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Original Article | Open Access

Effect of radiotherapy and chemotherapy on the survival rate of Asian Americans with nasopharyngeal carcinoma

Allen M. Chen1 ( )Lihong Qi2Rosemary D. Cress2,3Yueju Li2Laurel Beckett2Baoqing Li4
Department of Radiation Oncology, University of California, Irvine, School of Medicine, Orange, California, USA
Department of Public Health Sciences, University of California Davis, Davis, California, USA
Cancer Registry of Greater California, Public Health Institute, Sacramento, California, USA
Department of Radiation Oncology, Weill Cornell Medical College, New York, New York, USA
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Abstract

Objective

To evaluate how the addition of concurrent chemotherapy to radiation therapy (RT) affects outcomes for Asian American patients with nasopharyngeal carcinoma.

Methods

Using the California Cancer Registry – a population-based, state-sponsored database – Asian American patients with newly-diagnosed, locally advanced nasopharyngeal carcinoma diagnosed between 1998 and 2010 were identified. The Kaplan–Meier method was used to analyze overall survival and cancer-specific survival. Cox proportional hazards models were constructed to investigate the association with chemotherapy. Propensity score methods were used to control for measure confounders.

Results

A total of 812 Asian Americans were included; 91 (11.2%) underwent RT alone, and 721 (88.8%) underwent RT with chemotherapy. The overall survival at 5 years was 65% with RT alone versus 72% with RT plus chemotherapy (p = 0.31). The corresponding rates of cancer-specific survival were 70% and 78% (p = 0.35). Cox regression analysis confirmed a trend toward reduced mortality (HR 0.88, 95% CI 0.62–1.25, p = 0.37) in patients receiving RT and chemotherapy.

Conclusion

Consistent with other studies that have been published, the addition of chemotherapy to RT was associated with improved clinical outcomes. Although this improvement did not reach statistical significance, the use of concurrent chemoradiation seems reasonable for Asian Americans with nasopharyngeal carcinoma.

References

1

Chang ET, Adami HO. The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev. 2006; 15: 1765-1777.

2

Yu WM, Hussain SS. Incidence of nasopharyngeal carcinoma in Chinese immigrants, compared with Chinese in China and South East Asia: review. J Laryngol Otol. 2009; 123: 1067-1074.

3

Lee AW, Tung SY, Chua DT, et al. Randomized trial of radiotherapy plus concurrent-adjuvant chemotherapy vs radiotherapy alone for regionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 2010; 102: 1188-1198.

4

Al-Sarraf M, LeBlanc M, Giri PG, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase Ⅲ randomized Intergroup study 0099. J Clin Oncol. 1998; 16: 1310-1317.

5

Lee AW, Lau WH, Tung SY, et al. Hong Kong Nasopharyngeal Cancer Study Group. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol. 2005; 23: 6966-6975.

6

Lee AW, Tung SY, Chan AT, et al. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006; 1: 142-151.

7

Chen Y, Liu MZ, Liang SB, et al. Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of China. Int J Radiat Oncol Biol Phys. 2008; 71: 1356-1364.

8

Chan AT, Leung SF, Ngan RK, et al. Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 2005; 97: 536-539.

9

Kwong DL, Sham JS, Au GK, et al. Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: a factorial study. J Clin Oncol. 2004; 22: 2643-2653.

10

Lin JC, Jan JS, Hsu CY, et al. Phase Ⅲ study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 2003; 21: 631-637.

11

Lin JC, Liang WM, Jan JS, et al. Another way to estimate outcome of advanced nasopharyngeal carcinoma – is concurrent chemoradiotherapy adequate? Int J Radiat Oncol Biol Phys. 2004; 60: 156-164.

12

Wee J, Tan EH, Tai BC, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage Ⅲ and Ⅳ nasopharyngeal cancer of the endemic variety. J Clin Oncol. 2005; 23: 6730-6738.

13

Wee J. Nasopharyngeal cancer workgroup – the past, the present and the future. Ann Acad Med Singapore. 2008; 37: 606-614.

14

Hoppe RT, Williams J, Warnke R, et al. Carcinoma of the nasopharynx– the significance of histology. Int J Radiat Oncol Biol Phys. 1978; 4: 199-205.

15

Su CK, Wang CC. Prognostic value of Chinese race in nasopharyngeal cancer. Int J Radiat Oncol Biol Phys. 2002; 54: 752-758.

16

Blanchard P, Lee A, Marquet S, et al. Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol. 2015; 16: 645-655.

17

Lee N, Xia P, Quivey JM, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys. 2002; 53: 12-22.

18

Kam MK, Teo PM, Chau RM, et al. Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys. 2004; 60: 1440-1450.

19

International Nasopharynx Cancer Study Group. Preliminary results of a randomized trial comparing neoadjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy vs. radiotherapy alone in stage Ⅳ(>or = N2, M0) undifferentiated nasopharyngeal carcinoma: a positive effect on progression-free survival. VUMCA Ⅰ trial. Int J Radiat Oncol Biol Phys. 1996; 35: 463-469.

20

Chua DT, Sham JS, Choy D, et al. Preliminary report of the Asian-Oceanian Clinical Oncology Association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Asian-Oceanian Clinical Oncology Association Nasopharynx Cancer Study Group. Cancer. 1998; 83: 2270-2283.

21

Rossi A, Molinari R, Boracchi P, et al. Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study. J Clin Oncol. 1988; 6: 1401-1410.

22

Chan AT, Teo PM, Leung TW, et al. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1995; 33: 569-5677.

23

Du CR, Ying HM, Kong FF, et al. Concurrent chemoradiotherapy was associated with a higher severe late toxicity rate in nasopharyngeal carcinoma patients compared with radiotherapy alone: a meta-analysis based on randomized controlled trials. Radiat Oncol. 2015; 10: 70.

24

Peng G, Wang T, Zhang S, et al. A prospective randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol. 2012; 104: 286-293.

25

Zhang B, Mo Z, Du W, et al. Intensity-modulated radiation therapy versus 2D-RT or 3D-CRT for the treatment of nasopharyngeal carcinoma: a systematic review and meta-analysis. Oral Oncol. 2015; 51: 1041-1046.

26

Mazurek AM, Wygoda A, Rutkowski T, et al. Prognostic significance of Epstein-barr virus viral load in patients with T1-T2 nasopharyngeal cancer. J Med Virol. 2020; 92: 348-355.

27

Sun XS, Li SY, Xiao BB, et al. Establishment and validation of a nomogram for predicting the benefit of concurrent chemotherapy in stage Ⅱ nasopharyngeal carcinoma: a study based on a phase Ⅲ randomized clinical trial with 10-year follow-up. Oral Oncol. 2020; 100:104490.

28

Zhang LL, Xu, F, Song D, et al. Development of a nomogram modal for treatment of nonmetastatic nasopharyngeal carcinoma. JAMA Netw Open. 2020; 3:e2029882.

29

Yip PL, Lee SF, Choi CH, et al. External validation of a nomogram to predict survival and benefit of concurrent chemoradiation for stage Ⅱ nasopharyngeal carcinoma. Cancers (Basel). 2021; 13: 4286.

Precision Radiation Oncology
Pages 157-163
Cite this article:
Chen AM, Qi L, Cress RD, et al. Effect of radiotherapy and chemotherapy on the survival rate of Asian Americans with nasopharyngeal carcinoma. Precision Radiation Oncology, 2022, 6(2): 157-163. https://doi.org/10.1002/pro6.1154

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Received: 04 March 2022
Revised: 11 April 2022
Accepted: 19 April 2022
Published: 08 May 2022
© 2022 The Authors. Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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