剂量密集顺铂联合氟尿嘧啶治疗后鼻咽癌远处转移的选择性放射治疗

Selective Radiotherapy after Distant Metastasis of Nasopharyngeal Carcinoma Treated with Dose-Dense Cisplatin plus Fluorouracil.

作者信息

Liang Yong, Bu Jun-Guo, Cheng Jin-Ling, Gao Wei-Wei, Xu Yao-Can, Feng Jian, Chen Bo-Yu, Liang Wei-Chao, Chen Ke-Quan

机构信息

Department of Oncology, The People's Hospital of Guiping City of Guangxi, Guiping, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2015;16(14):6011-7. doi: 10.7314/apjcp.2015.16.14.6011.

DOI:10.7314/apjcp.2015.16.14.6011

PMID:26320489

Abstract

PURPOSE

To investigate the efficacy and safety of selective radiotherapy after distant metastasis of nasopharyngeal carcinoma (NPC) treated with dose-dense cisplatin plus fluorouracil.

MATERIALS AND METHODS

Eligible patients were randomly assigned to a study group treated with dose-dense cisplatin plus fluorouracil following selective radiotherapy and a control group receiving traditional cisplatin plus fluorouracil following selective radiotherapy according to a 1:1 distribution using a digital random table method. The primary endpoint was overall survival (OS). Secondary endpoints were progression-free survival (PFS), objective response rate, relapse or progression rate in the radiation field and treatment toxicity.

RESULTS

Of 52 patients in the study group, 20 cases underwent radiotherapy., while in the control group of 51 patients, 16 underwent radiotherapy. The median PFS, median OS, survival rates in 1, 2 and 3 years in study and control group were 20.9 vs 12.7months, 28.3 vs 18.8months, 85.2%vs 65.9%, 62.2% vs 18.3%, and 36.6%vs 5.2% (p values of 0.00, 0.00, 0.04, 0.00 and 0.00, respectively). Subgroup analysis showed that the median OS and survival rates of 1, 2, 3 years for patients undergoing radiotherapy in the study group better than that in control group( 43.2vs24.1 months, 94.1% vs 86.7%, 82.4% vs 43.3%, 64.7% vs 17.3%, (p=0.00, 0.57, 0.04 and 0.01, respectively). The complete response rate, objective response rate after chemotherapy and three months after radiotherapy, relapse or progression rate in radiation field in study group and in control group were 19.2% vs 3.9%, 86.5% vs 56.9%, 85% vs 50%, 95% vs 81.3% and 41.3% vs 66.7% (p =0.03, 0.00, 0.03,0.30, 0.01 respectively). The grade 3-4 acute adverse reactions in the study group were significantly higher than in the control group (53.8% vs 9.8%, p=0.00).

CONCLUSIONS

The survival of patients benefits from selective radiotherapy after distant metastasis of NPC treated with dose-dense cisplatin plus fluorouracil.

摘要

目的

探讨剂量密集顺铂联合氟尿嘧啶治疗后鼻咽癌（NPC）远处转移患者行选择性放疗的疗效及安全性。

材料与方法

符合条件的患者采用数字随机表法按1:1比例随机分为研究组和对照组。研究组在选择性放疗后接受剂量密集顺铂联合氟尿嘧啶治疗，对照组在选择性放疗后接受传统顺铂联合氟尿嘧啶治疗。主要终点为总生存期（OS）。次要终点为无进展生存期（PFS）、客观缓解率、放射野内复发或进展率及治疗毒性。

结果

研究组52例患者中，20例行放疗；对照组51例患者中，16例行放疗。研究组和对照组的中位PFS分别为20.9个月和12.7个月，中位OS分别为28.3个月和18.8个月，1年、2年和3年生存率分别为85.2%对65.9%、62.2%对18.3%、36.6%对5.2%（p值分别为0.00、0.00、0.04、0.00和0.00）。亚组分析显示，研究组接受放疗患者的中位OS及1年、2年、3年生存率均优于对照组（分别为43.2个月对24.1个月、94.1%对86.7%、82.4%对43.3%、64.7%对17.3%，p值分别为0.00、0.57、0.04和0.01）。研究组和对照组的完全缓解率、化疗后及放疗后3个月的客观缓解率、放射野内复发或进展率分别为19.2%对3.9%、86.5%对56.9%、85%对50%、95%对81.3%、41.3%对66.7%（p值分别为0.03、0.00、0.03、0.30、0.01）。研究组3-4级急性不良反应显著高于对照组（53.8%对9.8%，p=0.00）。