Real-world data on the efficacy and toxicity of induction chemotherapy in locally advanced nasopharyngeal carcinoma in a non-endemic population

TL;DR

This study examines the effectiveness and side effects of induction chemotherapy for advanced nasopharyngeal cancer in a non-endemic population.

Contribution

The study provides real-world data on induction chemotherapy efficacy and toxicity in a non-endemic population for nasopharyngeal carcinoma.

Findings

CR rates were similar across different ICT regimens (68.0% to 50%).

Poor OS was linked to ECOG-PS ≥2 and residual disease.

Stage IV and ECOG-PS ≥2 were associated with residual disease.

Abstract

Induction chemotherapy (ICT) is critical for managing locally advanced nasopharyngeal carcinoma (LA-NPC), but real-world data on its efficacy and toxicity are limited.

This retrospective study included LA-NPC patients treated with ICT from 2012 to 2022. We evaluated radiological response rates, overall survival (OS), treatment-related toxicities and complete response (CR) rates.

Among 217 patients, 119 met the inclusion criteria and were included in the final analysis. CR rates were similar across ICT regimens (docetaxel, cisplatin and 5-fluorouracil 68.0%; cisplatin and gemcitabine 57.1%; cisplatin and 5-fluorouracil 58.0%; others 50%, p = 0.72). Serious adverse events (SAEs) occurred in 22%, with 69.7% experiencing weight loss and 31.9% requiring enteral tube placement. Poor OS was linked to Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥2 hazard ratios (HR 2.8, p = 0.004) and residual disease (RD) (HR 7.4, p = 0.001). Stage IV (Odds Ratio [OR] 3.77, p = 0.005) and ECOG-PS ≥ 2 (OR 4.69, p = 0.006) were associated with RD.

ICT regimens had similar CR rates. Poor ECOG-PS and stage IV predicted RD. Managing toxicities is crucial for better outcomes.

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