[an error occurred while processing this directive] | [an error occurred while processing this directive]
A multicenter, prospective, randomized study of intensity-modulated radiotherapy combined with different chemotherapy regimens for locally advanced nasopharyngeal carcinoma
Deng Lin*,Wang Rensheng,Wu Fang,Tang Chunyuan,Feng Guosheng,Li Guisheng,Liu Meilian,Yan Haolin
*Department of Radiotherapy,First Affiliated Hospital of Guangxi Medical University, Nanning 530021,China
Abstract Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity-modulated radiotherapy (IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/m2 on day 1) and nedaplatin (80 mg/m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/m2 on day 1). The survival rates were calculated with the Kaplan-Meier method and the differences in the survival rates between the two groups were analyzed using the log-rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi-square test. Results The follow-up rate was 99.1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2-year local recurrence-free, regional recurrence-free, distant metastasis-free, and overall survival rates were 94.0%, 94.2%, 88.2%, and 90.3%, respectively, in the test group, versus 93.4%, 94.1%, 86.7%, and 87.3% in the control group (P=0.757、0.478、0.509、0.413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the controlgroup (P=0.027,0.028,0.035). The incidence rates and severity of hemoglobin reduction and nausea/vomiting were significantly lower in the test group than in the control group (P=0.000,0.023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups (P=0.483,0.781). Conclusions The short-term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.
Corresponding Authors:
Wang Rensheng,Email:13807806008@163.com
Cite this article:
Deng Lin*,Wang Rensheng,Wu Fang et al. A multicenter, prospective, randomized study of intensity-modulated radiotherapy combined with different chemotherapy regimens for locally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(4): 417-420.
Deng Lin*,Wang Rensheng,Wu Fang et al. A multicenter, prospective, randomized study of intensity-modulated radiotherapy combined with different chemotherapy regimens for locally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(4): 417-420.
[1] 徐瑾,郝俊芳.局部晚期鼻咽癌放射治疗的研究进展[J].中华肿瘤防治杂志,2011,18(2):156-160.DOI:10.16073/j.cnki.cjcpt.2011.02.025. [2] 孙健达,李德锐.鼻咽癌的治疗进展[J].医学综述,2010,16(21):3255-3259.DOI:1006-2084(2010) 21-3255-05. [3] Airoldi M,Gabriele AM,Garzaro M,et al. Induction chemotherapy with cisplatin and epirubicin followed by radiotherapy and concurrent cisplatin in locally advanced nasopharyngeal carcinoma observed in a non-endemic population[J].Radiother Oncol,2009,92(1):105-110.DOI:10.1016/j.radonc.2009.02.005. [4] Wu F, Wang R, Lu H,et al. Concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma:treatment outcomes of a prospective,multicentric clinical study[J].Radiother Oncol,2014,112(1):106-111.DOI:10.1016/j.radonc.2014.05.005. [5] 李继东,王舒,肖永久,等.国产奈达铂联合吉西他滨治疗晚期非小细胞肺癌[J].实用医学杂志,2008,24(5):811-812. [6] 管忠震,徐瑞华.奈达铂临床研究进展[J].中国肿瘤临床,2004,31(13):774-779. [7] Li CH,Liu MY,Liu W,et al. Randomized control study of nedaplatin or cisplatin concomitant with other chemotherapy in the treatment of advanced non-small cell lung cancer[J].Asian Pac J Cancer Prev,2014,15(2):731-736. [8] Shimada M, Itamochi H, Kigawa J. Nedaplatin:a cisplatin derivative in cancer chemotherapy[J].Cancer Manag Res,2013(5):67-76.DOI:10.2147/CMAR.S35785. [9] 罗金红,林昀,周俊,等.多西他赛联合奈达铂诱导化疗及奈达铂单药同期放化疗治疗晚期鼻咽癌的临床观察[J].肿瘤,2011,31(6):532-537.DOI:10.3781/j.issn.1000-7431.2011.06.011. [10] 邓颖,邓春美,胡洪林,等.奈达铂或顺铂联合紫杉醇同步放化疗局部晚期鼻咽癌的疗效比较[J].实用肿瘤杂志,2011,26(2):175-177.DOI:1001-5930(2011) 02-0175-03. [11] Demizu Y, Sasaki R, Soejima T, et al. Efficacy and feasibility of cisplatin-based concurrent chemoradiotherapy for nasopharyngeal carcinoma[J]. Jpn J Clin Oncol,2006,36(10):620-625. [12] Wang W, Feng M, Fan Z, et al. Clinical outcomes and prognostic factors of 695 nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy[J/OL].Biomed Res Int,2014,814948[2014-09-25].http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139082/.DOI:10.1155/2014/814948. [13] OuYang PY,Xie C,Mao YP,et al. Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials[J].Ann Oncol,2013,24(8):2136-2146.DOI:10.1093/annonc/mdt146. [14] Zhang L,Zhao C,Ghimire B,et al. The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population:a meta-analysis of the phase Ⅲ randomized trials[J/OL].BMC Cancer,2010,10:558[2014-09-25].http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2970609/.DOI:10.1186/1471-2407-10-558. [15] Hui P,Ma BB,Leung SF, et al. Randomized phase Ⅱ trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma[J].Clin Oncol,2009,27(2):242-249.DOI:10.1200/JCO.2008.18.1545. [16] Lin S,Lu JJ,Han L,et al. Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma:experience of 370 consecutive cases[J/OL].BMC Cancer,2010,10:39[2014-09-25].http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836300/.DOI:10.1186/1471-2407-10-39.
2015, Vol. 24 
