Sparing concurrent chemotherapy in low-risk locoregionally advanced nasopharyngeal carcinoma: A retrospective study from real-world experience

Abstract Objectives This study aims to explore the feasibility of sparing concurrent chemotherapy (CCT) after induction chemotherapy (ICT) in low-risk locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and methods LANPC patients(excluding N3/T4N2) who received ICT + CCRT/RT alone between January 2014 and December 2018 were candidates for this retrospective study. All the enrolled patients should achieved favorable response(CR/PR) after ICT. Results A total of 336 patients were included. No significant differences in 4-year OS, LRFFS, DMFS and PFS (all p > 0.05) between ICT + IMRT and ICT + CCRT groups were observed. Multivariate analysis confirmed that CCT was not an independent prognostic factor for all survival outcomes ( p > 0.05). Patients in the ICT + IMRT group had a significant lower incidence of grade 3–4 mucositis than those in the ICT + CCRT group (29.4% vs. 40.4%, p = 0.037), and other toxicities did not differ significantly. Conclusions Sparing CCT in those who achieved favorable response after ICT is feasible and has lower incidence of acute adverse events. Well-designed prospective clinical trials are expected to confirm our results.