Impact of three to four cycles of neoadjuvant chemotherapy on survival of patients with N2-N3 nasopharyngeal carcinoma
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.issn.1004-4221.2017.04.003
   		
        
        	
        		- VernacularTitle:3~4周期NACT对N2-N3期鼻咽癌临床价值分析
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jiawang WEI
			        		
			        		;
		        		
		        		
		        		
			        		Rong HUANG
			        		
			        		;
		        		
		        		
		        		
			        		Xin YU
			        		
			        		;
		        		
		        		
		        		
			        		Qiaoxuan WANG
			        		
			        		;
		        		
		        		
		        		
			        		Weiwei XIAO
			        		
			        		;
		        		
		        		
		        		
			        		Lixia LU
			        		
			        		;
		        		
		        		
		        		
			        		Yuanhong GAO
			        		
			        		;
		        		
		        		
		        		
			        		Hui CHANG
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Nasopharyngeal neoplasms/neoadjuvent chemotherapy;
			        		
			        		
			        		
				        		Prognosis
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Radiation Oncology
	            		
	            		 2017;26(4):380-383
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	Objective To evaluate the impact of three to four cycles of neoadjuvant chemotherapy (NACT) on the survival of patients with N2-N3 nasopharyngeal carcinoma (NPC).Methods The clinical data of 915 patients with T1-4N2-3M0 NPC from 2007 to 2010 were retrospectively analyzed.A total of 179 patients treated with 3-4 cycles of NACT (NACT≥3 group) were matched with 358 patients treated with 2 cycles of NACT (NACT=2 group) and 179 patients treated without NACT (NACT =0 group,concurrent chemoradiotherapy group) for age,N stage,pathological subtype,and NACT regimen.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),recurrence-free survival (RFS),and distant metastasis-free survival (DMFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox proportional hazards model was used for multivariate prognostic analysis.Results For the NACT≥ 3,NACT =2,and NACT =0 groups,the 5-year OS rates were 89.4%,81.6%,and 73.7%,respectively (P=O.000),the 5-year DFS rates were 83.2%,69.8%,and 64.2%,respectively (P=O.000),the 5-year RFS rates were 86.0%,76.0%,and 69.3%,respectively (P=0.001),and the 5-year DMFS rates were 86.6%,76.0%,and 68.3%,respectively (P=0.000).Three to four cycles of NACT was an independent protective factor for OS,DFS,RFS,and DMFS in patients with N2-N3 NPC.Conclusion Three to four cycles of NACT can significantly improve the survival of patients with N2-N3 NPC.