Abstract:
Objective The efficacy of sequential capecitabine maintenance chemotherapy after radical chemoradiotherapy for stage N2- 3 nasopharyngeal carcinoma in non- endemic areas of northwest China was retrospectively analyzed to clarify the value of capecitabine maintenance chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma.
Methods From Jannary 2014 to December 2016, patients with stage N2-3 nasopharyngeal carcinoma underwent 2 or 3 cycles of induction chemotherapy combined with concurrent chemoradiotherapy. The study group continued to receive capecitabine for 4 cycles of chemotherapy after radical chemoradiotherapy, whereas the control group was only observed. The survival differences between the two groups were compared, and the toxicity and compliance of the two regimens were evaluated.
Result A total of 179 patients were included in this study, among whom 84 were included in the maintain chemotherapy group and 95 in the control group. The median follow-up time was 44.4 (5.97-70.26) months. The 3-year distant metastasis-free survival rates and 3-year disease-free survival rates were 79.3% and 68.1% (chi-square=3.898, P=0.048) and 75.6% and 64.2% (chi-square=5.428, P=0.020) for the maintain chemotherapy and control groups, respectively. The differences were statistically significant. There was no difference between the two groups in acute and late toxicity (P> 0.05). The toxicity of capecitabine-specific drugs was below grade 2.
Conclusions For N2-3 stage nasopharyngeal carcinoma in non-endemic areas in northwest China, the 3- year distant metastasis- free survival and disease- free survival rates following sequential capecitabine maintenance therapy after radical radiotherapy and chemotherapy are improved. Treatment was well-tolerated, and compliance was good, with no obvious adverse reactions.