidence of nasopharyngeal carcinoma (NPC) is 15 to 50 cases per 100,000 annually in Southern China, Singapore, and Malaysia that vary with age, ethnicity, and geographical origin [1]. Concurrent chemoradiotherapy (CCRT) with or without adjuvant chemotherapy, which provides a benefit in overall survival, has become the standard treatment for LA NPC, with acute toxicities [6,7,8]. A previous metaanalysis showed that compared with CCRT alone, addition of neoadjuvant chemotherapy (NAC) to CCRT reduces distant failure in LA NPC patients [9, 10], and another current meta-analysis confirmed that NAC followed by CCRT significantly improved progression-free survival (PFS) and overall survival (OS) [11]. The efficacy of the addition of NAC to CCRT in LA NPC patients remains controversial [12,13,14]. The incidence of distant failure in LA NPC patients after combined treatment is more than 20% [15]. New and effective regimens with tolerable toxicity for LA NPC are needed
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