Zou Rui, Yuan Jing-Jing, Li Qiang, Ding Jian-Wu, Liao Bing, Tu Zi-Wei, Hu Rong-Huan, Gong Dan, Hu Jia-Li, Zeng Lei
Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Jiangxi Key Laboratory of Clinical Translational Cancer Research, Nanchang, China.
Front Oncol. 2021 Feb 26;10:619625. doi: 10.3389/fonc.2020.619625. eCollection 2020.
To analyze the outcomes and toxicities of induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CCRT) plus adjuvant chemotherapy (ACT) in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).
Retrospective analysis of 163 patients with LA-NPC referred from August 2015 to December 2018 was carried out. All patients underwent platinum-based ICT followed by CCRT plus ACT.
The median follow-up time was 40 months, ranging from 5 to 69 months. The 3-year disease-free survival (DFS), overall survival (OS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates were 80.8, 90.0, 91.6, and 87.4%, respectively. The most frequent acute grade 3/4 adverse events were leukopenia (66.8%), neutropenia (55.8%), mucositis (41.1%), thrombocytopenia (27.0%), and anemia (14.7%).
ICT followed by CCRT plus ACT did not seemingly enhance DFS and OS in LA-NPC patients compared to the addition of ICT to CCRT (historical controls). In contrast, ICT followed by CCRT plus ACT had more acute adverse events than ICT followed by CCRT. Longer-term clinical studies are required to examine the treatment outcomes and late toxicities.
分析诱导化疗（ICT）序贯同步放化疗（CCRT）加辅助化疗（ACT）治疗局部晚期鼻咽癌（LA-NPC）患者的疗效和毒性。
对2015年8月至2018年12月转诊的163例LA-NPC患者进行回顾性分析。所有患者均接受铂类ICT，随后进行CCRT加ACT。
中位随访时间为40个月，范围为5至69个月。3年无病生存率（DFS）、总生存率（OS）、局部区域无复发生存率（LRRFS）和远处转移无复发生存率（DMFS）分别为80.8%、90.0%、91.6%和87.4%。最常见的3/4级急性不良事件为白细胞减少（66.8%）、中性粒细胞减少（55.8%）；口腔黏膜炎（41.1%）、血小板减少（27.0%）和贫血（14.7%）。
与CCRT联合ICT（历史对照）相比，ICT序贯CCRT加ACT似乎并未提高LA-NPC患者的DFS和OS。相比之下，ICT序贯CCRT加ACT比ICT序贯CCRT具有更多的急性不良事件。需要进行长期临床研究以检验治疗效果和晚期毒性。
