Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma
Objective This study aimed to evaluate the efficacy and toxicity of various adjuvant chemotherapy (AC) regimens for treating locoregionally advanced nasopharyngeal carcinoma.Methods and analysis In this retrospective study, the patients received either intravenous AC regimens (cisplatin–fluorouracil...
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Oncology |
| Online Access: | https://bmjoncology.bmj.com/content/4/1/e000718.full |
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| author | Jie Chen Sai-Lan Liu Qiu-Yan Chen Lin-Quan Tang Hai-Qiang Mai Hui Cheng Pan Wang Yi-Fu Li Yu-Chen Li Hao-Xiang Long Jie-Yi Lin Chun Fung Tse Bo-Wen Shen Shan-Shan Guo Shu-Ming Liang Li-Ting Liu |
| author_facet | Jie Chen Sai-Lan Liu Qiu-Yan Chen Lin-Quan Tang Hai-Qiang Mai Hui Cheng Pan Wang Yi-Fu Li Yu-Chen Li Hao-Xiang Long Jie-Yi Lin Chun Fung Tse Bo-Wen Shen Shan-Shan Guo Shu-Ming Liang Li-Ting Liu |
| author_sort | Jie Chen |
| collection | DOAJ |
| description | Objective This study aimed to evaluate the efficacy and toxicity of various adjuvant chemotherapy (AC) regimens for treating locoregionally advanced nasopharyngeal carcinoma.Methods and analysis In this retrospective study, the patients received either intravenous AC regimens (cisplatin–fluorouracil (PF) or cisplatin–gemcitabine (GP)) or oral regimens (capecitabine or tegafur, gimeracil and oteracil potassium capsule (S-1)) following concurrent chemoradiotherapy (CCRT). The primary endpoint was progression-free survival (PFS).Results A total of 229 patients were documented in the oral administration group (127 patients received capecitabine and 102 received S-1), whereas 241 patients were recorded in the intravenous group (164 patients received the PF regimen and 77 received the GP regimen). There was no significant difference in PFS between the intravenous and oral groups (n=154 each) after propensity score matching (3-year PFS rate: 76.3% vs 73.9%; HR, 0.803; 95% CI 0.523 to 1.233, p=0.316). However, based on the overall cohort, the GP regimen showed a superior 3-year PFS rate (89.1%) compared with PF (74.6%), capecitabine (76.0%) and S-1 (74.3%) regimen (p=0.005, 0.012 and 0.003, respectively), while multivariable analyses also demonstrated that the GP regimen (HRPFS, 0.38; 95% CI 0.18 to 0.81, p=0.012) was associated with better survival. Additionally, the intravenous group, which included PF and GP, exhibited a higher incidence of grade≥3 leucocytopenia (50.0% vs 22.7%), neutropenia (30.5% vs 18.2%), anaemia (16.2% vs 3.9%), hyponatraemia (3.2% vs 0) and hypokalaemia (12.3% vs 4.5%) than the oral group.Conclusion For patients treated with upfront CCRT, AC should be considered, and intravenous GP is preferred, although patients should be counselled about an increased risk of haematological toxicities. For patients treated with induction chemotherapy and CCRT, oral chemotherapy, either with capecitabine or S-1, was efficacious and tolerable. |
| format | Article |
| id | doaj-art-4f3ec3402cfc40d19ebed02b2dad4202 |
| institution | DOAJ |
| issn | 2752-7948 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Oncology |
| spelling | doaj-art-4f3ec3402cfc40d19ebed02b2dad42022025-08-20T02:46:44ZengBMJ Publishing GroupBMJ Oncology2752-79482025-07-014110.1136/bmjonc-2024-000718Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinomaJie Chen0Sai-Lan Liu1Qiu-Yan Chen2Lin-Quan Tang3Hai-Qiang Mai4Hui Cheng5Pan Wang6Yi-Fu Li7Yu-Chen Li8Hao-Xiang Long9Jie-Yi Lin10Chun Fung Tse11Bo-Wen Shen12Shan-Shan Guo13Shu-Ming Liang14Li-Ting Liu152 State Key Laboratory of Eye Health, Shanghai, People`s Republic of China1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People`s Republic of China1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People`s Republic of China1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People`s Republic of China1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People`s Republic of ChinaDepartment of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China2 Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USAState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaDepartment of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaZhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaObjective This study aimed to evaluate the efficacy and toxicity of various adjuvant chemotherapy (AC) regimens for treating locoregionally advanced nasopharyngeal carcinoma.Methods and analysis In this retrospective study, the patients received either intravenous AC regimens (cisplatin–fluorouracil (PF) or cisplatin–gemcitabine (GP)) or oral regimens (capecitabine or tegafur, gimeracil and oteracil potassium capsule (S-1)) following concurrent chemoradiotherapy (CCRT). The primary endpoint was progression-free survival (PFS).Results A total of 229 patients were documented in the oral administration group (127 patients received capecitabine and 102 received S-1), whereas 241 patients were recorded in the intravenous group (164 patients received the PF regimen and 77 received the GP regimen). There was no significant difference in PFS between the intravenous and oral groups (n=154 each) after propensity score matching (3-year PFS rate: 76.3% vs 73.9%; HR, 0.803; 95% CI 0.523 to 1.233, p=0.316). However, based on the overall cohort, the GP regimen showed a superior 3-year PFS rate (89.1%) compared with PF (74.6%), capecitabine (76.0%) and S-1 (74.3%) regimen (p=0.005, 0.012 and 0.003, respectively), while multivariable analyses also demonstrated that the GP regimen (HRPFS, 0.38; 95% CI 0.18 to 0.81, p=0.012) was associated with better survival. Additionally, the intravenous group, which included PF and GP, exhibited a higher incidence of grade≥3 leucocytopenia (50.0% vs 22.7%), neutropenia (30.5% vs 18.2%), anaemia (16.2% vs 3.9%), hyponatraemia (3.2% vs 0) and hypokalaemia (12.3% vs 4.5%) than the oral group.Conclusion For patients treated with upfront CCRT, AC should be considered, and intravenous GP is preferred, although patients should be counselled about an increased risk of haematological toxicities. For patients treated with induction chemotherapy and CCRT, oral chemotherapy, either with capecitabine or S-1, was efficacious and tolerable.https://bmjoncology.bmj.com/content/4/1/e000718.full |
| spellingShingle | Jie Chen Sai-Lan Liu Qiu-Yan Chen Lin-Quan Tang Hai-Qiang Mai Hui Cheng Pan Wang Yi-Fu Li Yu-Chen Li Hao-Xiang Long Jie-Yi Lin Chun Fung Tse Bo-Wen Shen Shan-Shan Guo Shu-Ming Liang Li-Ting Liu Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma BMJ Oncology |
| title | Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma |
| title_full | Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma |
| title_fullStr | Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma |
| title_full_unstemmed | Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma |
| title_short | Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma |
| title_sort | real world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma |
| url | https://bmjoncology.bmj.com/content/4/1/e000718.full |
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