Head and Neck Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Invest New Drugs. 2021 Apr;39(2):564-570. doi: 10.1007/s10637-020-00999-y. Epub 2020 Sep 17.
There is an unmet need for improving survival outcomes of locally advanced nasopharyngeal carcinoma, for example, T4/ N3 stage disease. To this end, we administered induction chemotherapy (IC) with TPF (docetaxel, cisplatin, and fluorouracil) because this stage of disease is associated with a high risk of recurrence and is difficult to control with standard treatments, such as chemoradiotherapy (CRT) alone or CRT followed by adjuvant chemotherapy. The aim of this retrospective single-center study was to clarify the short-term outcomes of locally far-advanced nasopharyngeal carcinoma patients treated with IC-TPF, followed by CRT with cisplatin. Data from 11 patients were extracted from our database, indicating that the overall response rate to IC-TPF, clinical complete response rate after CRT, 1-year progression-free survival, and 1-year overall survival were 73%, 91%, 68%, and 89%, respectively. Hematological toxicity was the most common adverse event reported during IC-TPF with 64% of patients suffering grade 3 or 4 neutropenia, 55% grade 3 or 4 leucopenia and 9% febrile neutropenia. Despite the small number of patients, these data are important because there is a limited number of studies investigating IC-TPF followed by CRT in Japanese patients. This pilot study provides some indication of the short-term effectiveness and toxicity of this therapeutic approach, which may be superior to standard treatments. Long-term follow-up is warranted to assess the effectiveness of IC-TPF in terms of clinical outcome and late-phase toxicity.
目前,提高局部晚期鼻咽癌(例如 T4/N3 期疾病)的生存结果存在未满足的需求。为此,我们采用 TPF(多西他赛、顺铂和氟尿嘧啶)诱导化疗(IC),因为这种疾病阶段与高复发风险相关,并且难以用标准治疗(如单纯放化疗或放化疗后辅助化疗)控制。这项回顾性单中心研究的目的是阐明局部晚期鼻咽癌患者接受 IC-TPF 治疗后接受顺铂放化疗的短期结果。从我们的数据库中提取了 11 名患者的数据,结果表明 IC-TPF 的总体缓解率、CRT 后的临床完全缓解率、1 年无进展生存率和 1 年总生存率分别为 73%、91%、68%和 89%。IC-TPF 期间最常见的不良反应是血液学毒性,64%的患者发生 3 级或 4 级中性粒细胞减少症,55%的患者发生 3 级或 4 级白细胞减少症,9%的患者发生发热性中性粒细胞减少症。尽管患者人数较少,但这些数据很重要,因为很少有研究调查日本患者接受 IC-TPF 后接受 CRT 的情况。这项初步研究提供了关于这种治疗方法短期有效性和毒性的一些证据,该方法可能优于标准治疗。需要长期随访以评估 IC-TPF 在临床结果和晚期毒性方面的有效性。