PhaseⅡclinical trial of induction chrono-chemotherapy followed by concurrent chemoradiation in loco-regionally advanced nasopharyngeal carcinoma
10.3969/j.issn.1000-8179.2013.15.009
- VernacularTitle:时辰诱导化疗序贯同步放化疗治疗局部晚期鼻咽癌的Ⅱ期临床研究
- Author:
Yuanyuan LI
;
Feng JIN
;
Weili WU
;
Haixia CHEN
;
Jinhua LONG
;
Xiuyun GONG
;
Guoyan CHEN
;
Ting BI
;
Zhuolin LI
;
Qianyong HE
- Publication Type:Journal Article
- Keywords:
nasopharyngeal carcinoma;
induction chemotherapy;
chrono-chemotherapy;
intensity modulated radiotherapy;
concur-rent chemoradiation
- From:
Chinese Journal of Clinical Oncology
2013;(15):914-918
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The present study aimed to investigate the short-term efficacy and adverse effects of induction chrono-che-motherapy including docetaxe1 (TXT), cisplatin (DDP), and 5 fluorouraci1 (5-FU) followed by concomitant chemoradiotherapy in lo-co-regionally advanced nasopharyngeal carcinoma (NPC). Methods:Newly diagnosed locally advanced (Ⅲ~Ⅳb) NPC patients were enrolled in this study. All patients received three cycles of TPF regimen. The TPF chemotherapy regimen was administered as follows:TXT, 75 mg/m2, i.v. infusion, d1; DDP, 75 mg/m2, bolus infusion from 10:00 to 22:00, d1-5; and 5-FU 750 mg/m2/d bolus infusion from 22:00 to 10:00, d1-5, with 21 days each cycle, followed by concomitant IMRT and chemotherapy (paclitaxel 135 mg/m2 i.v. infu-sion, with 21 days each cycle and a total of 2 courses). Acute and late toxicities were graded according to the Common Terminology Cri-teria for Adverse Events v3.0 scoring criteria. Tumor response was evaluated using 2000 Response Evaluation Criteria in Solid Tumors criteria. Results:The CR and PR rates of induction chemotherapy were 23.8%and 68.6%, respectively;whereas the CR and PR rates of the combined modality treatment were 64.8%and 31.4%, respectively. Two-year overall survival rate was 91.4%, two-year progres-sion free survival rate was 87.0%, and two-year distant metastasis-free survival rate was 88.4%. The main side effects from induction chemotherapy include an over grade 3 granulocytopenia of 28.6%. Major toxicity from concurrent chemo-radiotherapy was oral mucosi-tis (81.0%);grade 3 to 4 oral mucositis was 16%. No treatment-related deaths occurred in this study. Conclusion:Induction chrono-che-motherapy using TPF followed by concurrent chemoradiotherapy of paclitaxel is a well-tolerated treatment with short-term efficacy and severity for locally advanced NPC. Further follow-up is required to assess the late effects and long-term efficacy.
