Comparison Of Therapeutic Effect And Prognosis Between Concurrent Radiotherapy And Chemotherapy And Sequential Radiotherapy Alone After Tpf Regimen Induction Chemotherapy For Locally Advanced Nasopharyngeal Carcinoma

Objective: Retrospective analysis of the efficacy and prognosis of patients with locally advanced nasopharyngeal carcinoma after TPF induction chemotherapy combined with concurrent radiotherapy and sequential radiotherapy alone.Methods: A total of 1216 patients with nasopharyngeal carcinoma diagnosed in the Nanxishan Hospital of Guangxi Zhuang Autonomous Region from February 2015 to February 2019 were collected.According to the eighth edition of the International Union against Cancer / American Joint Committee on Cancer(UICC/AJCC),they were diagnosed as locally advanced nasopharyngeal carcinoma(Ⅲ-IVa),and received sequential IMRT or IMRT concurrent cisplatin therapy with TPF regimen.After excluding the incomplete data,90 cases were included for retrospective analysis.All patients received TPF induction chemotherapy and IMRT therapy,including in synchronous groups(n=45)and simple groups(n=45).The synchronous group received IMRT therapy combined with simultaneous chemotherapy after TPF induction chemotherapy,while the simple group received only IMRT therapy after TPF induction chemotherapy.The therapeutic effects,adverse reactions and survival of the patients were compared between the two groups.Results: 1.The short-term effect showed that the effective remission rate(CR+PR)of the simple group was 93.3% and that of the synchronous group was 95.6%.There was no significant difference between the two groups(P > 0.05).2.The 3-year OS of the simple group and the synchronous group was 86.7% and 80.0%(P=0.396),and the 3-year PFS was 77.8% and 68.9%(P=0.340),the 3-year LRFS was 91.1% and91.1%(P=1.000),and the 3-year DMFS was 86.7% and 71.1%(P=0.071).There was no significant difference between the two groups.3.During radiotherapy,The hematological toxicity(leukopenia/neutropenia,and thrombocytopenia)and gastrointestinal reactions(malignancy,vomiting)in the synchronous group were more significant than those in the simple group.There was a significant difference between the two groups(P<0.05).4.Age and clinical stage as independent prognostic factors for OS.Conclusion:Compared with radiotherapy alone after TPF induction chemotherapy,there was no significant difference in short-term and long-term effects between the two groups,and the toxicity and side effects were greater in the simultaneous radiotherapy and chemotherapy group.Age and clinical stage are independent prognostic factors for OS.