吉西他滨对比多西他赛联合顺铂用于鼻咽癌诱导化疗。

Gemcitabine Versus Docetaxel Plus Cisplatin as Induction Chemotherapy in Nasopharyngeal Carcinoma.

机构信息

National Clinical Research Center for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China.

Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Laryngoscope. 2022 Dec;132(12):2379-2387. doi: 10.1002/lary.30092. Epub 2022 Mar 3.

DOI:10.1002/lary.30092

PMID:35238403

Abstract

OBJECTIVES

To compare tumor volume reduction after induction chemotherapy (IC) with gemcitabine plus cisplatin (GP) and docetaxel plus cisplatin (DP) and to evaluate the influence on subsequent radiotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC).

STUDY DESIGN

Retrospective clinical study.

METHODS

Patients who received GP or DP IC followed by concurrent chemoradiotherapy (CCRT) were retrospectively enrolled. Propensity score matching (PSM) was adopted to control the balance between the GP and DP groups.

RESULTS

A total of 41 patients treated with GP and 53 patients treated with DP were enrolled. After matching, 33 sub-pairs of 66 patients were generated in the post-PSM cohort. As compared with DP, GP was superior in its gross tumor volume of the nasopharynx (GTVnx) reduction (28.88% vs. 18.73%; P = .014) but equivalent in its gross tumor volume of the lymph nodes (GTVnd) reduction (37.58% vs. 29.79%; P = .229). Univariate and multivariate analyses confirmed that the chemotherapy regimen was an independent factor associated with the reduction in GTVnx (P = .011). The GP group exhibited advantages in the dosimetric parameters of the planning target volume of high-risk volume and low-risk volume (PTV1 and PTV2), lenses, temporal lobes, and parotid glands. Univariate and multivariate analyses confirmed that chemotherapy regimen was an independent factor associated with the dosimetric parameters of PTV1, PTV2, lenses, temporal lobes, and parotid glands.

CONCLUSION

GP regimen achieves a greater GTVnx reduction than DP regimen and has an advantage in the dosimetry of subsequent CCRT.

LEVEL OF EVIDENCE

3 Laryngoscope, 132:2379-2387, 2022.

摘要

目的

比较吉西他滨联合顺铂（GP）与多西他赛联合顺铂（DP）诱导化疗后肿瘤体积缩小，并评估其对局部晚期鼻咽癌（NPC）后续放疗的影响。

研究设计

回顾性临床研究。

方法

回顾性纳入接受 GP 或 DP 诱导化疗后行同期放化疗（CCRT）的患者。采用倾向评分匹配（PSM）控制 GP 组和 DP 组之间的平衡。

结果

共纳入 41 例 GP 治疗患者和 53 例 DP 治疗患者。匹配后，在 PS 后队列中生成 33 对 66 例亚组。与 DP 相比，GP 在鼻咽大体肿瘤体积（GTVnx）缩小方面更具优势（28.88%比 18.73%；P=0.014），但在颈部淋巴结大体肿瘤体积（GTVnd）缩小方面无差异（37.58%比 29.79%；P=0.229）。单因素和多因素分析均证实化疗方案是 GTVnx 缩小的独立相关因素（P=0.011）。GP 组在高危靶区（PTV1 和 PTV2）、晶状体、颞叶和腮腺的剂量学参数方面具有优势。单因素和多因素分析均证实化疗方案是 PTV1、PTV2、晶状体、颞叶和腮腺剂量学参数的独立相关因素。