Efficacy of Induction Chemotherapy Combined with Concurrent Chemoradiotherapy for Advanced Nasopharyngeal Carcinoma
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摘要:
目的 比较诱导化疗加同期化放疗(IC/CCRT)与单纯同期化放疗(CCRT)在治疗局部晚期鼻咽癌中的近期疗效及不良反应的发生率。 方法 2003年9月至2006年5月广西百色市人民医院肿瘤科接受治疗的200例鼻咽癌患者随机分为诱导化疗加同期化放疗组(IC/CCRT)和单纯同期化放疗组(CCRT)。两组患者接受相同的同期化放疗方案: 在放疗的第7、28、49天接受卡铂(AUC=6)化疗, 诱导化疗加同期放化疗组在同期化放疗前接受了诱导化疗: 2个疗程5-FU(750 mg/m2)+卡铂(AUC=6)。 结果 IC/CCRT组与CCRT组Ⅲ、Ⅳ级不良反应的发生率分别为24.5%和17.8%(P < 0.001), 两组3年总生存率分别为83.5%和79.4%(P=0.30), 两组方案的3年无瘤生存率、局部控制率和远处转移控制率比较差异均无统计学意义。 结论 与单纯同期化放疗相比, 诱导化疗加同期化放疗治疗局部晚期鼻咽癌, 患者的总生存率及无复发生存未明显提高, 但不良反应有所增加。 Abstract:Objective To compare the efficacy and adverse reactions of induction chemotherapy combined with concurrent chemoradiotherapy(IC/CCRT) with those of concurrent chemoradiotherapy(CCRT) alone for patients with advanced nasopharyngeal carcinoma(NPC). Methods From September 2003 to May 2006, 200 patients with advanced NPC treated in the Guangxi Baise People's Hospital were enrolled in this study.The patients were randomly divided into two groups: the IC/CCRT group, and the CCRT group.Patients in the two groups received the same concurrent chemoradiotherapy regimen consisting of caboplatin(AUC = 6) at days 7, 28, and 49 of the radiotherapy.Patients in the IC/CCRT group received two cycles of induction thermotherapy consisting of 5-FU(750 mg/m2) and caboplatin(AUC = 6) prior to the concurrent chemoradiotherapy. Results TheⅢandⅣdegree adverse reactions of the IC/CCRT and CCRT groups were 25.4%and 17.9%, respectively(P < 0.001).The 3-year overall survival rates of the IC/CCRT and CCRT groups were 83.5%and 79.4%, respectively(P = 0.3).No significant difference in the 3-year disease-free survival rate, as well as in the locoregional control rate and the distant control rate of advanced NPC patients was observed between the two groups. Conclusion Compared with CCRT alone, IC/CCRT does not significantly improve the overall and disease-free survival rates of advanced NPC patients.In addition, the acute adverse reactions were more severe in the IC/CCRT group. -
表 1 两组患者一般情况比较 例
Table 1. Clinical characteristics of the patients
表 2 两组急性不良反应发生率的比较 %
Table 2. Side effects in the two grops
表 3 两组患者的生存预后比较 %
Table 3. Prognosis of the patients in the two grops
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[1] Fandi A, Altun M, Azli N, et al. Nasopharyngeal cancer: epidemiology, staging, and treatment[J]. Semin Oncol, 1994, 21(3), 382-397. http://www.ncbi.nlm.nih.gov/pubmed/8209270 [2] Vokes EE, Liebowitz DN, Weichselbaum RR. Nasopharyngeal carcinoma[J]. Lancet, 1997, 350(9084): 1087-1091. doi: 10.1016/S0140-6736(97)07269-3 [3] Marks JE, Phillips JL, Menck HR. The National Cancer Data Base report on the relationship of race and national origin to the histology of nasopharyngeal carcinoma[J]. Cancer, 1998, 83(3): 582-588. doi: 10.1002/(SICI)1097-0142(19980801)83:3<582::AID-CNCR29>3.0.CO;2-R [4] 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 [5] Lee AW, Sze WM, AuJS, et al. Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience[J]. Int J Radiat Oncol Biol Phys, 2005, 61(4): 1107-1116. doi: 10.1016/j.ijrobp.2004.07.702 [6] Le QT, Tate D, Koong A, et al. Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys, 2003, 56(4): 1046-1054. doi: 10.1016/S0360-3016(03)00117-2 [7] Hsiung CY, Yorke ED, Chui CS, et al. Intensity-modulated radiotherapy versus conventional three-dimensional conformal radiodierapy for boost or salvage treatment of nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys, 2002, 53(3): 638-647. doi: 10.1016/S0360-3016(02)02760-8 [8] Langendijk JA, Leemans CR, Buter J, et al. The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: a meta-analysis of the published literature[J]. J Clin Oncol, 2004, 22(22): 4604-4612. doi: 10.1200/JCO.2004.10.074 [9] Baujat B, Audry H, Bourhis J, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta -analysis of eight randomized trials and 1753 patients[J]. IntJ Radiat Oncol Biol Phys, 2006, 64(1): 47-56. doi: 10.1016/j.ijrobp.2005.06.037 [10] Chua DT, Ma J, Sham JS, et al. Long-term survival after cisplatin—based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: a pooled data analysis of two phaseⅢtrials[J]. J Clin Oncol, 2005, 23(6): 1118-1124. doi: 10.1200/JCO.2005.12.081 [11] Wee J, Tan EH, Tai BC, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage HI and IV nasopharyngeal cancer of the endemic variety[J]. J Clin Oncol, 2005, 23(27): 6730-6738. doi: 10.1200/JCO.2005.16.790 [12] Lee AW, Tung SY, Chan AT, et al. Preliminary results of a randomized study(NPC—9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys, 2006, 66(1): 142-151. doi: 10.1016/j.ijrobp.2006.03.054 [13] Sanguined G, Bossi P, Pou A, Licitra L. Timing of chemoradiotherapy and patient selection for locally advanced nasopharyngeal carcinoma[J]. Clin Oncol(R Coll Radiol), 2003, 15(8): 451-460. doi: 10.1016/S0936-6555(03)00201-2 [14] Yau TK, Lee AW, Wong DH, et al. Treatment of StageⅣ(A-B) nasopharyngeal carcinoma by induction-concurrent chemoradiotherapy and accelerated fractionation: impact of chemotherapy schemes[J]. IntJ Radiat Oncol Biol Phys, 2006, 66(4): 1004-1010. doi: 10.1016/j.ijrobp.2006.06.016 [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 -
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