Patterns of care and outcomes with the addition of chemotherapy to radiation therapy for stage I nasopharyngeal cancer

Vivek Verma, Jeffrey M. Ryckman, Charles B. Simone, Chi Lin

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: The standard of care for stage I (T1N0) nasopharyngeal cancer (NPC) is definitive radiotherapy (RT). Given the phase III evidence supporting combined chemoradiotherapy (CRT) for stage II NPC, we investigated practice patterns and outcomes associated with administration of chemotherapy to RT alone for stage I NPC. Methods: The National Cancer Data Base (NCDB) was queried for clinical T1N0 primary NPC cases (2004–2013) receiving curative-intent RT. Patients with unknown RT/chemotherapy status were excluded, as were benign/sarcomatous histologies and receipt of pharyngectomy. Patient, tumor, and treatment parameters were extracted. Logistic regression analysis ascertained factors associated with receipt of additional chemotherapy. Kaplan–Meier analysis was used to evaluate overall survival (OS) between patients receiving RT versus CRT. Cox proportional hazards modeling determined variables associated with receipt of OS. Results: In total, 396 patients were analyzed. Chemotherapy was delivered in 147 patients (37%). On multivariate analysis, patients treated at academic/integrated centers were less likely to receive chemotherapy (p =.008); a racial predilection was noted, as non-black/non-white patients were also less likely to receive chemotherapy (p =.006). Respective 5-year OS in patients receiving RT alone versus CRT were 77% and 75% (p =.428). Receipt of chemotherapy did not independently predict for greater OS (p =.447). Conclusions: These data do not support the routine addition of chemotherapy to definitive RT for T1N0 NPC.

Original languageEnglish (US)
Pages (from-to)257-261
Number of pages5
JournalActa Oncologica
Volume57
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Nasopharyngeal Neoplasms
Radiotherapy
Drug Therapy
Chemoradiotherapy
Survival
Pharyngectomy
Standard of Care
Neoplasms
Histology
Multivariate Analysis
Logistic Models
Regression Analysis
Databases

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Patterns of care and outcomes with the addition of chemotherapy to radiation therapy for stage I nasopharyngeal cancer. / Verma, Vivek; Ryckman, Jeffrey M.; Simone, Charles B.; Lin, Chi.

In: Acta Oncologica, Vol. 57, No. 2, 01.02.2018, p. 257-261.

Research output: Contribution to journalArticle

Verma, Vivek ; Ryckman, Jeffrey M. ; Simone, Charles B. ; Lin, Chi. / Patterns of care and outcomes with the addition of chemotherapy to radiation therapy for stage I nasopharyngeal cancer. In: Acta Oncologica. 2018 ; Vol. 57, No. 2. pp. 257-261.
@article{7c42eb6cf08746f7a642f513d930025b,
title = "Patterns of care and outcomes with the addition of chemotherapy to radiation therapy for stage I nasopharyngeal cancer",
abstract = "Purpose: The standard of care for stage I (T1N0) nasopharyngeal cancer (NPC) is definitive radiotherapy (RT). Given the phase III evidence supporting combined chemoradiotherapy (CRT) for stage II NPC, we investigated practice patterns and outcomes associated with administration of chemotherapy to RT alone for stage I NPC. Methods: The National Cancer Data Base (NCDB) was queried for clinical T1N0 primary NPC cases (2004–2013) receiving curative-intent RT. Patients with unknown RT/chemotherapy status were excluded, as were benign/sarcomatous histologies and receipt of pharyngectomy. Patient, tumor, and treatment parameters were extracted. Logistic regression analysis ascertained factors associated with receipt of additional chemotherapy. Kaplan–Meier analysis was used to evaluate overall survival (OS) between patients receiving RT versus CRT. Cox proportional hazards modeling determined variables associated with receipt of OS. Results: In total, 396 patients were analyzed. Chemotherapy was delivered in 147 patients (37{\%}). On multivariate analysis, patients treated at academic/integrated centers were less likely to receive chemotherapy (p =.008); a racial predilection was noted, as non-black/non-white patients were also less likely to receive chemotherapy (p =.006). Respective 5-year OS in patients receiving RT alone versus CRT were 77{\%} and 75{\%} (p =.428). Receipt of chemotherapy did not independently predict for greater OS (p =.447). Conclusions: These data do not support the routine addition of chemotherapy to definitive RT for T1N0 NPC.",
author = "Vivek Verma and Ryckman, {Jeffrey M.} and Simone, {Charles B.} and Chi Lin",
year = "2018",
month = "2",
day = "1",
doi = "10.1080/0284186X.2017.1351039",
language = "English (US)",
volume = "57",
pages = "257--261",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Informa Healthcare",
number = "2",

}

TY - JOUR

T1 - Patterns of care and outcomes with the addition of chemotherapy to radiation therapy for stage I nasopharyngeal cancer

AU - Verma, Vivek

AU - Ryckman, Jeffrey M.

AU - Simone, Charles B.

AU - Lin, Chi

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Purpose: The standard of care for stage I (T1N0) nasopharyngeal cancer (NPC) is definitive radiotherapy (RT). Given the phase III evidence supporting combined chemoradiotherapy (CRT) for stage II NPC, we investigated practice patterns and outcomes associated with administration of chemotherapy to RT alone for stage I NPC. Methods: The National Cancer Data Base (NCDB) was queried for clinical T1N0 primary NPC cases (2004–2013) receiving curative-intent RT. Patients with unknown RT/chemotherapy status were excluded, as were benign/sarcomatous histologies and receipt of pharyngectomy. Patient, tumor, and treatment parameters were extracted. Logistic regression analysis ascertained factors associated with receipt of additional chemotherapy. Kaplan–Meier analysis was used to evaluate overall survival (OS) between patients receiving RT versus CRT. Cox proportional hazards modeling determined variables associated with receipt of OS. Results: In total, 396 patients were analyzed. Chemotherapy was delivered in 147 patients (37%). On multivariate analysis, patients treated at academic/integrated centers were less likely to receive chemotherapy (p =.008); a racial predilection was noted, as non-black/non-white patients were also less likely to receive chemotherapy (p =.006). Respective 5-year OS in patients receiving RT alone versus CRT were 77% and 75% (p =.428). Receipt of chemotherapy did not independently predict for greater OS (p =.447). Conclusions: These data do not support the routine addition of chemotherapy to definitive RT for T1N0 NPC.

AB - Purpose: The standard of care for stage I (T1N0) nasopharyngeal cancer (NPC) is definitive radiotherapy (RT). Given the phase III evidence supporting combined chemoradiotherapy (CRT) for stage II NPC, we investigated practice patterns and outcomes associated with administration of chemotherapy to RT alone for stage I NPC. Methods: The National Cancer Data Base (NCDB) was queried for clinical T1N0 primary NPC cases (2004–2013) receiving curative-intent RT. Patients with unknown RT/chemotherapy status were excluded, as were benign/sarcomatous histologies and receipt of pharyngectomy. Patient, tumor, and treatment parameters were extracted. Logistic regression analysis ascertained factors associated with receipt of additional chemotherapy. Kaplan–Meier analysis was used to evaluate overall survival (OS) between patients receiving RT versus CRT. Cox proportional hazards modeling determined variables associated with receipt of OS. Results: In total, 396 patients were analyzed. Chemotherapy was delivered in 147 patients (37%). On multivariate analysis, patients treated at academic/integrated centers were less likely to receive chemotherapy (p =.008); a racial predilection was noted, as non-black/non-white patients were also less likely to receive chemotherapy (p =.006). Respective 5-year OS in patients receiving RT alone versus CRT were 77% and 75% (p =.428). Receipt of chemotherapy did not independently predict for greater OS (p =.447). Conclusions: These data do not support the routine addition of chemotherapy to definitive RT for T1N0 NPC.

UR - http://www.scopus.com/inward/record.url?scp=85025175780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85025175780&partnerID=8YFLogxK

U2 - 10.1080/0284186X.2017.1351039

DO - 10.1080/0284186X.2017.1351039

M3 - Article

VL - 57

SP - 257

EP - 261

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 2

ER -