评估诱导化疗联合同期放化疗治疗晚期鼻咽癌：顺铂、氟尿嘧啶和多西他赛与吉西他滨和顺铂的比较。
Assessment of Concurrent Chemoradiotherapy plus Induction Chemotherapy in Advanced Nasopharyngeal Carcinoma: Cisplatin, Fluorouracil, and Docetaxel versus Gemcitabine and Cisplatin.
机构信息
Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, and Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Head and Neck Oncology, Cancer Center, and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China.
出版信息
Sci Rep. 2018 Oct 22;8(1):15581. doi: 10.1038/s41598-018-33614-5.
Induction chemotherapy treatment for nasopharyngeal carcinoma (NPC) is controversial. The aim of this study was to evaluate the treatment outcomes and toxicities between two induction chemotherapy regimens, with both followed by concurrent chemoradiotherapy. The first strategy used docetaxel, cisplatin and fluorouracil for induction chemotherapy (TPF), and the second utilised gemcitabine and cisplatin (GP). A retrospective analysis was performed on eligible NPC patients attending our hospital between May 2009 and Dec 2014. A total of 113 patients were enrolled with 58 patients receiving TPF and 55 receiving GP induction chemotherapy. Ninety-four patients (83.2%) were alive after 36-months follow-up. The median overall survival (OS) and progression-free survival (PFS) time were 48.3 and 39.7 months, respectively. The 3-year OS for the TPF regimen was 87.9% and 87.4% with GP chemotherapy (P = 0.928). The 3-year PFS of the TPF treatment was 84.5%, while it was 83.5% for the GP group (P = 0.551). Univariate analysis showed that lymph node metastasis was a significant PFS prognostic factor, while N3 stage was an independent predictor of PFS and distant failure-free survival (DMFS) in multivariate analysis. There were no significant differences in adverse toxicities or treatment efficacy between the chemotherapy regimens in the treatment of locoregionally advanced NPC.
诱导化疗治疗鼻咽癌（NPC）存在争议。本研究旨在评估两种诱导化疗方案（均联合同期放化疗）的治疗结果和毒性。第一种方案使用多西他赛、顺铂和氟尿嘧啶进行诱导化疗（TPF），第二种方案使用吉西他滨和顺铂（GP）。对 2009 年 5 月至 2014 年 12 月在我院就诊的符合条件的 NPC 患者进行回顾性分析。共纳入 113 例患者，其中 58 例接受 TPF 诱导化疗，55 例接受 GP 诱导化疗。94 例（83.2%）患者在 36 个月随访后存活。中位总生存期（OS）和无进展生存期（PFS）分别为 48.3 个月和 39.7 个月。TPF 方案 3 年 OS 率为 87.9%，GP 组为 87.4%（P=0.928）。TPF 治疗的 3 年 PFS 为 84.5%，GP 组为 83.5%（P=0.551）。单因素分析显示，淋巴结转移是 PFS 的显著预后因素，而 N3 期是多因素分析中 PFS 和远处无失败生存（DMFS）的独立预测因素。在治疗局部晚期 NPC 方面，两种化疗方案的不良反应或疗效无显著差异。
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