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接受TPF诱导化疗后序贯顺铂同步放化疗的局部区域晚期鼻咽癌患者的长期生存及预后因素

Long-Term Survival and Prognostic Factors in Locoregionally Advanced Nasopharyngeal Carcinoma Patients Treated with TPF Induction Chemotherapy followed by Cisplatin-Combined Concurrent Chemoradiotherapy.

作者信息

Zhang Qun, Wang Yan, Liao Jun-Fang, Ren Yu-Feng, Shen Guo-Ping, Niu Shao-Qing, Luo Wei

机构信息

Department of Radiotherapy, First affiliated hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.

Cancer Hospital Chinese Academy of Medical Science, Shenzhen Center, Shenzhen, People's Republic of China.

出版信息

J Cancer. 2019 Jun 24;10(17):3899-3907. doi: 10.7150/jca.31663. eCollection 2019.

DOI:10.7150/jca.31663
PMID:31417633
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6692629/
Abstract

: The objective of this study was to report long-term results of docetaxel, cisplatin, and 5-fluorouracil (TPF) induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and identify prognostic factors for this group of patients. : From December 2010 to January 2015, 109 patients with locoregionally advanced (III-IVB) NPC were included. Patients were scheduled to complete TPF induction chemotherapy followed by cisplatin based CCRT. Failure-free survival (FFS), overall survival (OS), locoregional failure-free survival (LRFFS) and distant failure-free survival (DFFS) served as clinical outcomes. Kaplan-Meier method, Cox proportional hazards model and receiver operating characteristic (ROC) curves were used for analyzing. : With a median follow-up of 60.2 months (range, 7.9-91.6 months), 3-year FFS, OS, LRFFS, and DFFS were 76.8%, 85.1%, 88.3%, and 84.1%, respectively. The highest incidence rate of recurrence and metastasis were in the first year after treatment. Multivariate analyses showed that age, total time of radiation therapy (RTT), and total time of therapy (TTT) were independent prognostic factors for FFS and OS. Body mass index (BMI), RTT and TTT were significant variables predicting DFFS. TTT was the only independent prognostic factor for LRFFS. : This study indicated that TPF regimen produced encouraging results in Asian patients with locoregionally advanced nasopharyngeal carcinoma. Toxicity was tolerable and reversible. However, overall treatment time is an important factor that we should take into consideration when make plans of induction chemotherapy related treatment.

摘要

本研究的目的是报告多西他赛、顺铂和5-氟尿嘧啶(TPF)诱导化疗后同步放化疗(CCRT)治疗局部晚期鼻咽癌(NPC)患者的长期结果,并确定该组患者的预后因素。

2010年12月至2015年1月,纳入109例局部晚期(III-IVB期)NPC患者。患者计划完成TPF诱导化疗,随后进行以顺铂为基础的CCRT。无失败生存(FFS)、总生存(OS)、局部区域无失败生存(LRFFS)和远处无失败生存(DFFS)作为临床结局。采用Kaplan-Meier法、Cox比例风险模型和受试者工作特征(ROC)曲线进行分析。

中位随访60.2个月(范围7.9-91.6个月),3年FFS、OS、LRFFS和DFFS分别为76.8%、85.1%、88.3%和84.1%。复发和转移的最高发生率出现在治疗后的第一年。多因素分析显示,年龄、放疗总时间(RTT)和治疗总时间(TTT)是FFS和OS的独立预后因素。体重指数(BMI)、RTT和TTT是预测DFFS的显著变量。TTT是LRFFS的唯一独立预后因素。

本研究表明,TPF方案在亚洲局部晚期鼻咽癌患者中产生了令人鼓舞的结果。毒性是可耐受且可逆的。然而,在制定诱导化疗相关治疗计划时,总体治疗时间是一个我们应考虑的重要因素。

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