顺铂和5-氟尿嘧啶诱导化疗联合或不联合多西紫杉醇治疗中青年局部晚期鼻咽癌的长期疗效

IF 2.7 3区 医学 Q3 ONCOLOGY
Yuming Zheng, Fen Xue, Dan Ou, Xiaoshuang Niu, Chaosu Hu, Xiayun He
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引用次数: 0

摘要

目的:本研究旨在评价两种诱导化疗(IC)方案(TPF:多西紫杉醇、顺铂和5-氟尿嘧啶,PF:顺铂和5-氟尿嘧啶)联合放疗治疗中青年局部区域晚期鼻咽癌(LA-NPC)的疗效和毒性。方法:回顾性分析2005年9月至2017年2月我院329例III-IVA期鼻咽癌患者的临床资料。329例患者中,253例采用TPF方案(多西紫杉醇:60 mg/m2第1天,顺铂:25 mg/m2第1-3天,5-氟尿嘧啶:500 mg/m2第1-5天,静脉输注120 h), 76例采用PF方案(顺铂:25 mg/m2第1-3天,5-氟尿嘧啶:500 mg/m2第1-5天,静脉输注120 h)每3周。在IC后进行放疗,同时或不同时进行化疗。生存率采用Kaplan-Meier分析进行评估,生存曲线采用log - rank检验进行比较。结果:PF组和TPF组的5年和8年总生存率分别为80.1%和72.1%,87.3%和78.4% (p = 0.405)。PF组和TPF组的区域无复发生存率(RRFS)和远处无转移生存率(DMFS)比较,差异无统计学意义(p分别为0.585和0.500)。PF组和TPF组患者5年和8年估计局部无复发生存率(LRFS)分别为91.1%和78.0%,96.2%和93.7% (p = 0.026)。此外,非CCRT组和CCRT组的OS、LRFS、RRFS和DMFS率具有可比性(p分别= 0.542、0.319、0.070、0.986)。与PF组相比,TPF组3级或4级中性粒细胞减少和白细胞减少发生率显著增加(p结论:PF和TPF联合放疗或不联合化疗对LA-NPC的抗肿瘤效果较好,两种化疗方案5年、8年OS、RRFS、DMFS率比较,差异均无统计学意义。与PF相比,TPF诱导化疗在LA-NPC中获得了更满意的LRFS率和可接受的毒性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-term results of locoregionally advanced nasopharyngeal carcinoma treated with cisplatin and 5-fluorouracil induction chemotherapy with or without docetaxel in young and middle aged adults.

Purpose: This study aims to evaluate the efficacy and toxicity of the two induction chemotherapy (IC) regimens (TPF: docetaxel, cisplatin and 5-fluorouracil, and PF: cisplatin and 5-fluorouracil) combined with radiotherapy in young and middle aged patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).

Methods: A retrospective analysis was conducted on 329 cases with stage III-IVA nasopharyngeal carcinoma from September 2005 to February 2017. Of the 329 cases, 253 cases underwent TPF (docetaxel: 60 mg/m2 on day 1, cisplatin: 25 mg/m2 on days 1-3, 5-fluorouracil: 500 mg/m2 on days 1-5, intravenous 120-h infusion), while 76 cases received the PF regimen (cisplatin: 25 mg/m2 on days 1-3, 5-fluorouracil: 500 mg/m2 on days 1-5, intravenous 120-h infusion) every 3 weeks. Radiotherapy was administered after IC with or without concurrent chemotherapy. The survival rates were assessed by Kaplan-Meier analysis, and the survival curves were compared using a log‑rank test.

Results: The 5-year and 8-year overall survival (OS) rates of the PF group and TPF group were 80.1% and 72.1%, 87.3% and 78.4% respectively (p = 0.405). There were no statistical differences in regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) rates between PF and TPF groups(p = 0.585 and 0.500, respectively).The 5-year and 8-year estimated local recurrence free survival (LRFS) rates for patients in PF and TPF group were 91.1% and 78.0%, 96.2% and 93.7%, respectively (p = 0.026). Moreover, The OS, LRFS, RRFS and DMFS rates were comparable between the non CCRT or CCRT subgroup (p = 0.542, 0.319, 0.070, 0.986, respectively). Compared with PF group, the TPF group significantly increased the occurrence of grade 3 or 4 neutropenia and leukopenia (p < 0.001).

Conclusion: PF and TPF followed by radiotherapy with or without concurrent chemotherapy performed encouraging anti-tumor effects in LA-NPC, there was no statistical significance in 5-year and 8-year OS, RRFS, and DMFS rates between two chemotherapy regimens. Compared with PF, TPF induction chemotherapy achieved more satisfactory LRFS rate in LA-NPC with acceptable toxicity.

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来源期刊
CiteScore
4.00
自引率
2.80%
发文量
577
审稿时长
2 months
期刊介绍: The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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