Capecitabine maintenance in the treatment of locally advanced nasopharyngeal carcinoma: a retrospective study
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摘要:
目的 回顾性分析中国西北地区非高发区N2~3期鼻咽癌根治性放化疗后序贯卡培他滨维持化疗的疗效，以明确卡培他滨维持化疗在局部晚期鼻咽癌治疗中的价值。 方法 选取2014年1月至2016年12月空军军医大学第一附属医院初诊初治、经病理确诊为鼻咽癌N2~3期的患者，给予诱导化疗2~3个周期后联合同期放化疗，研究组（维持化疗组）在根治性放化疗后继续予以卡培他滨维持化疗4个周期，对照组（未维持化疗组）观察随访。比较两组患者的生存差异，评价两种方案的不良反应及顺应性。 结果 共179例患者纳入本研究，研究组84例，对照组95例。两组病例一般临床资料均衡。全组中位随访时间44.4（5.97~70.26）个月，研究组与对照组3年无远处转移生存率（distant metastasis-free survival，DMFS）分别为79.3%、68.1%（χ2=3.898，P=0.048），3年无病生存率（disease-free survival，DFS）分别为75.6%、64.2%（χ2=5.428，P=0.020），差异具有统计学意义。急性不良反应及晚期不良反应两组间差异无统计学意义（P>0.05），卡培他滨特异性药物不良反应均为2级以下。 结论 在中国西北地区非高发区N2~3期鼻咽癌患者中，根治性放化疗后序贯卡培他滨维持治疗后3年DMFS和3年DFS获益，患者治疗耐受性、依从性良好，未增加明显的不良反应。 Abstract:Objective The efficacy of sequential capecitabine maintenance chemotherapy after radical chemoradiotherapy for stage N2- 3 nasopharyngeal carcinoma in non- endemic areas of northwest China was retrospectively analyzed to clarify the value of capecitabine maintenance chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma. Methods From Jannary 2014 to December 2016, patients with stage N2-3 nasopharyngeal carcinoma underwent 2 or 3 cycles of induction chemotherapy combined with concurrent chemoradiotherapy. The study group continued to receive capecitabine for 4 cycles of chemotherapy after radical chemoradiotherapy, whereas the control group was only observed. The survival differences between the two groups were compared, and the toxicity and compliance of the two regimens were evaluated. Result A total of 179 patients were included in this study, among whom 84 were included in the maintain chemotherapy group and 95 in the control group. The median follow-up time was 44.4 (5.97-70.26) months. The 3-year distant metastasis-free survival rates and 3-year disease-free survival rates were 79.3% and 68.1% (chi-square=3.898, P=0.048) and 75.6% and 64.2% (chi-square=5.428, P=0.020) for the maintain chemotherapy and control groups, respectively. The differences were statistically significant. There was no difference between the two groups in acute and late toxicity (P> 0.05). The toxicity of capecitabine-specific drugs was below grade 2. Conclusions For N2-3 stage nasopharyngeal carcinoma in non-endemic areas in northwest China, the 3- year distant metastasis- free survival and disease- free survival rates following sequential capecitabine maintenance therapy after radical radiotherapy and chemotherapy are improved. Treatment was well-tolerated, and compliance was good, with no obvious adverse reactions. -
Key words:
- nasopharyngeal carcinoma /
- non-endemic area /
- capecitabine /
- maintenance chemotherapy /
- efficacy
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表 1 179例N晚期鼻咽癌患者临床资料
表 2 治疗相关的急性及晚期不良反应
表 3 卡培他滨治疗期间相关不良反应
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