Jin Ting, Qin Wei-Feng, Jiang Feng, Jin Qi-Feng, Wei Qi-Chun, Jia Yong-Shi, Sun Xiao-Nan, Li Wen-Feng, Chen Xiao-Zhong
Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, Zhejiang 310022, People's Republic of China; Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, People's Republic of China.
Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, People's Republic of China; Key Laboratory of Radiation Oncology in Zhejiang Province, Hangzhou, Zhejiang 310022,People's Republic of China.
Transl Oncol. 2019 Apr;12(4):633-639. doi: 10.1016/j.tranon.2019.01.002. Epub 2019 Feb 20.
In this study, we aim to compare the progression-free survival (PFS) rates and side effects of induction chemotherapy based on docetaxel, cisplatin and fluorouracil (TPF) versus cisplatin and fluorouracil (PF) in patients with locoregionally-advanced nasopharyngeal carcinoma who received subsequent chemoradiotherapy. We randomly assigned 278 patients with stage III or IV NPC (without distant metastases) to receive either TPF or PF induction chemotherapy, followed by cisplatin-based chemoradiotherapy every 3 weeks and intensity-modulated radiation therapy for 5 days per week. After a minimum of 2 years follow-up, a PFS benefit was observed for TPF compared to PF, though this difference was not statistically significant (84.5% vs. 77.9%, P = .380). Due to increased frequencies of grade 3 or 4 neutropenia and diarrhea, significantly more patients in the TPF group required treatment delays and dose modifications. Our findings suggest that PF induction chemotherapy has substantially better tolerance and compliance rates than TPF induction chemotherapy. However, the treatment efficacy of PF is not superior to TPF induction chemotherapy in patients with locoregionally-advanced NPC (ClinicalTrials.gov number, NCT01536223).
在本研究中，我们旨在比较多西他赛、顺铂和氟尿嘧啶（TPF）诱导化疗与顺铂和氟尿嘧啶（PF）诱导化疗对接受后续放化疗的局部晚期鼻咽癌患者的无进展生存期（PFS）率和副作用。我们将278例III期或IV期鼻咽癌患者（无远处转移）随机分为两组，分别接受TPF或PF诱导化疗，随后每3周进行一次以顺铂为基础的放化疗，每周进行5天的调强放疗。经过至少2年的随访，与PF相比，TPF组观察到PFS获益，尽管这种差异无统计学意义（84.5%对77.9%，P = 0.380）。由于3级或4级中性粒细胞减少症和腹泻的发生率增加，TPF组需要延迟治疗和调整剂量的患者明显更多。我们的研究结果表明，PF诱导化疗的耐受性和依从率明显优于TPF诱导化疗。然而，在局部晚期鼻咽癌患者中，PF的治疗效果并不优于TPF诱导化疗（ClinicalTrials.gov编号，NCT01536223）。
