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The Cumulative Cisplatin Dose Affects the Long-Term Survival Outcomes of Patients with Nasopharyngeal Carcinoma Receiving Concurrent Chemoradiotherapy.

Peng H, Chen L, Li WF, Guo R, Mao YP, Zhang Y, Zhang F, Liu LZ, Tian L, Lin AH, Sun Y, Ma J - Sci Rep (2016)

Bottom Line: Patient survival between different CCD groups were compared.For the whole cohort, multivariate analysis identified the CCD was an independent prognostic factor for DFS (HR, 0.515; 95% CI, 0.267-0.995; P = 0.048).However, CCD (≥ 240 mg/m(2)) had no prognostic value in subgroup analysis with stratification by the cut-off value of pre-DNA (P > 0.05 for all rates).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China.

ABSTRACT
The prognostic value of the cumulative cisplatin dose (CCD) remains controversial for patients with nasopharyngeal carcinoma (NPC) receiving only concurrent chemoradiotherapy (CCRT). We retrospectively reviewed 549 consecutive patients with non-metastatic, histologically-proven NPC treated using intensity-modulated radiotherapy (IMRT) at Sun Yat-sen university cancer center. Patient survival between different CCD groups were compared. The cut-off value of pre-treatment plasma EBV DNA (pre-DNA) and CCD based on disease-free survival (DFS) were 1460 copies/ml (AUC, 0.691; sensitivity, 0.717; specificity, 0.635) and 240 mg/m(2) (AUC, 0.506; sensitivity, 0.526; specificity, 0.538), respectively. Of the entire cohort, 92/549 (16.8%) patients received a CCD ≥ 240 mg/m(2) and 457 (83.2%) patients, < 240 mg/m(2). For CCD ≥ 240 mg/m(2) vs. < 240 mg/m(2), the estimated 4-year DFS, overall survival (OS), locoregional-free survival (LRFFS) and distant metastasis-free survival (DMFS) rates were 89.1% vs. 81.3% (P = 0.097), 92.4% vs. 90.0% (P = 0.369), 95.6% vs. 91.2% (P = 0.156), and 91.3% vs. 88.4% (P = 0.375), respectively. For the whole cohort, multivariate analysis identified the CCD was an independent prognostic factor for DFS (HR, 0.515; 95% CI, 0.267-0.995; P = 0.048). However, CCD (≥ 240 mg/m(2)) had no prognostic value in subgroup analysis with stratification by the cut-off value of pre-DNA (P > 0.05 for all rates).

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier DFS (A), OS (B), LRRFS (C) and DMFS (D) curves for NPC patients with pre-DNA < 1460 copies/ml stratified as the cumulative cisplatin dose <240 mg/m2 and ≥240 mg/m2 group. Abbreviations: Pre-DNA = pre-treatment EBV DNA; DFS = disease-free survival; OS = overall survival; LRRFS = local-regional relapse-free survival; DMFS = distant metastasis-free survival.
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f2: Kaplan-Meier DFS (A), OS (B), LRRFS (C) and DMFS (D) curves for NPC patients with pre-DNA < 1460 copies/ml stratified as the cumulative cisplatin dose <240 mg/m2 and ≥240 mg/m2 group. Abbreviations: Pre-DNA = pre-treatment EBV DNA; DFS = disease-free survival; OS = overall survival; LRRFS = local-regional relapse-free survival; DMFS = distant metastasis-free survival.

Mentions: Among the 285/500 (57%) patients with pre-DNA < 1460 copies/ml, the median CCD was 160 mg/m2 (range, 25–300 mg/m2). Estimated 4-year DFS, OS, LRRFS, and DMFS rates for patients with a CCD ≥ 240 mg/m2 vs. < 240 mg/m2 were 95.8% vs. 90.6% (P = 0.203, Fig. 2A), 95.8% vs. 95.6% (P = 0.78, Fig. 2B), 97.9% vs. 93.9% (P = 0.253, Fig. 2C), and 95.8% vs. 95.5% (P = 0.828, Fig. 2D), respectively. Multivariate analysis indicated CCD was not an independent prognostic factor for DFS (HR, 0.405; 95% CI, 0.096–1.712; P = 0.219), OS (HR, 0.867; 95% CI, 0.194–3.878; P = 0.852), LRRFS (HR, 0.326; 95% CI, 0.043–2.467; P = 0.278) or DMFS (HR, 0.927; 95% CI, 0.205–4.190; P = 0.921) for patients with pre-DNA < 1460 copies/ml.


The Cumulative Cisplatin Dose Affects the Long-Term Survival Outcomes of Patients with Nasopharyngeal Carcinoma Receiving Concurrent Chemoradiotherapy.

Peng H, Chen L, Li WF, Guo R, Mao YP, Zhang Y, Zhang F, Liu LZ, Tian L, Lin AH, Sun Y, Ma J - Sci Rep (2016)

Kaplan-Meier DFS (A), OS (B), LRRFS (C) and DMFS (D) curves for NPC patients with pre-DNA < 1460 copies/ml stratified as the cumulative cisplatin dose <240 mg/m2 and ≥240 mg/m2 group. Abbreviations: Pre-DNA = pre-treatment EBV DNA; DFS = disease-free survival; OS = overall survival; LRRFS = local-regional relapse-free survival; DMFS = distant metastasis-free survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4829825&req=5

f2: Kaplan-Meier DFS (A), OS (B), LRRFS (C) and DMFS (D) curves for NPC patients with pre-DNA < 1460 copies/ml stratified as the cumulative cisplatin dose <240 mg/m2 and ≥240 mg/m2 group. Abbreviations: Pre-DNA = pre-treatment EBV DNA; DFS = disease-free survival; OS = overall survival; LRRFS = local-regional relapse-free survival; DMFS = distant metastasis-free survival.
Mentions: Among the 285/500 (57%) patients with pre-DNA < 1460 copies/ml, the median CCD was 160 mg/m2 (range, 25–300 mg/m2). Estimated 4-year DFS, OS, LRRFS, and DMFS rates for patients with a CCD ≥ 240 mg/m2 vs. < 240 mg/m2 were 95.8% vs. 90.6% (P = 0.203, Fig. 2A), 95.8% vs. 95.6% (P = 0.78, Fig. 2B), 97.9% vs. 93.9% (P = 0.253, Fig. 2C), and 95.8% vs. 95.5% (P = 0.828, Fig. 2D), respectively. Multivariate analysis indicated CCD was not an independent prognostic factor for DFS (HR, 0.405; 95% CI, 0.096–1.712; P = 0.219), OS (HR, 0.867; 95% CI, 0.194–3.878; P = 0.852), LRRFS (HR, 0.326; 95% CI, 0.043–2.467; P = 0.278) or DMFS (HR, 0.927; 95% CI, 0.205–4.190; P = 0.921) for patients with pre-DNA < 1460 copies/ml.

Bottom Line: Patient survival between different CCD groups were compared.For the whole cohort, multivariate analysis identified the CCD was an independent prognostic factor for DFS (HR, 0.515; 95% CI, 0.267-0.995; P = 0.048).However, CCD (≥ 240 mg/m(2)) had no prognostic value in subgroup analysis with stratification by the cut-off value of pre-DNA (P > 0.05 for all rates).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, People's Republic of China.

ABSTRACT
The prognostic value of the cumulative cisplatin dose (CCD) remains controversial for patients with nasopharyngeal carcinoma (NPC) receiving only concurrent chemoradiotherapy (CCRT). We retrospectively reviewed 549 consecutive patients with non-metastatic, histologically-proven NPC treated using intensity-modulated radiotherapy (IMRT) at Sun Yat-sen university cancer center. Patient survival between different CCD groups were compared. The cut-off value of pre-treatment plasma EBV DNA (pre-DNA) and CCD based on disease-free survival (DFS) were 1460 copies/ml (AUC, 0.691; sensitivity, 0.717; specificity, 0.635) and 240 mg/m(2) (AUC, 0.506; sensitivity, 0.526; specificity, 0.538), respectively. Of the entire cohort, 92/549 (16.8%) patients received a CCD ≥ 240 mg/m(2) and 457 (83.2%) patients, < 240 mg/m(2). For CCD ≥ 240 mg/m(2) vs. < 240 mg/m(2), the estimated 4-year DFS, overall survival (OS), locoregional-free survival (LRFFS) and distant metastasis-free survival (DMFS) rates were 89.1% vs. 81.3% (P = 0.097), 92.4% vs. 90.0% (P = 0.369), 95.6% vs. 91.2% (P = 0.156), and 91.3% vs. 88.4% (P = 0.375), respectively. For the whole cohort, multivariate analysis identified the CCD was an independent prognostic factor for DFS (HR, 0.515; 95% CI, 0.267-0.995; P = 0.048). However, CCD (≥ 240 mg/m(2)) had no prognostic value in subgroup analysis with stratification by the cut-off value of pre-DNA (P > 0.05 for all rates).

No MeSH data available.


Related in: MedlinePlus