Advanced T Stage is the Sole Determining Factor of
Survival in Patients with Nasopharyngeal Carcinoma:
The Outcomes of the Multi-Modality Management
Chanyoot Bandidwattanawong MD¹, Porrawee Pramotesiri MD¹
Affiliation :
¹ Department of Internal Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Background : Thailand is an endemic area of nasopharyngeal carcinoma (NPC). Multi-modality treatment results in significant improvement in
survivals.
Objective : The overall survival (OS) of patients with early and locally-advanced (E and LA, stage I-IVa and IVb) diseases was the primary objective.
Materials and Methods : The present study was a retrospective cohort study of patients with NPC treated at Vajira Hospital between 2013 and 2016. Baseline characteristics including age, gender, histopathology, staging, modality of treatment, time to radiotherapy completion, serious adverse events, treatment responses, patterns of recurrence, and metastasis were collected.
Results : One hundred patients with mostly undifferentiated histology that presented with LA disease were included in this study. Stage III, IVa, and IVb accounted for 28%, 18%, and 22%, respectively. After median follow-up of 41.1 months, the median OS of patients E/LA diseases (stage I, II, III, IVa, and IVb) was not reached. Neither induction chemotherapy (IC) nor adjuvant chemotherapy (AC) was associated with superior disease- free survival (DFS) compared to definitive concurrent chemoradiotherapy (CRT) alone across all stage subgroups. Only T3 and T4 disease were significantly related to worse OS.
Conclusion : With the standard CCRT, patients with E and LA diseases had excellent survival outcomes compared to the results from international studies.
Received 25 May 2020 | Revised 4 August 2020 | Accepted 7 August 2020
doi.org/10.35755/jmedassocthai.2021.01.11451
Keywords :
Nasopharyngeal carcinoma, Multi-modality treatment, Outcomes, Real-life practice
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