ESTRO 2024 - Abstract Book

S1365

Clinical - Head & neck

ESTRO 2024

2019

Digital Poster

The Impact of Concurrent Chemotherapy on Stage II Nasopharyngeal Carcinoma

Melek Tugce Yilmaz 1 , Alper Kahvecioglu 1 , Sepideh Mohammadipour 1 , Mustafa Cengiz 1 , Ibrahim Gullu 2 , Sercan Aksoy 2 , Gokhan Ozyigit 1 , Gozde Yazici 1

1 Hacettepe University, Radiation Oncology, Ankara, Turkey. 2 Hacettepe University, Medical Oncology, Ankara, Turkey

Purpose/Objective:

For patients with early-stage nasopharyngeal carcinoma (NPC), the standard treatment approach is definitive radiotherapy (RT). Although the role of concurrent chemotherapy (CHT) is unclear for patients with stage II disease, it may be considered for high-risk features such as lymph node metastasis, bulky tumor volume, and a high serum EBV-DNA copy number. In this study, we aimed to evaluate the role of concurrent CHT in patients with stage II NPC.

Material/Methods:

The medical records of 85 patients with AJCC 8th stage II NPC treated with either definitive RT alone or definitive concurrent chemoradiotherapy (CRT) between 1994 and 2021 were retrospectively evaluated. None of the patients received induction or adjuvant CHT. We utilized SPSS version 25.0 (IBM, Armonk, NY, USA) for all statistical analyses.

Results:

The median age was 50 years (range, 17-74 years). Fifty-nine patients (69%) were male, and 26 (31%) were female. According to the AJCC 8th stage classification, 52 (61%) patients had T1N1M0, 16 (19%) had T2N0M0, and 17 (20%) had T2N1M0 disease. Thirty-two patients (38%) were treated with definitive RT alone, and 53 patients (62%) received CRT. Baseline patient, tumor, and treatment characteristics are summarized in Table 1. Characteristics were well balanced between treatment groups, except for the presence of lymph node metastasis. The median follow-up was 83 months (range, 11-329 months). The five-year rates of overall (OS), local regional recurrence-free (LRRFS), and distant metastasis- free survival (DMFS) were 81%, 77%, and 77%, respectively. In univariate analysis, age (≤50 years) was prognostic for both OS and LRRFS (see Table 2). The female gender was associated with improved LRRFS and DMFS. The addition of concurrent CHT had no effect on any of the survival rates (Figure 1). In multivariate analysis, age was the only independent prognostic factor for OS (hazard ratio [HR]: 2.2, 95% confidence interval [CI]: 1-4.9, p=0.03). In subgroup analyses, no benefit of concurrent CHT was detected at any stage, such as T1-2N0 and T1-2N1.

Figure 1. Kaplan-Meier Survival Curve for overall survival according to the treatment group