Real-world evidence of cisplatin versus carboplatin in patients with locally advanced nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: A multicenter analysis
Issued Date
2023-02-01
Resource Type
ISSN
17437555
eISSN
17437563
Scopus ID
2-s2.0-85127564220
Pubmed ID
35394108
Journal Title
Asia-Pacific Journal of Clinical Oncology
Volume
19
Issue
1
Start Page
51
End Page
61
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asia-Pacific Journal of Clinical Oncology Vol.19 No.1 (2023) , 51-61
Suggested Citation
Dechaphunkul A., Danchaivijitr P., Jiratrachu R., Dechaphunkul T., Sookthon C., Jiarpinitnun C., Paoin C., Setakornnukul J., Suktitipat B., Pattaranutaporn P., Ngamphaiboon N. Real-world evidence of cisplatin versus carboplatin in patients with locally advanced nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: A multicenter analysis. Asia-Pacific Journal of Clinical Oncology Vol.19 No.1 (2023) , 51-61. 61. doi:10.1111/ajco.13668 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85137
Title
Real-world evidence of cisplatin versus carboplatin in patients with locally advanced nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: A multicenter analysis
Other Contributor(s)
Abstract
Background: Though concurrent chemoradiotherapy (CCRT) with cisplatin remains a standard of care for patients with locally advanced nasopharyngeal carcinoma (LA-NPC), carboplatin has alternatively been used without sufficient supportive evidences. Thus, we evaluated an efficacy and tolerability of carboplatin CCRT compared with cisplatin in LA-NPC patients. Methods: Patients with LA-NPC treated with CCRT were identified through the Thai multicenter head and neck cancer database. Patient tolerability and survival were analyzed and compared between regimens. Survivals were calculated by using the Kaplan–Meier method, and compared by the log-rank test. A p-value of <0.05 was considered statistically significant. Results: A total of 135 of 980 patients (13.8%) were treated with carboplatin. Patients treated with carboplatin were significantly associated with older age (p < 0.001), smoking (p = 0.003), more comorbidity (p = 0.014), kidney disease (p = 0.016), and lower baseline creatinine clearance (p < 0.001). Intensity-modulated radiation therapy was used significantly more in the cisplatin group than carboplatin group (p < 0.001). Patients who received carboplatin were associated with delay (p = 0.049) and hospitalization (p = 0.006), whereas cisplatin CCRT had more dose reduction (p = 0.001). Patients treated with cisplatin had CCRT interruption from grade 3–4 mucositis (p = 0.019) more than carboplatin, whereas carboplatin had more grade 3–4 thrombocytopenia (p < 0.001). The 5-year overall survival (OS) of patients treated with cisplatin and carboplatin was 59% and 49%, respectively (p = 0.128). Cisplatin or carboplatin CCRT was not a significant predictor for OS and locoregional recurrence-free survival in multivariate analysis. Conclusions: Carboplatin CCRT provided acceptable efficacy and tolerability profiles in real-world practice. Carboplatin should be considered as an alternative regimen, particularly in cisplatin-ineligible patients with LA-NPC treated with CCRT.