Abstract:
Objective This study aims to evaluate the efficacy, toxicity, and long-term survival in oxaliplatin and 5-fluorouracil combined with chronomodulated chemotherapy treated nasopharyngeal cancer patients.
Method Forty-six patients were randomly and equally distributed into the chronomodulated (CC) and conventional (RC) chemotherapy groups. All patients received two cycles of induced chemotherapy followed by radiotherapy. The patients in the CC group received full chemotherapy with a daily dose of 130 mg/m3 of oxaliplatin from 10:00 to 22:00 for three days. In addition, 1 g/m2·d of 5-fluorouracil was given from 22:00 of the first day to 10:00 of the second day. Each patient received at least two cycles (one cycle = 14 days) of treatment. The dosage and administration times for the RC group was the same as that of the CC group. Both groups received conventional doses of external beam radiation (60 Gy to 70 Gy for every 6 to 7 weeks) for their neck and nasopharyngeal lesions. The prophylactic dose for the neck was 50 Gy per 5 weeks.
Results The incidence rates of peripheral neuropathy, blood toxicity, and diarrhea in the CC group were lower than in the RC group (P < 0.05). The response ratios (CR + PR) of the CC and RC groups were 95.6 % and 86.9 %, respectively. However, that of the CC group had an increasing trend. The 1-, 3-, and 5-year survival rates of the two groups were not significantly different (P < 0.05).
Conclusion The nasopharyngeal cancer treatment administered to the CC group can significantly reduce the toxicity of oxaliplatin and 5-fluorouracil, without reducing patients' long-term survival. Moreover, the chronomodulated chemotherapy is safer and more effective in treating nasopharyngeal cancer than the conventional method.
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