Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up

You, Rui; Hua, Yi-Jun; Liu, You-Ping; Yang, Qi; Zhang, Yi-Nuan; Li, Ji-Bin; Li, Chao-Feng; Zou, Xiong; Yu, Tao; Cao, Jing-Yu; Zhang, Meng-Xia; Jiang, Rou; Sun, Rui; Mo, Hao-Yuan; Guo, Ling; Cao, Ka-Jia; Lin, Ai-Hua; Sun, Ying; Qian, Chao-Nan; Ma, Jun; Chen, Ming-Yuan

doi:10.7150/thno.19710

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Theranostics 2017; 7(8):2314-2324. doi:10.7150/thno.19710 This issue Cite

Research Paper

Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up

Rui You^{1, 2*}, Yi-Jun Hua^{1, 2*}, You-Ping Liu^{1, 2*}, Qi Yang^{1, 2*}, Yi-Nuan Zhang^{1, 2}, Ji-Bin Li^{2, 3}, Chao-Feng Li^{2, 4}, Xiong Zou^{1, 2}, Tao Yu^{1, 2}, Jing-Yu Cao^{1, 2}, Meng-Xia Zhang^{1, 2}, Rou Jiang^{1, 2}, Rui Sun^{1, 2}, Hao-Yuan Mo^{1, 2}, Ling Guo^{1, 2}, Ka-Jia Cao^{1, 2}, Ai-Hua Lin⁵, Ying Sun^{1, 6}, Chao-Nan Qian^{1, 2}, Jun Ma^{1, 6}, Ming-Yuan Chen^{1, 2 ✉}

1. Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, P. R. China;
2. Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center
Guangzhou 510060, P. R. China
3. Department of Clinical Research, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, P. R. China;
4. Department of Information Technology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, P. R. China;
5. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou 510080, P. R. China;
6. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, P. R. China.
* Rui You, Yi-Jun Hua, You-Ping Liu, Qi Yang contributed equally to this study.

Citation:

You R, Hua YJ, Liu YP, Yang Q, Zhang YN, Li JB, Li CF, Zou X, Yu T, Cao JY, Zhang MX, Jiang R, Sun R, Mo HY, Guo L, Cao KJ, Lin AH, Sun Y, Qian CN, Ma J, Chen MY. Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up. Theranostics 2017; 7(8):2314-2324. doi:10.7150/thno.19710. https://www.thno.org/v07p2314.htm

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Abstract

We examined the benefits of the combination of anti-EGFR targeted treatment, cetuximab (CTX) or nimotuzumab (NTZ) and concurrent platinum-based chemoradiotherapy (CCRT) compared with CCRT alone in patients with stage II - IV_b nasopharyngeal carcinoma (NPC). A total of 1,628 eligible patients with stage II - IV_bNPC, who received CCRT (three cycles of 100 mg/m² cisplatin every 3 weeks with intensity-modulated radiotherapy) with or without CTX or NTZ between June 2009 and December 2013 were included in the analysis. Using propensity scores to adjust for potential prognostic factors, a well-balanced cohort of 878 patients was created by matching each patient who received CTX or NTZ plus CCRT with no more than four patients who received CCRT alone (1:4). Efficacy and safety were compared between CTX/NTZ plus CCRT and CCRT alone arms. Compared with CCRT alone, treatment with CTX/NTZ plus CCRT was associated with a significantly increased overall survival (3-year OS, 96.6% vs. 92.9%, P = 0.015), improved disease-free survival (3-year DFS, 93.5% vs 86.9%, P = 0.028), and improved distant metastasis-free survival (3-year DMFS, 94.6% vs 89.3%, P = 0.030). Increased rate of CTX related-skin reaction and mucositis was observed in the CTX plus CCRT arm. Multivariate analysis demonstrated the combination of CTX/NTZ was a significant protective factor for OS, DFS, and DMFS in patients treated with CCRT. Our analysis suggests that the addition of CTX/NTZ to CCRT is more effective for maximizing survival in patients with stage II-IVb NPC compared with CCRT alone.

Keywords: nasopharyngeal carcinoma, IMRT, concurrent chemoradiotherapy, nimotuzumab, cetuximab, survival outcome, adverse events.

Citation styles

APA

You, R., Hua, Y.J., Liu, Y.P., Yang, Q., Zhang, Y.N., Li, J.B., Li, C.F., Zou, X., Yu, T., Cao, J.Y., Zhang, M.X., Jiang, R., Sun, R., Mo, H.Y., Guo, L., Cao, K.J., Lin, A.H., Sun, Y., Qian, C.N., Ma, J., Chen, M.Y. (2017). Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up. Theranostics, 7(8), 2314-2324. https://doi.org/10.7150/thno.19710.

ACS

You, R.; Hua, Y.J.; Liu, Y.P.; Yang, Q.; Zhang, Y.N.; Li, J.B.; Li, C.F.; Zou, X.; Yu, T.; Cao, J.Y.; Zhang, M.X.; Jiang, R.; Sun, R.; Mo, H.Y.; Guo, L.; Cao, K.J.; Lin, A.H.; Sun, Y.; Qian, C.N.; Ma, J.; Chen, M.Y. Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up. Theranostics 2017, 7 (8), 2314-2324. DOI: 10.7150/thno.19710.

NLM

CSE

You R, Hua YJ, Liu YP, Yang Q, Zhang YN, Li JB, Li CF, Zou X, Yu T, Cao JY, Zhang MX, Jiang R, Sun R, Mo HY, Guo L, Cao KJ, Lin AH, Sun Y, Qian CN, Ma J, Chen MY. 2017. Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up. Theranostics. 7(8):2314-2324.

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