Impact of concurrent chemotherapy dose on long-term survival in locally advanced nasopharyngeal carcinoma: a 10-year single-center study

The aim of this study is to compare the acute adverse reactions and long-term efficacy of concurrent chemoradiotherapy with different doses of cisplatin in the treatment of nasopharyngeal carcinoma. One hundred forty patients with locally advanced nasopharyngeal carcinoma treated at a hospital in Guangxi, China from March to October 2010 were randomly assigned to the A group (n = 72) (80 mg/m ²) and a B group (n = 68) (100 mg/m ²) according to different cisplatin usage regimens. The acute toxicities and long-term survival of the two groups were compared and analyzed. The median follow-up time of this study was 125 months (5 -183 months), and the overall survival (OS), local recurrence-free survival (LRRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) of the two groups were not statistically significant. The 10-year OS, LRRFS, PFS, and DMFS were 64.6%, 88.1%, 83.4%, and 97.7% in the B group and 66.5%, 90.8%, 84.5%, and 96.2% in the A group. Multivariate analysis showed that age and T stage were independent risk factors for DMFS. In term of acute toxicities, the control group had an increased risk of bone marrow suppression and renal dysfunction. This study shows that reducing the dose of cisplatin concomitant chemotherapy does not reduce the long-term survival benefit of patients with locally advanced nasopharyngeal carcinoma, and it is beneficial to reduce the risk of acute toxicities.