Department of Otolaryngology, and Head and Neck Surgery, Yokohama City University School of Medicine, 9-3 Fukuura, Kanazawa-Ku, Yokohama 236-0004, Japan.
Anticancer Res. 2012 Feb;32(2):681-6.
The study aimed to evaluate the efficacy of concurrent chemoradiotherapy (CCRT) with platinum-based chemotherapy as a primary treatment for nasopharyngeal carcinoma (NPC) and to further compare the results of CCRT with these of neoadjuvant chemotherapy (NAC) followed by radiotherapy (RT).
Before 1998, 21 patients with NPC received NAC followed by RT (NAC-RT). Between 1999 and 2008, a total of 25 NPC patients received CCRT. The CCRT group received a regimen including docetaxel (50 mg/m(2), day1), cisplatin (CDDP, 60 mg/m(2), day4) and continuous 5-fluorouracil (5-FU) infusion (600 mg/m(2), day 1-5), the TPF regimen, or a regimen including CDDP (60 mg/m(2), day4), continuous 5-FU infusion (600 mg/m(2), day 1-5), methotrexate (MTX, 30 mg/m(2), day 1) and leucovorin (LV, 20 mg/m(2), day 1-5), PFML regimen. The CCRT group received 2 cycles of chemotherapy during definitive RT. The NAC group of patients received a PFML regimen.
The overall response rate after CCRT was 96%. The 3-year and 5-year disease-specific survival rates were 75.6% and 60.1%, respectively. In patients receiving NAC-RT, the 3-year and 5-year disease-specific survival rates were 84.1% and 67.3%, respectively. There was no difference observed in terms of survival rates between the group receiving CCRT and that receiving NAC-RT.
CCRT with the TPF or PFML regimen was tolerable, and the NPC patients receiving this treatment showed excellent survival rates. In comparison to the group receiving NAC-RT, CCRT had no advantage in terms of the survival rate. In the future, the control of distant metastasis might play an important role in improving the survival rate of patients with advanced NPC receiving CCRT.
本研究旨在评估顺铂为基础的同期放化疗（CCRT）作为鼻咽癌（NPC）一线治疗的疗效，并进一步比较 CCRT 与新辅助化疗（NAC）后放疗（RT）的结果。
1998 年之前，21 例 NPC 患者接受 NAC 后 RT（NAC-RT）。1999 年至 2008 年，共有 25 例 NPC 患者接受 CCRT。CCRT 组接受包括多西紫杉醇（50mg/m2，第 1 天）、顺铂（CDDP，60mg/m2，第 4 天）和持续 5-氟尿嘧啶（5-FU）输注（600mg/m2，第 1-5 天）、TPF 方案或包括顺铂（CDDP，60mg/m2，第 4 天）、持续 5-FU 输注（600mg/m2，第 1-5 天）、甲氨蝶呤（MTX，30mg/m2，第 1 天）和亚叶酸（LV，20mg/m2，第 1-5 天）、PFML 方案。CCRT 组在根治性 RT 期间接受 2 个周期化疗。NAC 组患者接受 PFML 方案。
CCRT 后的总缓解率为 96%。3 年和 5 年疾病特异性生存率分别为 75.6%和 60.1%。NAC-RT 组患者 3 年和 5 年疾病特异性生存率分别为 84.1%和 67.3%。CCRT 组和 NAC-RT 组的生存率无差异。
TPF 或 PFML 方案的 CCRT 耐受良好，接受该治疗的 NPC 患者生存率较高。与 NAC-RT 组相比，CCRT 在生存率方面没有优势。未来，控制远处转移可能在提高接受 CCRT 的晚期 NPC 患者的生存率方面发挥重要作用。
