Influence of COVID-19 Vaccination on Treatment-Related Adverse Events and Oncologic Outcomes of Nonmetastatic Nasopharyngeal Carcinoma.

Abstract

The influence of COVID-19 vaccination before chemoradiotherapy on nonmetastatic nasopharyngeal carcinoma (NPC) is not known. Propensity score matching was used to minimize potential selection bias between groups. Primary endpoints were treatment-related adverse events (TRAEs). The Kaplan-Meier method and Cox proportional hazards models were performed to conduct survival analysis. The Benjamini-Hochberg false discovery rate control procedure was used to adjust for multiple comparisons. Eight hundred ninety-three patients with newly diagnosed nonmetastatic NPC were enrolled. On propensity score matching analysis, vaccinated group exhibited higher prevalence of neutropenia (p = 0.049), fatigue (p = 0.011) during induction chemotherapy, and higher prevalence of fatigue (p =0.016) during radiotherapy after adjustment for multiple comparisons. [Correction added after first online publication on 20 March 2025. P values have been updated in this sentence.] No significant differences were observed in 2-year OS, PFS, DMFS, and LRRFS in matched groups. Additionally, vaccinated patients exhibited a high and comparable absolute lymphocyte count. COVID-19 vaccination before chemoradiotherapy increases the prevalence of acute TRAEs, while no significant influence is observed on the oncologic outcomes of patients with nonmetastatic NPC.