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

AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.