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Phase Ⅱ study of gemcitabine plus cisplatin chemotherapy combined with intensity modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma
OU Dan, HE Xia-yun, HU Chao-su, YING Hong-mei, ZHU Guo-pei
Department of Radiation Oncology, Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University;Shanghai 200032, China Corresponding author:HE Xia-yun,Email:xiayunhesh@yahoo.cn
Abstract Objective To evaluate the efficacy and toxicity of gemcitabine plus cisplatin (GP) chemotherapy combined with intensity-modulated radiation therapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (NPC). Methods 71 patients (Stage Ⅲ:41, Stage ⅣA:30) with locoregionally advanced NPC were entered this study. Neoadjuvant chemotherapy was consisted of cisplatin 25 mg/m2 intravenously on d1-3 and gemcitabine 1000 mg/m2 in 30 minutes intravenous infusion on days 1 and 8, every 3 weeks for 2 cycles. Adjuvant chemotherapy consisted of 2 cycles of the same GP regimen was given at 28 days after the end of radiotherapy. The prescription doses was 66.0－70.4 Gy to the gross tumor volume, 66 Gy to positive neck nodes, 60 Gy to the high-risk clinical target volume, 54 Gy to the low-risk clinical target volume. Results The overall response rate to neoadjuvant chemotherapy was 91.2%,acute toxicity was mainly grade 1－2 myleosuppression. All patients completed IMRT. The median follow-up duration was 38 months. The 3-year nasopharyngeal local control, regional control, distant metastasis-free survival rate and overall survival rate were 93%, 99%, 91%, 90%, respectively. Severe late toxicities included grade 3 trismus in 1 patient, grade 3 hearing impairment in 2 patients and cranial nerve palsy in 2 patients, respectively. No grade 4 late toxicities were observed. Conclusions The combination of GP chemotherapy and IMRT for locoregionally advanced nasopharyngeal carcinoma is well-tolerated, convenient, effective, and warrants further studies of more proper cycles of GP regimen.
OU Dan,HE Xia-yun,HU Chao-su et al. Phase Ⅱ study of gemcitabine plus cisplatin chemotherapy combined with intensity modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(5): 412-414.
OU Dan,HE Xia-yun,HU Chao-su et al. Phase Ⅱ study of gemcitabine plus cisplatin chemotherapy combined with intensity modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(5): 412-414.
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2012, Vol. 21 
