Department of Otorhinolaryngology, College of Traditional Chinese Medicine, Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang 443000, China.
J BUON. 2021 May-Jun;26(3):774-780.
The purpose of this study was to compare the efficacy and safety of induction chemotherapy combined with chrono-chemotherapy or conventional chemotherapy and intensity-modulated radiotherapy (IMRT) in locally advanced nasopharyngeal carcinoma.
150 patients with locally advanced nasopharyngeal carcinoma were divided into two groups: chrono-chemotherapy group (n=75, receiving induction chemotherapy combined with chrono-chemotherapy and IMRT, and control group (n=75, receiving induction chemotherapy combined with conventional chemotherapy and IMRT. Besides, the levels of T lymphocyte subsets in peripheral blood before and after treatment were compared, and the long-term survival and disease progression were followed up and recorded.
After treatment, the short-term efficacy of patients was evaluated. The overall response rate was 94.7% (71/75) in chrono-chemotherapy group and 96.0% (72/75) in control group. Moreover, the levels of cluster of differentiation (CD)3+, CD4+, CD8+, CD4+/CD8+, CD16+CD56+ and CD19+ T cells in peripheral blood of patients at 6 months after treatment were significantly lower than those before treatment. The level of posttreatment CD16+CD56+ T cells in chrono-chemotherapy group was significantly higher than that in control group. Furthermore, the follow-up results showed that the 3-year overall survival (OS) was 73.3% and 69.3%, and the 3-year progression-free survival (PFS) was 60.0% and 62.7% in chrono-chemotherapy group and control group, respectively. Finally, Log-rank test showed no significant differences in OS and PFS between the two groups of patients.
As a new treatment mode, chrono-chemotherapy combined with induction chemotherapy and IMRT can reduce the incidence rate and severity of treatment-related adverse reactions and improve immunosuppression without reducing clinical efficacy, which is worthy of clinical promotion and application.
本研究旨在比较诱导化疗联合时辰化疗或常规化疗与调强放疗（IMRT）治疗局部晚期鼻咽癌的疗效和安全性。
将 150 例局部晚期鼻咽癌患者分为两组：时辰化疗组（n=75，接受诱导化疗联合时辰化疗和 IMRT）和对照组（n=75，接受诱导化疗联合常规化疗和 IMRT）。比较两组患者治疗前后外周血 T 淋巴细胞亚群水平，随访并记录长期生存和疾病进展情况。
治疗后评估患者近期疗效，时辰化疗组总有效率为 94.7%（71/75），对照组为 96.0%（72/75）。此外，治疗后 6 个月两组患者外周血中 CD3+、CD4+、CD8+、CD4+/CD8+、CD16+CD56+和 CD19+T 细胞水平均明显低于治疗前，且时辰化疗组治疗后 CD16+CD56+T 细胞水平明显高于对照组。随访结果显示，两组患者 3 年总生存率（OS）分别为 73.3%和 69.3%，无进展生存率（PFS）分别为 60.0%和 62.7%。Log-rank 检验结果显示，两组患者 OS 和 PFS 差异均无统计学意义。
时辰化疗联合诱导化疗和 IMRT 作为一种新的治疗模式，可降低治疗相关不良反应的发生率和严重程度，改善免疫抑制，且不降低临床疗效，值得临床推广应用。
