Identification of surrogate endpoints in patients with locoregionally advanced nasopharyngeal carcinoma receiving neoadjuvant chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy aloneReportar como inadecuado




Identification of surrogate endpoints in patients with locoregionally advanced nasopharyngeal carcinoma receiving neoadjuvant chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Cancer

, 15:930

First Online: 24 November 2015Received: 03 February 2015Accepted: 16 October 2015DOI: 10.1186-s12885-015-1816-6

Cite this article as: Chen, YP., Zhang, WN., Tang, LL. et al. BMC Cancer 2015 15: 930. doi:10.1186-s12885-015-1816-6

Abstract

BackgroundIn the era of intensity-modulated radiotherapy IMRT, the efficacy of additional neoadjuvant chemotherapy NACT to concurrent chemoradiotherapy CCRT in locoregionally advanced nasopharyngeal carcinoma NPC is currently being investigated in ongoing trials. Overall survival OS is the gold standard endpoint in NPC trials. We performed this analysis to identify surrogate endpoints for OS, which could shorten follow-up duration and speed up assessment of treatment effects.

MethodsWe retrospectively analysed 208 matched-pair patients with locoregionally advanced NPC receiving NACT+CCRT or CCRT. Progression-free survival PFS, failure-free survival FFS, distant failure-free survival D-FFS and locoregional failure-free survival LR-FFS at 2 and 3 years were assessed as surrogates for 5-year OS according to Prentice’s criteria. The strength of the associations were assessed using Spearman’s rank correlation coefficient.

ResultsNo significant differences were observed between treatment arms for any surrogate endpoint at 2 years, which rejected Prentice’s second criterion. In contrast, 3-year LR-FFS, PFS, FFS and D-FFS were consistent with all four of Prentice’s criteria; the rank correlation coefficient 0.730 between 3-year PFS and 5-year OS was highest.

Conclusions3-year PFS, FFS and D-FFS could be valid surrogate endpoints for 5-year OS; 3-year PFS may be the most accurate.

KeywordsNasopharyngeal carcinoma Neoadjuvant chemotherapy Concurrent chemoradiotherapy Surrogate endpoint Overall survival AbbreviationsNPCnasopharyngeal carcinoma

RTradiotherapy

IMRTintensity modulated radiation therapy

CCRTconcurrent chemoradiotherapy

ACadjuvant chemotherapy

NACTneoadjuvant chemotherapy

OSoverall survival

PFSprogression-free survival

FFSfailure-free survival

D-FFSdistant failure-free survival

LR-FFSlocoregional failure-free survival

PFcisplatin-fluorouracil

UICC-AJCCInternational Cancer Control-American Joint Committee On Cancer

SYSUCCSun Yat-Sen University Cancer Center

HRhazard ratio

Yu-Pei Chen, Wen-Na Zhang and Ling-Long Tang contributed equally to this work.

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Autor: Yu-Pei Chen - Wen-Na Zhang - Ling-Long Tang - Yan-Ping Mao - Xu Liu - Lei Chen - Guan-Qun Zhou - Hai-Qiang Mai - Jian-Yong

Fuente: https://link.springer.com/







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