Table 4.
Treatment-related acute toxicities during NACT or RT in NPC patients treated with NACT + IMRT + CCRT vs NACT + IMRT
| During radiotherapy | NACT + IMRT (n=36) | NACT + IMRT + CCRT (n=89) | P-value | ||||||
|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||
| Acute toxicities | During NACT
|
During radiotherapy
|
During NACT
|
During radiotherapy
|
|||||
| Grade 1-2 | Grade 3-4 | Grade 1-2 | Grade 3-4 | Grade 1-2 | Grade 3-4 | Grade 1-2 | Grade 3-4 | ||
|
| |||||||||
| Hematologic | |||||||||
| Leukopenia | 27 (75%) | 7 (19.4%) | 20 (54.2%) | 4 (11.1%) | 59 (66.3%) | 9 (10.1%) | 55 (61.8%) | 4 (4.5%) | 0.362 |
| Neutropenia | 15 (41.7%) | 13 (36.1%) | 15 (41.7%) | 3 (8.3%) | 40 (44.9%) | 25 (28.1%) | 27 (30.3%) | 6 (6.7%) | 0.925 |
| Neutropenia fever | 1 (2.8%) | 1 (2.8%) | 0 | 0 | 2 (2.2%) | 0 | 1 (1.1%) | 0 | N.A. |
| Thrombocytopena | 9 (25%) | 7 (19.4%) | 12 (33.3%) | 3 (8.3%) | 18 (20.2%) | 9 (10.1%) | 31 (34.8%) | 5 (5.6%) | 0.702 |
| Anemia | 23 (62.5%) | 5 (13.9%) | 20 (54.2%) | 3 (8.3%) | 58 (65.2%) | 1 (1.1%) | 47 (52.8%) | 4 (4.5%) | 0.040 |
| Nonhematologic | |||||||||
| Liver dysfunction | 20 (54.2%) | 5 (13.9%) | 6 (16.7%) | 2 (5.6%) | 49 (55.1%) | 6 (6.7%) | 15 (16.9%) | 1 (1.1%) | 0.394 |
| Kidney dysfunction | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
| Diarrhea | 1 (2.8%) | 0 | 0 | 0 | 2 (2.2%) | 0 | 1 (1.1%) | 0 | N.A. |
| Rash | 6 (16.7%) | 0 | 1 (2.8%) | 0 | 11 (12.4%) | 0 | 5 (5.6%) | 0 | N.A. |
| Nausea/vomiting | 18 (50.0%) | 4 (11.1%) | 5 (13.9%) | 1 (2.8%) | 33 (37.1%) | 6 (6.7%) | 47 (52.8%) | 14 (15.7%) | 0.003 |
| Neurotoxicity | 5 (13.9%) | 0 | 3 (8.3%) | 0 | 7 (7.9%) | 0 | 10 (10.7%) | 0 | N.A. |
| Oropharyngeal | 3 (8.3%) | 0 | 31 (86.1%) | 6 (16.7%) | 5 (5.6%) | 0 | 72 (80.9%) | 12 (13.5%) | N.A. |
| mucositis | |||||||||
| Hearing loss | 1 (2.8%) | 0 | 1 (2.8%) | 0 | 2 (2.2%) | 0 | 1 (1.1%) | 0 | N.A. |
| Radiodermatitis | – | – | 6 (16.7%) | 1 (2.8%) | – | – | 14 (15.7%) | 4 (4.5%) | N.A. |
Abbreviations: CCRT, concurrent chemotherapy; IMRT, intensity modulated radiotherapy; N.A., not applicable; NACT, neoadjuvant chemotherapy; NPC, nasopharyngeal carcinoma; RT, radiotherapy.