Cancer Communications
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[ Special series on Nasopharyngeal carcinoma ]
doi: 10.1186/s40880-017-0195-6
Radiotherapy with neoadjuvant chemotherapy versus concurrent chemoradiotherapy for ascending-type nasopharyngeal carcinoma: a retrospective comparison of toxicity and prognosis
Ji-Jin Yao, Xiao-Li Yu, Fan Zhang, Wang-Jian Zhang, Guan-Qun Zhou, Ling-Long Tang, Yan-Ping Mao, Lei Chen, Jun Ma and Ying Sun
Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center; Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University
[Abstract]

Background
In the era of intensity-modulated radiotherapy (IMRT), the role of neoadjuvant chemotherapy (NACT) in treating ascending-type nasopharyngeal carcinoma (NPC) is under-evaluated. This study was to compare the efficacy of NACT followed by IMRT (NACT + RT) with the efficacy of concurrent chemoradiotherapy (CCRT) on ascending-type NPC.
Methods
Clinical data of 214 patients with ascending-type NPC treated with NACT + RT or CCRT between December 2009 and July 2011 were analyzed. Of the 214 patients, 98 were treated with NACT followed by IMRT, and 116 were treated with CCRT. The survival rates were assessed using Kaplan–Meier analysis, and the survival curves were compared using a log-rank test.
Results
The 4-year overall survival, locoregional failure-free survival, distant failure-free survival, and failure-free survival rates were not significantly different between the two groups (all P > 0.05). However, patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT + RT group during radiotherapy, including leukopenia (30.2% vs. 15.3%, P = 0.016), neutropenia (25.9% vs. 11.2%, P = 0.011), and mucositis (57.8% vs. 40.8%, P = 0.028). After radiotherapy, patients in the CCRT group exhibited significantly higher rates of xerostomia (21.6% vs. 10.2%, P = 0.041) and hearing loss (17.2% vs. 6.1%, P = 0.023).
Conclusions
The treatment outcomes of the NACT + RT and CCRT groups were similar; however, CCRT led to higher rates of acute and late toxicities. NACT + RT may therefore be a better treatment strategy for ascending-type NPC.
Chinese Journal of Cancer 2017, Volume: 36, Issue 4
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Ji-Jin Yao, Xiao-Li Yu, Fan Zhang, Wang-Jian Zhang, Guan-Qun Zhou, Ling-Long Tang, Yan-Ping Mao, Lei Chen, Jun Ma and Ying Sun. Radiotherapy with neoadjuvant chemotherapy versus concurrent chemoradiotherapy for ascending-type nasopharyngeal carcinoma: a retrospective comparison of toxicity and prognosis. Chin J Cancer. 2017, 36:26. doi:10.1186/s40880-017-0195-6


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