Comparison of the efficacy between concurrent chemoradiotherapy with or without adjuvant chemotherapy and intensity-modulated radiotherapy alone for stage II nasopharyngeal carcinoma

Objective: This study aimed to explore whether concurrent chemoradiotherapy (CCRT) with or without Adjuvant Chemotherapy (AC) could improved the survival in stage II nasopharyngeal carcinoma (NPC). Methods: Patients with stage II NPC treated with CCRT (n = 80) or CCRT + AC (n= 40) or IMRT alone (n= 42) between January 2007 and September 2014 were retrospectively analyzed. The three patient groups were matched based on prognostic factors. All patients were treated with IMRT. The endpoints were overall survival (OS), distant metastasis-free survival (DMFS), locoregional relapse-free survival (LRRFS), and failure-free survival (FFS). The treatment-related acute toxicity reactions between the three groups were compared also. Results: The three groups indicated similar outcomes: survival of the CCRT group, CCRT + AC group and RT alone group were (93.9%, 95.0%, 95.2%, P = 0.937) for OS, (96.8%, 94.9%, 93.0%, P = 0.756) for LRRFS, (91.1%, 97.5%, 100%, P = 0.185) for DMFS and (84.9%, 92.5%, 93.0%, P = 0.597) for FFS. Both the univariate and multivariate analysis indicated that older age predicted lower LRRFS and FFS. The CCRT and CCRT + AC groups showed more acute toxicity reactions, especially in bone marrow suppression, Liver dysfunction, gastrointestinal reactions (nausea/vomiting) and weight loss. Conclusion: CCRT with/without AC could not improve the survival conditions of patients with stage II NPC, but remarkably increased treatment-associated acute toxic reactions when compared with IMRT alone.