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Research Article
Gang Peng
Wuhan Union Hospital
Corresponding Author
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Background: Induction chemotherapy (IC) was associated with a decreased risk of distant metastasis in locally advanced nasopharyngeal carcinoma (LA-NPC). However, compared with TPF, whether the TP regimen can reduce the related toxicities caused by 5-FU while ensuring the survival benefit remains unclear.
Methods: 213 patients diagnosed with LA-NPC (stage III-IVA) were included retrospectively. The prognosis of TPF and TP was compared by Kaplan-Meier and Cox proportional hazard regression. The treatment-related toxicities were evaluated according to CTCAE v4.0 and RTOG criteria.
Results: TPF was found to have a higher 5-year DMFS in stage IVA and N2-3 patients, which not applicable to stage III and N0-1. The optimal value of pre-treatment SII was 432.48. A further subgroup analysis revealed that patients in stage IVA combined with pretreatment SII≥432.48 could get higher OS (P=0.038) and DMFS (P=0.028) from TPF. Multivariate analysis showed that SII was a prognostic factor for PFS (HR 2.801, P=0.018) and DMFS (HR 3.735, P=0.032), and IC regimen (HR 2.182, P=0.049) for predicting DMFS. The rate of grade 3-4 leukopenia (P=0.038), neutropenia (P=0.021), radiation oral mucositis (P=0.048) and diarrhea (P=0.036) were more common in TPF group.
Conclusion: Our study revealed that TPF regimen showed a higher 5-year DMFS for stage IVA and N2-3 patients, while TP may be enough for stage III and N0-1. In LA-NPC patients with high risk (stage IVA combined with pre-treatment SII ≥ 432.48), TPF had a higher 5-year OS and DMFS, although grade 3-4 toxicities were more common but tolerable.
Keywords
locally advanced nasopharyngeal carcinoma, induction chemotherapy, systemic immune-inflammation index, prognosis, toxicity
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Gang Peng
Wuhan Union Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 07 May, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Induction chemotherapy (IC) was associated with a decreased risk of distant metastasis in locally advanced nasopharyngeal carcinoma (LA-NPC). However, compared with TPF, whether the TP regimen can reduce the related toxicities caused by 5-FU while ensuring the survival benefit remains unclear.
Methods: 213 patients diagnosed with LA-NPC (stage III-IVA) were included retrospectively. The prognosis of TPF and TP was compared by Kaplan-Meier and Cox proportional hazard regression. The treatment-related toxicities were evaluated according to CTCAE v4.0 and RTOG criteria.
Results: TPF was found to have a higher 5-year DMFS in stage IVA and N2-3 patients, which not applicable to stage III and N0-1. The optimal value of pre-treatment SII was 432.48. A further subgroup analysis revealed that patients in stage IVA combined with pretreatment SII≥432.48 could get higher OS (P=0.038) and DMFS (P=0.028) from TPF. Multivariate analysis showed that SII was a prognostic factor for PFS (HR 2.801, P=0.018) and DMFS (HR 3.735, P=0.032), and IC regimen (HR 2.182, P=0.049) for predicting DMFS. The rate of grade 3-4 leukopenia (P=0.038), neutropenia (P=0.021), radiation oral mucositis (P=0.048) and diarrhea (P=0.036) were more common in TPF group.
Conclusion: Our study revealed that TPF regimen showed a higher 5-year DMFS for stage IVA and N2-3 patients, while TP may be enough for stage III and N0-1. In LA-NPC patients with high risk (stage IVA combined with pre-treatment SII ≥ 432.48), TPF had a higher 5-year OS and DMFS, although grade 3-4 toxicities were more common but tolerable.
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
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