同期放化疗治疗鼻咽癌时，顺铂周疗与 3 周方案的比较。

Comparison of weekly and triweekly cisplatin regimens during concurrent chemoradiotherapy for nasopharyngeal carcinoma.

机构信息

Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangdong Pharmaceutical University, 19 Nonglinxia Road, Guangzhou, 510062, China.

Department of Integrated Therapy in Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 East Dongfeng Road, Guangzhou, 510060, China.

出版信息

BMC Cancer. 2019 May 22;19(1):482. doi: 10.1186/s12885-019-5688-z.

DOI:10.1186/s12885-019-5688-z

PMID:31117967

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6532163/

Abstract

BACKGROUND

We compared the survival outcomes and acute toxicities of weekly and triweekly cisplatin regimens during concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients.

METHODS

Patients were treated with CCRT alone. CCRT was initiated on the first day of RT. Cisplatin 30-40 mg/m was infused on days 1, 8, 15, 22, 29, 36 and 43 in the Weekly Group, while cisplatin 80-100 mg/m was delivered on days 1, 22 and 43 in the Triweekly Group. The survival outcomes were revealed by the Kaplan-Meier method and Cox regression modelling to measure 5-year overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS).

RESULTS

Ninety-three (28.9%) patients received three to 7 cycles of cisplatin weekly (Weekly Group) and 229 (71.1%) patients received two to 3 cycles of cisplatin triweekly (Triweekly Group). Five-year OS (weekly vs. triweekly, 96.7% vs. 88.3%, P = 0.036) and DFS (weekly vs. triweekly, 90.7% vs. 80.5%, P = 0.028) were better in the Weekly Group than in the Triweekly Group. The weekly vs. triweekly 5-year DMFS and LRFS rates were: DMFS, 96.7% vs. 91.4%, χ = 2.694, P = 0.101; LRFS, 96.3% vs. 93.5%, χ = 1.317, P = 0.251. Cisplatin delivery regimen was not an independent prognostic factor. The incidence rate of acute toxicities was similar between the groups.

CONCLUSIONS

Compared with Triweekly cisplatin regimen, Weekly regimen may be a better choice during CCRT.

摘要

背景

我们比较了同期放化疗（CCRT）中每周和每三周顺铂方案治疗鼻咽癌（NPC）患者的生存结局和急性毒性。

方法

患者接受 CCRT 单独治疗。CCRT 于放疗第一天开始。每周组中，顺铂 30-40mg/m 于第 1、8、15、22、29、36 和 43 天输注，而每三周组中，顺铂 80-100mg/m 于第 1、22 和 43 天输注。生存结果通过 Kaplan-Meier 方法和 Cox 回归模型揭示，以测量 5 年总生存率（OS）、无病生存率（DFS）、局部区域无复发生存率（LRFS）和无远处转移生存率（DMFS）。

结果

93 例（28.9%）患者接受三至 7 个周期的每周顺铂（每周组），229 例（71.1%）患者接受二至 3 个周期的每三周顺铂（每三周组）。每周组 5 年 OS（每周 vs. 每三周，96.7% vs. 88.3%，P=0.036）和 DFS（每周 vs. 每三周，90.7% vs. 80.5%，P=0.028）均优于每三周组。每周组与每三周组的 5 年 DMFS 和 LRFS 率分别为：DMFS，96.7% vs. 91.4%，χ=2.694，P=0.101；LRFS，96.3% vs. 93.5%，χ=1.317，P=0.251。顺铂给药方案不是独立的预后因素。两组急性毒性发生率相似。