Comparison of long-term efficacy between concurrent chemoradiotherapy and intensity-modulated radiotherapy alone for stage II nasopharyngeal carcinoma

Objective To compare the long-term efficacy between intensity-modulated radiotherapy (IMRT) alone and concurrent chemoradiotherapy (CCRT) in the treatment of stage Ⅱ nasopharyngeal carcinoma (NPC) patients. Methods The clinical data of 123 patients with stage Ⅱ NPC were retrospectively analyzed. Eighty-one patients received IMRT alone, and 42 patients received CCRT.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to compare the survival rates. Results The 5-year overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and progression-free survival (PFS) rates in all patients were 96.7%, 94.7%, 93.1%, and 87.8%, respectively. There were no significant differences between the patients receiving IMRT alone and CCRT in 5-year OS (98.7% vs.92.9%, P=0.569), LRFS (94.8% vs. 94.5%, P=0.770), DMFS (94.5% vs. 90.2%, P=0.408), and PFS (90.6% vs. 82.2%, P=0.340). For patients with stage T2N1 NPC, the 5-year OS, LRFS, DMFS, and PFS also showed no significant differences between those receiving IMRT alone and CCRT (P=0.929, 0.967, 0.917, 0.492). The incidence rates of neutropenia, leukopenia, and mucositis were significantly higher in patients receiving CCRT than in those receiving IMRT alone (P=0.000, 0.000, 0.012, 0.010), while the incidence of late toxicities was similar between the two groups of patients (P=0.823, 0.622, 0.113). Conclusions For stage Ⅱ NPC patients treated with IMRT, the addition of concurrent chemotherapy fails to improve the prognosis, and increases the incidence of acute toxicities. Key words: Nasopharygeal neoplasms/chemoradiotherapy; Chemoradiotherapy, concurrent; Radiotherapy, intensity-modulated; Prognosis