Abstract:
Objective The present study aimed to investigate the short-term efficacy and adverse effects of induction chrono-chemotherapy including docetaxe1 (TXT), cisplatin (DDP), and 5 fluorouraci1 (5-FU) followed by concomitant chemoradiotherapy in loco- regionally advanced nasopharyngeal carcinoma (NPC).
Methods Newly diagnosed locally advanced (Ⅲ~Ⅳb) NPC patients were enrolled in this study. All patients received three cycles of TPF regimen. The TPF chemotherapy regimen was administered as follows: TXT, 75 mg/m2, i.v. infusion, d1; DDP, 75 mg/m2, bolus infusion from 10:00 to 22:00, d1-5; and 5-FU 750 mg/m2/d bolus infusion from 22:00 to 10:00, d1-5, with 21 days each cycle, followed by concomitant IMRT and chemotherapy (paclitaxel 135 mg/m2 i.v. infusion, with 21 days each cycle and a total of 2 courses). Acute and late toxicities were graded according to the Common Terminology Criteria for Adverse Events v3.0 scoring criteria. Tumor response was evaluated using 2000 Response Evaluation Criteria in Solid Tumors criteria.
Results The CR and PR rates of induction chemotherapy were 23.8% and 68.6%, respectively; whereas the CR and PR rates of the combined modality treatment were 64.8% and 31.4%, respectively. Two-year overall survival rate was 91.4%, two-year progression free survival rate was 87.0%, and two-year distant metastasis-free survival rate was 88.4%. The main side effects from induction chemotherapy include an over grade 3 granulocytopenia of 28.6%. Major toxicity from concurrent chemo-radiotherapy was oral mucositis (81.0%); grade 3 to 4 oral mucositis was 16%. No treatment-related deaths occurred in this study.
Conclusion Induction chrono-chemotherapy using TPF followed by concurrent chemoradiotherapy of paclitaxel is a well-tolerated treatment with short-term efficacy and severity for locally advanced NPC. Further follow-up is required to assess the late effects and long-term efficacy.
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