Comparative efficacy and toxicity of two versus three induction chemotherapy cycles in locally advanced nasopharyngeal carcinoma: a propensity score matching analysis.
4 affiliations
- 1Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, Guangdong, 515031, P.R. China.
- 2Shantou University Medical College, Shantou, P.R. China.
- 3Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, Guangdong, 515031, P.R. China. [email protected].
- 4Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, Guangdong, 515031, P.R. China. [email protected].
Abstract
Background
For patients with locally advanced nasopharyngeal carcinoma (LA-NPC), the optimal number of cycles of induction chemotherapy (IC) remains uncertain. This study aimed to assess the efficiency and toxicity of different cycles of IC in LA-NPC patients.Methods
This retrospective study included 210 patients with LA-NPC and compared clinical outcomes and toxicity in two groups: 129 patients received two cycles of IC plus concurrent chemoradiotherapy (CCRT), and 81 patients received three cycles of IC plus CCRT. Propensity score matching was employed to mitigate selection bias and enhance the comparability of the two cohorts. Survival analysis was conducted using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards regression analyses.Results
Propensity score matching identified 81 matched pairs of patients. No significant differences were observed between the two-cycle and three-cycle groups regarding 5-year overall survival (OS) rates (88.1% vs. 80.4%, p = 0.21), 5-year locoregional relapse-free survival (LRRFS) rates (91.8% vs. 94.7%, p = 0.51), 5-year distant metastasis-free survival (DMFS) rates (80.9% vs. 84.8%, p = 0.55), or 5-year progression-free survival (PFS) rates (73.4% vs. 79.7%, p = 0.4). However, the three-cycle group had a greater incidence of grade 3/4 treatment-related acute toxicity, with the difference being significant during CCRT but not IC. Multivariate analysis identified stage IVa as an independent prognostic factor for OS, while LDH levels ≥ 245 U/L were independent predictors of poorer DMFS and PFS.Conclusion
For patients with LA-NPC, three cycles of IC did not significantly improve patients' survival compared to two cycles of IC but rather increased the incidence of toxicity.
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BibTeX
@article{xie2026comparative,
title = {{Comparative efficacy and toxicity of two versus three induction chemotherapy cycles in locally advanced nasopharyngeal carcinoma: a propensity score matching analysis.}},
author = {Renxian Xie and Xiaoluan Lin and Qiufeng Li and Junqing Pan and Keyan Xie and Jianzhou Chen and Ying Zhang and Chuangzhen Chen and Yizhou Zhan},
journal = {BMC cancer},
year = {2026},
month = jul,
doi = {10.1186/s12885-026-16655-2},
url = {https://europepmc.org/article/MED/42958105},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative efficacy and toxicity of two versus three induction chemotherapy cycles in locally advanced nasopharyngeal carcinoma: a propensity score matching analysis.
AU - Renxian Xie
AU - Xiaoluan Lin
AU - Qiufeng Li
AU - Junqing Pan
AU - Keyan Xie
AU - Jianzhou Chen
AU - Ying Zhang
AU - Chuangzhen Chen
AU - Yizhou Zhan
PY - 2026
DA - 2026/07/31
JO - BMC cancer
DO - 10.1186/s12885-026-16655-2
UR - https://europepmc.org/article/MED/42958105
AB - Background For patients with locally advanced nasopharyngeal carcinoma (LA-NPC), the optimal number of cycles of induction chemotherapy (IC) remains uncertain. This study aimed to assess the efficiency and toxicity of different cycles of IC in LA-NPC patients.Methods This retrospective study included 210 patients with LA-NPC and compared clinical outcomes and toxicity in two groups: 129 patients received two cycles of IC plus concurrent chemoradiotherapy (CCRT), and 81 patients received three cycles of IC plus CCRT. Propensity score matching was employed to mitigate selection bias and enhance the comparability of the two cohorts. Survival analysis was conducted using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards regression analyses.Results Propensity score matching identified 81 matched pairs of patients. No significant differences were observed between the two-cycle and three-cycle groups regarding 5-year overall survival (OS) rates (88.1% vs. 80.4%, p = 0.21), 5-year locoregional relapse-free survival (LRRFS) rates (91.8% vs. 94.7%, p = 0.51), 5-year distant metastasis-free survival (DMFS) rates (80.9% vs. 84.8%, p = 0.55), or 5-year progression-free survival (PFS) rates (73.4% vs. 79.7%, p = 0.4). However, the three-cycle group had a greater incidence of grade 3/4 treatment-related acute toxicity, with the difference being significant during CCRT but not IC. Multivariate analysis identified stage IVa as an independent prognostic factor for OS, while LDH levels ≥ 245 U/L were independent predictors of poorer DMFS and PFS.Conclusion For patients with LA-NPC, three cycles of IC did not significantly improve patients' survival compared to two cycles of IC but rather increased the incidence of toxicity.
SN - 1471-2407
ER -