PURPOSE: No large, head-to-head, phase III, randomized, controlled trial including an adequate sample size has investigated the effect of concurrent low-dose (LD) cisplatin or high-dose (HD) cisplatin with radiotherapy (RT) on nasopharyngeal cancer (NPC).
PATIENTS AND METHODS: We conducted a head-to-head, propensity score (PS)-matched, nationwide, population-based, cohort study in Taiwan to evaluate the outcomes of concurrent chemoradiotherapy (CCRT) with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC. Patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT, and LD-CCRT.
RESULTS: We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT cohorts, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (HR; 95% confidence interval [CI]) of 0.75 (0.54-1.06, P = .103) was derived for HD-CCRT.
CONCLUSION: LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.