Department of Radiotherapy, Lihuili Hospital, Ningbo Medical Center, Ningbo, China.
Ann Palliat Med. 2021 Sep;10(9):9669-9677. doi: 10.21037/apm-21-2073.
To evaluate the efficacy and toxicity of docetaxel, cisplatin, and fluorouracil (TPF) regimen followed by intensity modulated radiotherapy (IMRT) on locally advanced nasopharyngeal carcinoma (NPC).
A total of 150 patients with locally advanced NPC [American Joint Committee on Cancer (AJCC) 2009 stage IIIa-IVb] received 2 or 3 cycles of a TPF regimen as induction chemotherapy. A group of 67 participants (TPF group) continued to receive TPF chemotherapy and radiotherapy, and the remaining 83 participants (P group) received cisplatin chemotherapy and radiotherapy.
A median follow-up of 35 months (4-66 months) showed that there was no significant difference between P group and TPF group in progression-free survival (PFS) and overall survival (OS). The incidence rate of myelosuppression at 3-4 degrees was 16.9% and 34.3% in the P group and TPF group (P=0.029), respectively, and the oral mucosa reaction at 3-4 degrees was 18.1% and 37.3% in the P group and TPF group, respectively (P=0.007). The 3-4-degree skin reaction in the P group and TPF group was 15.7% and 29.9% (P=0.030), respectively. The rate of liver function injury in the P group was significantly lower than that in TPF group (P<0.05).
Compared with concurrent cisplatin chemotherapy and radiotherapy, the concurrent TPF regimen and IMRT showed no significant improvement in OS and PFS in patients with advanced NPC, but exhibited more severe hematologic toxicity, oral mucosal responses, skin reactions, and liver functional impairment.
评估多西他赛、顺铂和氟尿嘧啶（TPF）方案联合调强放疗（IMRT）治疗局部晚期鼻咽癌（NPC）的疗效和毒性。
共 150 例局部晚期 NPC [美国癌症联合委员会（AJCC）2009 分期 IIIa-IVb]患者接受 2 或 3 周期 TPF 方案诱导化疗。一组 67 名患者（TPF 组）继续接受 TPF 化疗和放疗，其余 83 名患者（P 组）接受顺铂化疗和放疗。
中位随访 35 个月（4-66 个月）显示，P 组和 TPF 组在无进展生存期（PFS）和总生存期（OS）方面无显著差异。P 组和 TPF 组 3-4 级骨髓抑制发生率分别为 16.9%和 34.3%（P=0.029），3-4 级口腔黏膜炎发生率分别为 18.1%和 37.3%（P=0.007）。P 组和 TPF 组 3-4 级皮肤反应发生率分别为 15.7%和 29.9%（P=0.030）。P 组肝功能损伤发生率明显低于 TPF 组（P<0.05）。
与同期顺铂化疗和放疗相比，晚期 NPC 患者接受同期 TPF 方案联合 IMRT 治疗并未显著提高 OS 和 PFS，但血液学毒性、口腔黏膜反应、皮肤反应和肝功能损害更为严重。
