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The results of our study have the potential to guide clinical practice and follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In total, 3123 patients with stage III-IVa NPC receiving Induction chemotherapy followed by concurrent cisplatin or not were analysed. The cut-off value of treatment failure was calculated using the minimum <jats:italic>P<\/jats:italic>-value approach. Random survival forest (RSF) model was to simulate the cumulative probabilities of treatment failure (locoregional recurrence and \/or distant metastasis) over-time, as well as the monthly time-specific, event-occurring probabilities, for patients at different treatment groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Based on subsequent prognosis, early locoregional failure (ELRF) should be defined as recurrence within 14 months (<jats:italic>P<\/jats:italic>\u2009=\u20091.47\u2009\u00d7\u200910\u2009\u2212\u20093), and early distant failure (EDF) should be defined as recurrence within 20 months (<jats:italic>P<\/jats:italic>\u2009=\u20091.95\u2009\u00d7\u200910\u2009\u2212\u20094). A cumulative cisplatin dose (CCD)\u2009&gt;\u2009200\u00a0mg\/m<jats:sup>2<\/jats:sup> independently reduced the risk of EDF (hazard ratio, 0.351; 95% confidence interval (CI), 0.169\u20130.732; <jats:italic>P<\/jats:italic>\u2009=\u20090.005). Better failure-free survival (FFS) and overall survival (OS) were observed in concurrent chemotherapy settings ([0\u00a0mg\/m<jats:sup>2<\/jats:sup> vs. 1-200\u00a0mg\/m<jats:sup>2<\/jats:sup> vs. &gt;200\u00a0mg\/m<jats:sup>2<\/jats:sup>]: FFS: 70.4% vs. 74.4% vs. 82.6%, all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.03; OS: 79.5% vs. 83.8% vs. 90.8%, all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). In the monthly analysis, treatment failure mainly occurred during the first 4 years, and the risk of distant failure in patients treated with concurrent chemotherapy never exceeded that of patients without concurrent chemotherapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Locoregional failure that developed within 14 months and\/or distant failure within 20 months had poorer subsequent survival. Concurrent chemotherapy provides a significant FFS benefit, primarily by reducing EDF, translating into a long-term OS benefit.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-022-10237-8","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T07:30:23Z","timestamp":1669707023000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cisplatin-based concurrent chemoradiotherapy improved the survival of locoregionally advanced nasopharyngeal carcinoma after induction chemotherapy by reducing early treatment failure"],"prefix":"10.1186","volume":"22","author":[{"given":"Xing-Li","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu-Lu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Kou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan-Qun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Fei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"issue":"6","key":"10237_CR1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. 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Cancer Sci. 2018;109(3):751\u201363.","journal-title":"Cancer Sci"}],"container-title":["BMC Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-022-10237-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12885-022-10237-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-022-10237-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T17:53:20Z","timestamp":1669744400000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccancer.biomedcentral.com\/articles\/10.1186\/s12885-022-10237-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["10237"],"URL":"https:\/\/doi.org\/10.1186\/s12885-022-10237-8","relation":{},"ISSN":["1471-2407"],"issn-type":[{"value":"1471-2407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,29]]},"assertion":[{"value":"12 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The current research was approved by the Research Ethics Committee of Sun Yat-sen University Cancer Center (SYSUCC). All methods were performed in accordance with the relevant guidelines and regulations. As our study was based on an analysis of patients\u2019 routine clinical and treatment data, the research ethics committees of SYSUCC waived the requirement for individual informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"There are no details on individuals reported within the manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1230"}}