非流行地区局部晚期鼻咽癌诱导化疗疗效和毒性的真实世界数据。
Real-world data on the efficacy and toxicity of induction chemotherapy in locally advanced nasopharyngeal carcinoma in a non-endemic population.
作者信息
Filho Cassio Murilo Hidalgo, Polho Gabriel Berlingieri, Moreira Otavio Augusto, de Oliveira Andrade Matheus, Parrela Vinicius Cruz, Shinkado Yumi Ricucci, de Almeida Robatto Amanda Acioli, Neto Felippe Lazar, Freitas Ana Julia, Souza Aurelio Teixeira, de Castro Junior Gilberto, Mak Milena Perez
机构信息
Department of Clinical Oncology, Instituto do Cancer do Estado de São Paulo ICESP, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05508-220, Brazil.
https://orcid.org/0000-0002-7046-0059.
出版信息
Ecancermedicalscience. 2025 Jan 23;19:1832. doi: 10.3332/ecancer.2025.1832. eCollection 2025.
BACKGROUND
Induction chemotherapy (ICT) is critical for managing locally advanced nasopharyngeal carcinoma (LA-NPC), but real-world data on its efficacy and toxicity are limited.
METHODS
This retrospective study included LA-NPC patients treated with ICT from 2012 to 2022. We evaluated radiological response rates, overall survival (OS), treatment-related toxicities and complete response (CR) rates.
RESULTS
Among 217 patients, 119 met the inclusion criteria and were included in the final analysis. CR rates were similar across ICT regimens (docetaxel, cisplatin and 5-fluorouracil 68.0%; cisplatin and gemcitabine 57.1%; cisplatin and 5-fluorouracil 58.0%; others 50%, = 0.72). Serious adverse events (SAEs) occurred in 22%, with 69.7% experiencing weight loss and 31.9% requiring enteral tube placement. Poor OS was linked to Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥2 hazard ratios (HR 2.8, = 0.004) and residual disease (RD) (HR 7.4, = 0.001). Stage IV (Odds Ratio [OR] 3.77, p = 0.005) and ECOG-PS ≥ 2 (OR 4.69, = 0.006) were associated with RD.
CONCLUSION
ICT regimens had similar CR rates. Poor ECOG-PS and stage IV predicted RD. Managing toxicities is crucial for better outcomes.
背景
诱导化疗（ICT）对于局部晚期鼻咽癌（LA-NPC）的治疗至关重要，但关于其疗效和毒性的真实世界数据有限。
方法
这项回顾性研究纳入了2012年至2022年接受ICT治疗的LA-NPC患者。我们评估了放射学缓解率、总生存期（OS）、治疗相关毒性和完全缓解（CR）率。
结果
在217例患者中，119例符合纳入标准并纳入最终分析。不同ICT方案的CR率相似（多西他赛、顺铂和5-氟尿嘧啶为68.0%；顺铂和吉西他滨为57.1%；顺铂和5-氟尿嘧啶为58.0%；其他为50%，P = 0.72）。22%的患者发生了严重不良事件（SAEs），69.7%的患者出现体重减轻，31.9%的患者需要放置肠内营养管。OS较差与东部肿瘤协作组体能状态（ECOG-PS）≥2（风险比[HR] 2.8，P = 0.004）和残留病灶（RD）（HR 7.4，P = 0.001）有关。IV期（优势比[OR] 3.77，p = 0.005）和ECOG-PS≥2（OR 4.69，P = 0.006）与RD相关。
结论
ICT方案的CR率相似。ECOG-PS差和IV期预示着RD。管理毒性对于获得更好的结果至关重要。
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