Induction Chemotherapy Followed by Concurrent Chemoradiotherapy in Filipinos With Locally Advanced Nasopharyngeal Carcinoma: A Cancer Institute Experience in a University Hospital
Reiner John S. Villafuerte, Eugenio V. Regala
Jan 2020 DOI 10.35460/2546-1621.2019-0042 Access
Purpose: The objectives of this study is to report the oncologic outcomes and safety and tolerability of induction chemotherapy in locally advanced nasopharyngeal carcinoma treated at our institution – The Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
Patients and Methods: Thirty-eight patients who underwent induction chemotherapy prior to concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma at our institution were retrospectively reviewed. Of these, 14 patients were excluded (5 patients had M1 disease at diagnosis, 5 patients received induction chemotherapy (IC) for recurrent disease, 4 patients had incomplete medical records) and 24 patients were included in the final outcomes and safety analysis.
Results: With a median follow-up of 39 months, the median overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFFS) and distant failure-free survival (DFFS) were not reached. The 3-year OS, PFS, LRFFS, and DFFS rates were 60.75%, 57.93%, 52.96%, and 80.67% respectively. In terms of safety, the most common adverse event reported were anemia, nausea/vomiting, and mucositis with very few reported adverse events of neutropenia (4.2% all grades) and no reported case of febrile neutropenia. In terms of tolerability, 87.5% were able to complete three or more cycles of induction chemotherapy and 70.8% completed at least two cycles of cisplatin concurrent with radiotherapy.
Conclusion: In this cohort of Filipinos with locally advanced nasopharyngeal carcinoma, induction chemotherapy strategy appears to be safe and tolerable. Oncologic outcomes were less favorable compared to the published report possibly due to very advanced disease, less use of taxane-containing regimen in this cohort, less use of advanced radiotherapy (RT) technique such as IMRT, and small sample size.
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