The Role of Neoadjuvant Chemotherapy in the Treatment of XXXX : A Multi-Institutional Retrospective Study Using Propensity Score Matching Analysis.

@entity1 @entity137 @entity189
Purpose: We compared the treatment results and @entity137 in @entity189 ( @entity189 ) @entity1 treated with concurrent chemotherapy (CCRT) alone (the CRT arm) or neoadjuvant chemotherapy followed by CCRT (the NCT arm). Materials and Methods: A multi-institutional retrospective study was conducted to review @entity189 patterns of care and treatment outcome. Data of 568 @entity189 @entity1 treated by CCRT alone or by neoadjuvant chemotherapy followed by CCRT were collected from 15 institutions. @entity1 in both treatment arms were matched using the propensity score matching method, and the clinical outcomes were analyzed. Results: After matching, 300 @entity1 (150 @entity1 in each group) were selected for analysis. Higher 5-year locoregional failure-free survival (LRFFS) was observed in the CRT arm (85% vs. 72%, p = 0.014). No significant differences in distant failure-free survival (DFFS), disease-free survival (DFS), and overall survival (OS) were observed between groups. In subgroup analysis, the NCT arm showed superior DFFS and DFS in stage IV @entity1 younger than 60 years. No significant difference in compliance and @entity137 was observed between groups, except the RT duration was slightly shorter in the CRT arm (50.0 vs. 53.9 days, p = 0.018). Conclusion: This study did not show the superiority of NCT followed by CCRT over CCRT alone. Because NCT could increase the risk of loco-regional recurrences, it can only be considered in selected young @entity1 with advanced stage IV disease. The role of NCT remains to be defined and should not be viewed as the standard of care.
