Treatment of advanced nasopharyngeal cancer using low- or high-dose concurrent chemoradiotherapy with intensity-modulated radiotherapy: A propensity score-matched, nationwide, population-based cohort study

Tsung Ming Chen, Kuan Chou Lin, Kevin Sheng Po Yuan, Chia Lun Chang, Jyh Ming Chow, Szu Yuan Wu

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Abstract

Background: No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. Methods: In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups. Results: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group. Conclusion: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.

Original languageEnglish
JournalRadiotherapy and Oncology
DOIs
Publication statusAccepted/In press - Jan 1 2017

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Nasopharyngeal Neoplasms
Intensity-Modulated Radiotherapy
Propensity Score
Chemoradiotherapy
Cohort Studies
Population
Therapeutics
Taiwan
Sample Size
Cisplatin
Radiotherapy
Randomized Controlled Trials
Regression Analysis
Confidence Intervals

Keywords

  • High-dose concurrent chemoradiotherapy
  • Intensity-modulated radiotherapy
  • Low-dose concurrent chemoradiotherapy
  • Nasopharyngeal cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{fd37474e7f8d47bf9189ae57d1df4175,
title = "Treatment of advanced nasopharyngeal cancer using low- or high-dose concurrent chemoradiotherapy with intensity-modulated radiotherapy: A propensity score-matched, nationwide, population-based cohort study",
abstract = "Background: No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. Methods: In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups. Results: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95{\%} confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group. Conclusion: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.",
keywords = "High-dose concurrent chemoradiotherapy, Intensity-modulated radiotherapy, Low-dose concurrent chemoradiotherapy, Nasopharyngeal cancer, Radiotherapy",
author = "Chen, {Tsung Ming} and Lin, {Kuan Chou} and Yuan, {Kevin Sheng Po} and Chang, {Chia Lun} and Chow, {Jyh Ming} and Wu, {Szu Yuan}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.radonc.2017.12.004",
language = "English",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
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T1 - Treatment of advanced nasopharyngeal cancer using low- or high-dose concurrent chemoradiotherapy with intensity-modulated radiotherapy

T2 - A propensity score-matched, nationwide, population-based cohort study

AU - Chen, Tsung Ming

AU - Lin, Kuan Chou

AU - Yuan, Kevin Sheng Po

AU - Chang, Chia Lun

AU - Chow, Jyh Ming

AU - Wu, Szu Yuan

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. Methods: In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups. Results: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group. Conclusion: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.

AB - Background: No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. Methods: In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups. Results: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group. Conclusion: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.

KW - High-dose concurrent chemoradiotherapy

KW - Intensity-modulated radiotherapy

KW - Low-dose concurrent chemoradiotherapy

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KW - Radiotherapy

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