Talbi Oumaima, Hinaje Khadija, Mhirech Samia, Maadin Kaoutar, Chakri Imad, Amaadour Lamiae, Oualla Karima, Benbrahim Zineb, Bouhafa Touria, Mellas Nawfel, Arifi Samia
Department of Medical Oncology, Hassan II University Hospital, Fez 30000, Morocco.
Department of Radiotherapy, Chu Hassan II of Fes, Fez 30000, Morocco.
Ecancermedicalscience. 2025 Jan 22;19:1829. doi: 10.3332/ecancer.2025.1829. eCollection 2025.
According to the latest guidelines for nasopharyngeal carcinoma (NPC), induction chemotherapy (IC) followed by concomitant chemoradiation therapy is recommended as the preferred standard of care for patients with locally advanced NPC (stage III-IVA). However, the optimal regimen for IC in patients with locally advanced NPC remains uncertain.
We conducted a retrospective study to compare the effectiveness and tolerability of two platinum-based IC regimens; gemcitabine - Cisplatin (GC), and doxorubicin-Cisplatin (DP) in the treatment of newly diagnosed locally advanced NPC. The main objective of this study was to compare efficacy, including objective response rates (ORRs), progression-free survival (PFS), overall survival (OS) and safety.
105 patients were satisfied with the eligibility criteria and were, therefore, selected for analysis (62 patients in the DP group and 43 in the GC group), including 65 men and 40 women, with a mean age of 49.5 years (range = 19-79 years) and a Karnofsky score ranging from 87% to 100%. 34% of patients were diagnosed at stage IVA.In the DP group, 3% of patients (2 out of 62) achieved a complete response complete response (CR), 60% achieved a partial response (PR), 25% remained stable S and 19% experienced progression. In the GC group, 2% of patients (1 out of 43) achieved a CR, 39.5% achieved a PR, 39.5% remained stable and 19% experienced progression. A statistically significant difference in PR was observed between the two groups ( = 0.028), and the difference in terms of progression is approaching the limit of significance ( = 0,06) after a median follow-up of 27 months (5.3-82). The 2-year PFS was 70% in the DP group compared to 80% in the GC group; the 2-year OS was 75% in the DP group and 90% in the GC group. No significant survival difference was observed between the two groups.Patients in the DP group exhibited less grade 3-4 thrombocytopenia but more grade 3-4 leukopenia and neutropenia compared to the GC group.
In patients with locally advanced NPC, DP-based IC demonstrated superior ORR compared with the GC regimen, with acceptable toxicity. Further studies are required to validate these results.
根据鼻咽癌（NPC）的最新指南，诱导化疗（IC）后序贯同步放化疗被推荐作为局部晚期NPC（III-IVA期）患者的首选标准治疗方案。然而，局部晚期NPC患者IC的最佳方案仍不确定。
我们进行了一项回顾性研究，比较两种铂类IC方案；吉西他滨-顺铂（GC）和阿霉素-顺铂（DP）在新诊断的局部晚期NPC治疗中的有效性和耐受性。本研究的主要目的是比较疗效，包括客观缓解率（ORR）、无进展生存期（PFS）、总生存期（OS）和安全性。
105例患者符合入选标准，因此被选入分析（DP组62例，GC组43例），包括65例男性和40例女性，平均年龄49.5岁（范围=19-79岁），卡诺夫斯基评分在87%至100%之间。34%的患者诊断为IVA期。在DP组中，3%的患者（62例中的2例）达到完全缓解（CR），60%达到部分缓解（PR），25%病情稳定（S），19%病情进展。在GC组中，2%的患者（43例中的1例）达到CR，39.5%达到PR，39.5%病情稳定，19%病情进展。两组间PR有统计学显著差异（P=0.028），在中位随访27个月（5.3-82）后，进展方面的差异接近显著性界限（P=0.06）。DP组2年PFS为70%，而GC组为80%；DP组2年OS为75%，GC组为90%。两组间未观察到显著的生存差异。与GC组相比，DP组3-4级血小板减少症患者较少，但3-4级白细胞减少症和中性粒细胞减少症患者较多。
在局部晚期NPC患者中，基于DP方案的IC与GC方案相比显示出更高的ORR，且毒性可接受。需要进一步研究来验证这些结果。
