局部晚期鼻咽癌洛铂单周方案同期放疗初探

doi:10.3760/cma.j.issn.1004-4221.2020.03.003

Abstract
Figure/Table
References(19)
Related Citation (6)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To define the maximum-tolerated dose (MTD) of lobaplatin (LBP) in a weekly regimen combined with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 18 cases with stage Ⅲ/IV A NPC were enrolled. Concurrent chemoradiotherapy was given to all the patients with a dose escalation of LBP. The initial dose of LBP was 15 mg/m² with an escalating dose of 5 mg/m². At least 3 patients were assigned into each group. Patients were proceeded into the next dose group if no dose-limiting toxicity (DLT) occurred until the MTD was achieved. Efficacy and toxicity were evaluated regularly. Results Three patients were assigned into the 10 mg/m², 3 into the 15 mg/m², and 6 into the 20 mg/m² and 25 mg/m² groups, respectively. Two patients experienced DLT in the 25 mg/m² group. Hence, the MTD was determined as 20 mg/m². At 3 months after corresponding treatment, the remission rate of nasopharyngeal tumors and neck-positive lymph nodes of the patients was 100%. The most common toxicity was reversible bone marrow suppression. Conclusions The MTD of weekly lobaplatin plus concurrent IMRT is 20 mg/m² for locally advanced NPC. This regimen is reliable and safe, which is worthy of further clinical study.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Pang Xuezhou
	Qing Dong
	Zhao Bin
	Ma Daiyuan

Key words： Nasopharyngeal neoplasm/concurrent chemoradiotherapy Lobaplatin Dose-limiting toxicity Maximum tolerated dose

Received: 14 May 2019

Fund:Bureau of Science and Technology nanchong city-Major technical problems in City-School Cooperation(18SXHZ0352)

Corresponding Authors: Ma Daiyuan,Email:mdylx@163.com

Cite this article:

Pang Xuezhou,Qing Dong,Zhao Bin et al. Dose-escalation trial of lobaplatin weekly plus concurrent radiotherapy for local-regionally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2020, 29(3): 171-174.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2020.03.003 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I3/171

[1] Wee JT,Ha TC,Loong SL,et al. Is nasopharyngeal cancer really a “Cantonese cancer”?[J]. Chin J Cancer,2010,29(5):517-526. DOI:10.5732/cjc.009.10329.
[2] Ou D,Blanchard P,Ei Khoury C,et al. Induction chemotherapy with docetaxel,cisplatin and fluorouracil followed by concurrent chemoradiotherapy or chemoradiotherapy alone in locally advanced non-endemic nasopharyngeal carcinoma[J]. Oral Oncol,2016,11(62):114-121. DOI:10.1016/j.oraloncology.2016.10.011.
[3] Yeh SA,Tang Y,Lui CC,et al. Treatment outcomes and late complications of 849 patients with nasopharyngeal carcinoma treated with radiotherapy alone[J]. Int J Radiat Oncol Biol Phys,2005,62(3):672-679. DOI:10.1016/j.ijrobp.2004.11.002.
[4] Jadis A,Lakin J,Hao D,et al. Dose delivery analysis of weekly versus 3-weekly cisplatin concurrent with radiation therapy for locally advanced nasopharyngeal carcinoma (NPC)[J]. Am J Clin Oncol,2012,37(1):63-69. DOI:10.1097/COC.0b013e31826b9b1a.
[5] Lee JY,Sun JM,Oh DR,et al. Comparison of weekly versus tri-weekly cisplatin delivered concurrently with radiation therapy in patients with locally advanced nasopharyngeal cancer:a multi-cencer randomized phase Ⅱ trail (KCSG-HN10-02)[J]. Radiother Oncol,2016,118(2):244-250. DOI:10.1016/j.radonc.2015.11.030.
[6] 杨柳青,秦叔逵. 第3代铂类药物洛铂的研究新进展[J]. 临床肿瘤学杂志,2009,14(12):1134-1139. DOI:10.3969/j.issn.1009-0460.2009.12.019.
Yang LQ,Qin SK. Progression of lobaplatin as the third generation platinum drug[J]. Chin Clin Oncol,2009,14(12):1134-1139. DOI:10.3969/j.issn.1009-0460.2009.12.019.
[7] 刘秀峰,秦叔逵. 洛铂的临床研究进展[J]. 临床肿瘤学杂志,2006,11(7):549-552. DOI:10.3969/j.issn.1009-0460.2006.07.024.
Liu XF,Qin SK. Progress in clinical research of lobaplatin[J]. Chin Clin Oncol,2006,11(7):549-552. DOI:10.3969/j.issn.1009-0460.2006.07.024.
[8] Ke LR,Xia WX,Qiu WZ,et al. Safety and efficacy of lobaplatin combined with 5-fluorouracil as first-line induction chemotherapy followed by lobaplatin-radiotherapy in locally advanced nasopharyngeal carcinoma:preliminary results of a prospective phase Ⅱ trial[J]. BMC Cancer,2017,17(1):134. DOI:10.1186/s12885-017-3080-4.
[9] 尤涛,赵微,党雪菲. 局部晚期鼻咽癌放疗同期洛铂化疗与顺铂化疗的比较研究[J]. 中国医药指南,2015,13(12):90.
You T,Zhao W,Dang XF. Chemoradiation comparing lobaplatin versus cisplatin in locally advanced nasopharyngeal cancer[J]. Guid China Med,2015,13(12):90.
[10] Fiebig HH,Henb H,Mross JK,et al. Phase Ⅰ clinical trial of lobaplatin (D-19466) after intravenous bolus injection[J]. Oncology Research and Treatment,1994,17(2):142-148. DOI:10.1159/000218399.
[11] Zhang S,Lin SM,Hu LK. Lobaplatin combined with docetaxel neoadjuvant chemotherapy followed by concurrent lobaplatin with intensity-modulated radiotherapy increases the survival of patients with high-risk lymph node positive nasopharyngeal carcinoma[J]. J BUON,2016,21(1):161-167.
[12] 谢福川,田允铭,蓝玉宏,等. 根治性调强放疗联合 TP 或 PF 方案同期化疗治疗局部晚期鼻咽癌的临床疗效对比[J]. 肿瘤药学,2016,6(3):221-225. DOI:10.3969/j.issn.2095-1264.2016.03.14.
Xie FC,Tian YM,Lan YH,et al. Clinical effects of intensity modulated radiotherapy combined with concurrent chemotherapy with TP or PF regimen on locally advanced nasopharyngeal carcinoma[J]. Anti-tumor Pharmacy,2016,6(3):221-225. DOI:10.3969/j.issn.2095-1264.2016.03.14.
[13] 向燕群,夏伟雄,郭翔. 洛铂放化疗治疗局部区域中晚期鼻咽癌剂量的初步探讨[J]. 肿瘤研究与临床,2013,25(6):389-392. DOI:10.3760/cma.j.issn.1006-9801.2013.06.008.
Xiang YQ,Xia WX,Guo X. Study of the dosage of lobaplatin for the chemoradiotherapy of local-regionally advanced nasopharyngeal carcinoma[J]. Cancer Res Clin,2013,25(6):389-392. DOI:10.3760/cma.j.issn.1006-9801.2013.06.008.
[14] Dilruba S,Kalayda GV. Platinum-based drugs:past,present and future[J]. Cancer Chemother Pharmacol,2016,77(6):1103-1124. DOI:10.1007/s00280-016-2976-z.
[15] Chitapanarux I,Lorvidhaya V,Kamnerdsupaphon P,et al. Chemoradiation comparing cisplatin versus carboplatin in locally advanced nasopharyngeal cancer:randomised,non-inferiority,open trial[J]. Eur J Cancer,2007,43(9):1399-1406. DOI:10.1016/j.ejca.2007.03.022.
[16] Huang PY,Cao KJ,Guo X,et al. A randomized trial of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy for locoregionally advanced nasopharyngeal carcinoma[J]. Oral Oncol,2012,48(10):1038-1044. DOI:10.1016/j.oraloncology.2012.04.006.
[17] Yau TK,Lee AW,Wong DH,et al. Treatment of stage Ⅳ(A-B) nasopharyngeal carcinoma by induction-concurrent chemoradiotherapy and accelerated fractionation:impact of chemotherapy schemes[J]. Int J Radiat Oncol Biol Phys,2006,66(4):1004-1010. DOI:10.1016/j.ijrobp.2006.06.016.
[18] 詹海燕,杨健. 某院201 例注射用洛铂超说明书用药及其不良反应相关因素分析[J]. 中国药师,2018,21(5):870-874. DOI:10.3969/j.issn.1008-049X.2018.05.030.
Zhan HY,Yang J. Analysis on 201 cases of off-label use and related factors for adverse reactions of lobaplatin for injection in a hospital[J]. China Pharmacist,2018,21(5):870-874.
[19] 广东省药学会. 铂类药物临床应用与不良反应管理专家共识[J/OL].今日药学[2019-03-26].http://yirui.jxlib.com:8001/rwt/CNKIBK/http/NNYHGLUDN3WXTLUPMW4A/kcms/detail/44.1650. R.20181127.0931.006.html.
Guangdong Pharmaceutical Association. Expert consensus on clinical application and adverse reaction management of platinum drugs[J/OL]. Pharmacy Today[2019-03-26].http://yirui.jxlib.com:8001/rwt/CNKIBK/http/NNYHGLUDN3WXTLUPMW4A/kcms/detail/44.1650. R.20181127.0931.006.html.