Systemic chemotherapy and sequential locoregional radiotherapy in initially metastatic nasopharyngeal carcinoma: Retrospective analysis with 821 cases
Tianying Huang, Ning Su, Xuanye Zhang, Shu‐Yun Ma, Guangzheng Zhong, Xiao‐Peng Tian, Qiuyan Chen, Ling‐Long Tang, Lixia Lu, Fang Yu, Jun Cai, Qingqing Cai
Abstract
BACKGROUND: We designed this retrospective study to explore the best treatment modality for patients with initially metastatic nasopharyngeal carcinoma (NPC). METHODS: From 2008 to 2017, 821 patients were enrolled. Treatment modalities and prognostic factors were analyzed. RESULTS: Compared with chemotherapy alone and radiotherapy-based treatment, systemic chemotherapy-sequential locoregional radiotherapy to the nasopharyngeal primary tumor site were associated with a significantly increased 3-year overall survival (OS) rate (40.3%, 11.7%, and 22.9%, P < .001). The overall response rate of the paclitaxel combined with platinum and fluorouracil (TPF) regimen as first-line chemotherapy was higher than that of the paclitaxel plus platinum (TP) regimen (78.2% vs 70.0%, P = .038). A better OS was achieved in the TPF group compared to doublet drug regimens (3-year OS, 35.7% vs 25.3%, P < .001). CONCLUSIONS: Systemic chemotherapy-sequential locoregional radiotherapy may prolong OS and progression-free survival for selected patients with initially metastatic NPC.