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多西他赛每周同步化疗联合放疗治疗Ⅲ期和ⅣA - B期鼻咽癌。

Concurrent weekly docetaxel chemotherapy in combination with radiotherapy for stage III and IVA-B nasopharyngeal carcinoma.

作者信息

Wei Wei-Hong, Cai Xiu-Yu, Xu Tao, Zhang Guo-Yi, Wu Yong-Feng, Feng Wei-Neng, Lin Li, Deng Yan-Ming, Lu Qiu-Xia, Huang Zhe-Li

机构信息

Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University, Foshan, China.

出版信息

Asian Pac J Cancer Prev. 2012;13(3):785-9. doi: 10.7314/apjcp.2012.13.3.785.

Abstract

BACKGROUND AND PURPOSE

Cisplatin is the most common chemotherapeutic agent for loco-regionally advanced nasopharyngeal carcinoma (NPC); however, toxicity is a limiting factor for some patients. We retrospectively compared the efficacy and toxicity of weekly docetaxel-based and cisplatin-based concurrent chemoradiotherapy in loco-regionally advanced NPC.

METHODS AND MATERIALS

Eighty-four patients with Stage III and IVA-B NPCs, treated between 2007 and 2008, were retrospectively analyzed. Thirty received weekly docetaxel-based concurrent chemotherapy, and 43 were given weekly cisplatin-based concurrent chemotherapy. Radiotherapy was administered using a conventional technique (seven weeks, 2.0 Gy per fraction, total dose 70-74 Gy) with 6-8 Gy boosts for some patients with locally advanced disease.

RESULTS

Median follow-up time was 42.3 months (range, 8.6-50.8 months). There were no significant differences in the 3-year loco-regional failure-free survival (85.6% vs. 92.3%; p=0.264), distant failure-free survival (87.0% vs. 92.5%; p=0.171), progression-free survival (85.7% vs. 88.4%; p=0.411) or overall survival (86.5% vs. 92.5%, p=0.298) of patients treated concurrently with docetaxel or cisplatin. Severe toxicity was not common in either group.

CONCLUSIONS

Weekly docetaxel-based concurrent chemoradiotherapy is potentially effective and has a tolerable toxicity; however, further investigations are required to determine if docetaxel is superior to cisplatin for advanced stage NPC.

摘要

背景与目的

顺铂是局部晚期鼻咽癌(NPC)最常用的化疗药物;然而,毒性是部分患者的限制因素。我们回顾性比较了以多西他赛为基础和以顺铂为基础的每周一次同步放化疗在局部晚期NPC中的疗效和毒性。

方法与材料

回顾性分析了2007年至2008年间接受治疗的84例III期和IVA - B期NPC患者。30例接受以多西他赛为基础的每周一次同步化疗,43例接受以顺铂为基础的每周一次同步化疗。放疗采用传统技术(7周,每次2.0 Gy,总剂量70 - 74 Gy),部分局部晚期患者给予6 - 8 Gy的追加剂量。

结果

中位随访时间为42.3个月(范围8.6 - 50.8个月)。接受多西他赛或顺铂同步治疗的患者,其3年局部区域无复发生存率(85.6%对92.3%;p = 0.264)、远处无复发生存率(87.0%对92.5%;p = 0.171)、无进展生存率(85.7%对88.4%;p = 0.411)或总生存率(86.5%对92.5%,p = 0.298)均无显著差异。两组中严重毒性均不常见。

结论

以多西他赛为基础的每周一次同步放化疗可能有效且毒性可耐受;然而,需要进一步研究以确定多西他赛对于晚期NPC是否优于顺铂。

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