Comparing three induction regimens for nasopharyngeal carcinoma: a propensity score-matched analysis

Area of Science:

• Oncology
• Medical Research
• Clinical Trials

Background:

• Locoregionally advanced nasopharyngeal carcinoma (LA-NPC) is a challenging diagnosis.
• Induction chemotherapy (IC) regimens, including gemcitabine plus cisplatin (GP), docetaxel plus cisplatin plus fluorouracil (TPF), and paclitaxel plus cisplatin (TP), are established treatment options.

Purpose of the Study:

• To compare the efficacy and toxicity of GP, TPF, and TP induction chemotherapy regimens in patients with LA-NPC.
• To evaluate survival outcomes and acute toxicities associated with these IC regimens.

Main Methods:

• A multicenter retrospective study involving 722 patients with stage III-IVA LA-NPC.
• Propensity score matching (PSM) was utilized to balance baseline characteristics before comparing outcomes.
• Survival endpoints included overall survival (OS), failure-free survival (FFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS).

Main Results:

• After PSM, the GP group demonstrated a significantly better 3-year OS rate compared to the TP group (p=0.019).
• No significant differences in 3-year OS were observed between the GP and TPF groups, or between the TPF and TP groups.
• There were no significant differences in 3-year FFS, LRFS, or DMFS rates among the three regimens. Toxicity profiles were generally acceptable and manageable.

Conclusions:

• The gemcitabine plus cisplatin (GP) induction regimen exhibits superior efficacy in overall survival for LA-NPC patients.
• GP offers a favorable safety profile, positioning it as a more clinically advantageous treatment option compared to TPF and TP regimens.