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Comment & Response
July 11, 2024

Chemotherapy, Radiation Therapy, and Nasopharyngeal Carcinoma

Author Affiliations
  • 1Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
JAMA Oncol. 2024;10(9):1292. doi:10.1001/jamaoncol.2024.2519

To the Editor We read the article by Dai et al1 with great interest. Omitting chemotherapy in patients receiving induction chemotherapy (IC) is a hot topic in nasopharyngeal carcinoma treatment, particularly in the intensity-modulated radiotherapy era. Yet, concurrent cisplatin is still recommended in advanced-stage disease, and the cumulative dose of concurrent cisplatin recommended is at least 200 mg/m2 in the latest American Society of Clinical Oncology/Chinese Society of Clinical Oncology guidelines.2 The authors in the current study gave 30-mg/m2 cisplatin per week and only 12.1% of patients had received 7 weeks of cisplatin, which makes a total 210 mg/m2. For patients receiving IC, at least a total 160-mg/m2 dose of cisplatin is recommended, which had been received by 85.8% of patients.3 Could the inadequate cumulative concurrent cisplatin dose be the reason why the IC in combination with radiotherapy (IC-RT) arm was noninferior to the IC with induction chemotherapy combined with chemoradiotherapy (IC-CCRT) arm? Therefore, we would kindly like the authors to separately analyze the results of patients receiving adequate doses of concurrent cisplatin.

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