Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study

doi:10.1186/s12935-021-02281-4

	Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study
	Jin, Ya-Nan 2; Qiang, Meng-Yun 3; Liu, Meng-Meng 4; Cheng, Zhi-Bin 5; Zhang, Wang-Jian 1; Ryan, Ian 6; Marks, Tia 6; Yao, Ji-Jin 5; Xia, Liang-Ping 2
刊名	CANCER CELL INTERNATIONAL
	2021-11-12
卷号	21
关键词	Nasopharyngeal carcinoma Cumulative cisplatin dose Children and adolescents Tumor response Neoadjuvant chemotherapy
DOI	10.1186/s12935-021-02281-4
通讯作者	Yao, Ji-Jin(yaojj23@mail.sysu.edu.cn) ; Xia, Liang-Ping(xialp@sysucc.org.cn)
英文摘要	Background We aimed to comprehensively investigate the optimal cumulative cisplatin dose during concurrent chemoradiotherapy (CC-CCD) for locoregionally advanced nasopharyngeal carcinoma (CA-LANPC) with different tumor responses after neoadjuvant chemotherapy (NAC). Methods Patients with CA-LANPC who underwent NAC followed by cisplatin-based concurrent chemoradiotherapy were retrospectively analyzed. Evaluation of tumor response in patients was conducted by Response Evaluation Criteria for Solid Tumor (RECIST) 1.1 after two to four cycles NAC. Multivariate Cox proportional hazards models were used for prognosis. Recursive partitioning analysis (RPA) was conducted to classify participates and predict disease-free survival (DFS). Results One hundred and thirty-two patients with favorable response after NAC were included. The median CC-CCD was 163 mg/m(2) (IQR, 145-194 mg/m(2)), and 160 mg/m(2) was selected as the cutoff point to group patients into low and high CC-CCD groups (< 160 vs. >= 160 mg/m(2)). There was significant improvement in 5-year DFS (91.2% vs. 72.6%; P = 0.003) for patients receiving high CC-CCD compared to those receiving low CC-CCD. Multivariate analysis revealed that CC-CCD, T stage, and Epstein-Barr virus (EBV) DNA were independent prognostic factors for DFS (P < 0.05 for all). Patients were further categorized into two prognostic groups by RPA: the low-risk group (T1-3 disease with regardless of EBV DNA, and T4 disease with EBV DNA < 4000 copy/mL), and the high-risk group (T4 disease with EBV DNA >= 4000 copy/mL). Significant 5-year DFS improvement was observed for the high-risk group (P = 0.004) with high CC-CCD. However, DFS improvement was relatively insignificant in the low-risk group (P = 0.073). Conclusions CC-CCD was a positive prognostic factor for responders after NAC in CA-LANPC. Furthermore, CC-CCD >= 160 mg/m(2) could significantly improve DFS in the high-risk group with CA-LANPC, but the benefit of high CC-CCD in the low-risk group needs further study.
资助项目	National Natural Science Foundation of China[81901699] ; National Natural Science Foundation of China[81773051] ; Health and Medical Collaborative Innovation Project of Guangzhou City, China[201803040003] ; Guangdong Medical Science and Technology Research Fund[C2018063]
WOS关键词	CONCURRENT CHEMORADIOTHERAPY ; PROGNOSTIC VALUE ; CHILDREN ; MULTICENTER ; DOCETAXEL ; FEATURES ; OUTCOMES ; TUMORS
WOS研究方向	Oncology
语种	英语
出版者	BMC
WOS记录号	WOS:000717990700001
资助机构	National Natural Science Foundation of China ; Health and Medical Collaborative Innovation Project of Guangzhou City, China ; Guangdong Medical Science and Technology Research Fund
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/126570]
专题	中国科学院合肥物质科学研究院
通讯作者	Yao, Ji-Jin; Xia, Liang-Ping
作者单位	1.Sun Yat Sen Univ, Sch Publ Hlth, Dept Med Stat, Guangzhou 510080, Guangdong, Peoples R China 2.Sun Yat Sen Univ Canc Ctr, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,VIP Reg, Guangdong Key Lab Nasopharyngeal Carcinoma Diag &, Guangzhou 510060, Guangdong, Peoples R China 3.Chinese Acad Sci, Canc Hosp, Inst Basic Med & Canc IBMC,Univ Chinese Acad Sci, Dept Head & Neck Radiotherapy,Zhejiang Canc Hosp, Hangzhou 310022, Zhejiang, Peoples R China 4.Sun Yat Sen Univ Canc Ctr, Collaborat Innovat Ctr Canc Med, Melanoma & Sarcoma Med Oncol Unit, State Key Lab Oncol South China, 651 Dongfeng Rd East, Guangzhou 510060, Guangdong, Peoples R China 5.Sun Yat Sen Univ, Canc Ctr, Affiliated Hosp 5, Guangdong Prov Key Lab Biomed Imaging, Zhuhai 519000, Guangdong, Peoples R China 6.SUNY Albany, Sch Publ Hlth, Dept Environm Hlth Sci, Rensselaer, NY 12144 USA
推荐引用方式 GB/T 7714	Jin, Ya-Nan,Qiang, Meng-Yun,Liu, Meng-Meng,et al. Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study[J]. CANCER CELL INTERNATIONAL,2021,21.
APA	Jin, Ya-Nan.,Qiang, Meng-Yun.,Liu, Meng-Meng.,Cheng, Zhi-Bin.,Zhang, Wang-Jian.,...&Xia, Liang-Ping.(2021).Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study.CANCER CELL INTERNATIONAL,21.
MLA	Jin, Ya-Nan,et al."Impact of cumulative cisplatin dose in childhood nasopharyngeal carcinoma based on neoadjuvant chemotherapy response in the intensity-modulated radiotherapy era: a real-world study".CANCER CELL INTERNATIONAL 21(2021).