First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study
Background The combined use of immune checkpoint inhibitors (ICIs) with palliative chemotherapy (PCT) is a promising first-line treatment for de novo metastatic nasopharyngeal carcinoma (mNPC). However, the efficacy of ICIs with PCT vs PCT with definitive radiation therapy (DRT) remain unclear. Meth...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-08-01
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| Series: | Cancer Control |
| Online Access: | https://doi.org/10.1177/10732748221124868 |
| _version_ | 1811187069732519936 |
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| author | Zhen-Chong Yang Ting Liu Yan-Zhou Chen Chun-Yan Guo Li-Ting Liu Sai-Lan Liu Qiu-Yan Chen Hai-Qiang Mai Shan-Shan Guo |
| author_facet | Zhen-Chong Yang Ting Liu Yan-Zhou Chen Chun-Yan Guo Li-Ting Liu Sai-Lan Liu Qiu-Yan Chen Hai-Qiang Mai Shan-Shan Guo |
| author_sort | Zhen-Chong Yang |
| collection | DOAJ |
| description | Background The combined use of immune checkpoint inhibitors (ICIs) with palliative chemotherapy (PCT) is a promising first-line treatment for de novo metastatic nasopharyngeal carcinoma (mNPC). However, the efficacy of ICIs with PCT vs PCT with definitive radiation therapy (DRT) remain unclear. Methods Patients with mNPC who received first-line immunochemotherapy (ICI + PCT) or PCT + DRT were included. Propensity score matching (PSM) was applied to balance potential confounders between patients who did and did not undergo DRT (at a ratio of 1:1). Progression free survival (PFS) and overall survival (OS) were compared between the 2 groups using a log-rank test and Cox proportional hazard model. Results Among all participants, 149 received ICI + PCT. After PSM, 149 patients were included in the PCT + DRT group. First-line immunochemotherapy was associated with significantly improved PFS (median 9.0 months vs 12.0 months, P < .001) and OS (median 12.5 months vs 19.9 months, P < .001). Subgroup analysis revealed that tumor response to immunochemotherapy, metastatic organs, and number of metastatic sites potentially affected the efficacy of DRT after first-line immunochemotherapy. Conclusion Compared with PCT + DRT, first-line immunochemotherapy was associated with improved PFS and OS in patients with mNPC but not in patients with unfavorable tumor response and metastasis involving the liver, distant nodes, or multiple sites. |
| first_indexed | 2024-04-11T13:57:00Z |
| format | Article |
| id | doaj.art-51792a83ad574c3491e8267abbac9b33 |
| institution | Directory Open Access Journal |
| issn | 1073-2748 |
| language | English |
| last_indexed | 2024-04-11T13:57:00Z |
| publishDate | 2022-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cancer Control |
| spelling | doaj.art-51792a83ad574c3491e8267abbac9b332022-12-22T04:20:15ZengSAGE PublishingCancer Control1073-27482022-08-012910.1177/10732748221124868First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort StudyZhen-Chong YangTing LiuYan-Zhou ChenChun-Yan GuoLi-Ting LiuSai-Lan LiuQiu-Yan ChenHai-Qiang MaiShan-Shan GuoBackground The combined use of immune checkpoint inhibitors (ICIs) with palliative chemotherapy (PCT) is a promising first-line treatment for de novo metastatic nasopharyngeal carcinoma (mNPC). However, the efficacy of ICIs with PCT vs PCT with definitive radiation therapy (DRT) remain unclear. Methods Patients with mNPC who received first-line immunochemotherapy (ICI + PCT) or PCT + DRT were included. Propensity score matching (PSM) was applied to balance potential confounders between patients who did and did not undergo DRT (at a ratio of 1:1). Progression free survival (PFS) and overall survival (OS) were compared between the 2 groups using a log-rank test and Cox proportional hazard model. Results Among all participants, 149 received ICI + PCT. After PSM, 149 patients were included in the PCT + DRT group. First-line immunochemotherapy was associated with significantly improved PFS (median 9.0 months vs 12.0 months, P < .001) and OS (median 12.5 months vs 19.9 months, P < .001). Subgroup analysis revealed that tumor response to immunochemotherapy, metastatic organs, and number of metastatic sites potentially affected the efficacy of DRT after first-line immunochemotherapy. Conclusion Compared with PCT + DRT, first-line immunochemotherapy was associated with improved PFS and OS in patients with mNPC but not in patients with unfavorable tumor response and metastasis involving the liver, distant nodes, or multiple sites.https://doi.org/10.1177/10732748221124868 |
| spellingShingle | Zhen-Chong Yang Ting Liu Yan-Zhou Chen Chun-Yan Guo Li-Ting Liu Sai-Lan Liu Qiu-Yan Chen Hai-Qiang Mai Shan-Shan Guo First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study Cancer Control |
| title | First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study |
| title_full | First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study |
| title_fullStr | First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study |
| title_full_unstemmed | First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study |
| title_short | First-Line Immunochemotherapy Versus Palliative Chemotherapy Plus Definitive Radiation Therapy for Metastatic Nasopharyngeal Carcinoma: A Matched Cohort Study |
| title_sort | first line immunochemotherapy versus palliative chemotherapy plus definitive radiation therapy for metastatic nasopharyngeal carcinoma a matched cohort study |
| url | https://doi.org/10.1177/10732748221124868 |
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