Chemotherapy benefit in nasopharyngeal carcinoma confirmed
medwireNews: Addition of chemotherapy to radiotherapy significantly improves outcomes in patients with nonmetastatic nasopharyngeal carcinoma, shows a meta-analysis.
Furthermore, the most profound benefit was provided by concomitant administration of chemotherapy, say Jean Pierre Pignon (Institut Gustave-Roussy, Villejuif, France) and co-workers.
“The benefits of the addition of induction or adjuvant chemotherapy in the context of concomitant chemo-radiation still need further assessment”, they write in The Lancet Oncology.
This update of a previously published meta-analysis included 19 trials comprising 4806 patients with treatment-naïve, nonmetastatic disease who were followed-up for a median of 7.7 years.
Addition of chemotherapy to radiotherapy significantly extended overall survival (OS), with a hazard ratio (HR) of 0.79. The absolute OS benefit at 5 years was 6.3%.
The OS benefit remained in analyses that excluded trials with fewer than 100 participants and those with a median follow-up of less than 5 years, the team reports.
Chemotherapy plus radiotherapy also significantly reduced the risk of progression by 25% and the risk of cancer-related mortality by 24% compared with radiotherapy alone. And chemotherapy was not associated with an increase in non-cancer-related deaths.
Moreover, patients given chemotherapy plus radiotherapy had significantly better locoregional control and distant control, with HRs of 0.73 and 0.67, respectively, versus those treated with just radiotherapy.
When participants were stratified by the timing of chemotherapy, the improvement in OS was significant in patients who received concomitant chemotherapy, either with or without adjuvant chemotherapy, with HRs of 0.65 and 0.80, respectively, but not in those given either adjuvant or induction chemotherapy alone.
“[T]his individual patient data meta-analysis confirms the benefits associated with the addition of chemotherapy to radiotherapy in nasopharyngeal carcinoma; the greatest benefit was found in the groups with concomitant administration”, the team summarises.
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