Xie Fang-Yun, Qi Shu-Nan, Hu Wei-Han, Zou Guo-Rong, Peng Miao, Li Ji-Shi
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, PR China.
Ai Zheng. 2007 Aug;26(8):880-4.
BACKGROUND & OBJECTIVE: Docetaxel and cisplatin (DDP) are effective drugs for head and neck tumors. Stage II-III clinical trial of TP regimen (docetaxel combined DDP) for head and neck tumors has completed. This study was to compare the efficacy and toxicity of TP regimen and PF regimen [DDP combined 5-fluorouracil (5-FU)] in treating nasopharyngeal carcinoma (NPC), to provide a new chemotherapeutic regimen for NPC.
Twenty NPC patients treated in Cancer Center of Sun Yat-sen University between Oct. 1, 2005 and Mar. 1, 2006 were subjected to study group (TP group). Twenty patients were chosen randomly from the 45 NPC patients treated with PF regimen between May 1, 2004 and Sep. 30, 2005 as control group (PF group). Both groups received concurrent radiotherapy. The efficacy and adverse events of the 2 groups were compared.
The mean number of chemotherapy cycles was significantly higher in TP group than in PF group (3.85 cycles vs. 2.75 cycles, P<0.001). After induction chemotherapy, in TP group, 18 achieved partial remission (PR) and 2 had stable disease (SD) for nasopharyngeal lesions, 7 achieved complete remission (CR), 11 achieved PR and 2 had SD for regional lymph nodes; in PF group, 17 achieved PR and 3 had SD for nasopharyngeal lesions, 2 achieved CR, 15 achieved PR and 1 had SD for regional lymph nodes. After concurrent chemoradiotherapy, all in TP group and 18 in PF group achieved CR for nasopharyngeal lesions, and 19 in TP group and 15 in PF group achieved CR for regional lymph nodes. There was no significant difference in efficacy between the 2 groups (P>0.05). The occurrence rates of grade 3-4 neutropenia were significantly higher in TP group than in PF group (40.5% vs. 0% after induction chemotherapy, 40.5% vs. 10.2% after concurrent radiochemotherapy, P<0.05). The occurrence rates of anemia and thrombocytopenia were significantly lower in TP group than in PF group (P<0.05). The uses of antibiotics and parenteral nutritional support in the 2 groups were similar.
The efficacy of TP regimen on NPC is similar to that of PF regimen, and the adverse events are tolerable, but the long-term outcomes and toxicities need to be further investigated.
多西他赛和顺铂（DDP）是治疗头颈部肿瘤的有效药物。头颈部肿瘤TP方案（多西他赛联合DDP）的II - III期临床试验已完成。本研究旨在比较TP方案和PF方案[DDP联合5 - 氟尿嘧啶（5 - FU）]治疗鼻咽癌（NPC）的疗效和毒性，为NPC提供一种新的化疗方案。
2005年10月1日至2006年3月1日在中山大学肿瘤防治中心接受治疗的20例NPC患者作为研究组（TP组）。从2004年5月1日至2005年9月30日接受PF方案治疗的45例NPC患者中随机选取20例作为对照组（PF组）。两组均接受同步放疗。比较两组的疗效和不良事件。
TP组化疗周期的平均次数显著高于PF组（3.85个周期对2.75个周期，P < 0.001）。诱导化疗后，TP组中，18例鼻咽癌病灶部分缓解（PR），2例病情稳定（SD），7例完全缓解（CR）；区域淋巴结7例CR，11例PR，2例SD。PF组中，17例鼻咽癌病灶PR，3例SD，2例CR；区域淋巴结2例CR，15例PR，1例SD。同步放化疗后，TP组所有患者及PF组18例患者鼻咽癌病灶达到CR，TP组19例患者及PF组15例患者区域淋巴结达到CR。两组疗效无显著差异（P > 0.05）。TP组3 - 4级中性粒细胞减少的发生率显著高于PF组（诱导化疗后分别为40.5%对0%，同步放化疗后分别为40.5%对10.2%，P < 0.05）。TP组贫血和血小板减少的发生率显著低于PF组（P < 0.05）。两组抗生素和肠外营养支持的使用情况相似。
TP方案治疗NPC的疗效与PF方案相似，不良事件可耐受，但长期疗效和毒性有待进一步研究。
