2025 Poster Presentations
P321: INDUCTION AND ADJUVANT CHEMOTHERAPY SIDE EFFECTS IN NASOPHARYNGEAL CARCINOMA PATIENTS
Matthew D Marquardt1; Mohammad Bilal Alsavaf, MD2; Moataz D Abouammo, MD2; Dukagjin Blakaj, MD3; Priyanka Bhateja, MD4; Ricardo L Carrau, MD, MBA2; Marcelo Bonomi, MD4; Kyle VanKoevering, MD2; 1The Ohio State University College of Medicine; 2The Ohio State University Wexner Medical Center Department of Otolaryngology; 3The Ohio State University Wexner Medical Center Department of Radiation Oncology; 4The Ohio State University Wexner Medical Center Division of Medical Oncology
Introduction: While nasopharyngeal carcinoma (NPC) is common in Asia and northern Africa, its incidence is rare in the USA. Concurrent chemoradiation (CCRT) is the primary treatment modality. The addition of chemotherapy in the induction (IC) or adjuvant (AC) setting seems to improve long term outcomes. However, few studies have looked at the prevalence of side effects in patients receiving IC and AC in a diverse American cohort.
Methods: A retrospective review of 155 NPC patients at a midwestern academic center (Aug 2000-Dec 2022) was conducted. Demographic, clinical, and survival data were extracted from medical records.
Results: We found that 47 patients received IC and 46 received AC in addition to chemoradiation. Both cohorts were demographically similar: IC (average age 51.4, 35 males, 25 white, 15 African American, 5 Asian, 1 Hispanic) and AC (average age 52.6, 36 males, 33 white, 6 African American, 6 Asian, 1 Hispanic). Staging, P16 and EBV positivity, and smoking history were comparable, but alcohol use was more prevalent among those who underwent IC (P=0.041). Among acute side effects, vomiting, nausea, ototoxicity, diarrhea, xerostomia, dermatitis, febrile neutropenia, anorexia, depression, anxiety, fatigue, dyspnea, pruritus, insomnia, and pain were not statistically different (P>0.05). Among long-term side effects, temporal lobe necrosis, cranial and peripheral neuropathy, vision changes, hearing changes, dry mouth, and dysphagia were found to be no different between groups (P>0.05). IC showed higher constipation (34% vs 11%, P=0.008), weight loss (40% vs 15%, P=0.007), dysgeusia (54% vs 87%, P=<0.001), nephrotoxicity (9% vs 0%, P=0.043), trismus (32% vs 15%, P=0.014), and lymphedema (51% vs 16%, P=0.013) rates compared to AC, which had a higher mucositis rate (54% vs 27%, P=0.009).
Conclusions: Our study of a diverse cohort of 155 NPC patients in the USA, found similar side effect rates for AC and IC; however, IC was associated with a larger number of side effects. These findings underscore the importance of personalized treatment planning and vigilant management of side effects in NPC patients undergoing chemotherapy.