A Retrospective Study to Compare Five Induction Chemotherapy Regimens Prior to Radiotherapy in the Reduction of Regional Lymph Node Size in Patients with Nasopharyngeal Carcinoma

Abstract

BackgroundCombined chemotherapy and radiation therapy are used to treat nasopharyngeal carcinoma (NPC). Previous studies have shown that induction chemotherapy, given before radiotherapy, is beneficial in patients with local lymph node metastases. The aim of this study was to evaluate regional lymph node size in patients with NPC and the efficacy of five induction chemotherapy regimens given before radiotherapy.Material/MethodsBetween December 2007 and June 2011, 190 patients were included in this study, who had regionally advanced NPC (Stages II–IV). Five induction chemotherapy regimens were given prior to radiation: 98 patients (51.6%) received the TPF regimen (docetaxel, cisplatin, and fluorouracil); 56 patients (29.5%) received PF regimen (cisplatin and fluorouracil); 26 patients (13.7%) received the TP regimen (cisplatin and docetaxel); seven patients (3.7%) received combined nimotuzumab with TPF; three patients (1.6%) received a combination of the novel modified recombinant human endostatin (Endostar) with PF. The length and width of the regional lymph nodes were measured using neck B-mode (high-resolution grey scale) ultrasonography before chemotherapy and on the second day following completion of chemotherapy. Gastrointestinal tract and bone marrow suppression were also monitored during and after chemotherapy.ResultsThe TPF chemotherapy induction regimen resulted in an improved early response of lymph node size reduction, compared with the PF and TP chemotherapy induction regimens. The combined use of nimotuzumab with the TPF regimen improved efficacy by 15%. The combined use of Endostar improved the efficacy of the PF regimen by 56% (P<0.05).ConclusionsIn a retrospective study in patients with NPC, different induction chemotherapy regimens had different effects on lymph node size before radiation therapy.

Inhibition of Nasopharyngeal Carcinoma by Beta-Lapachone Occurs by Targeting the Mammalian Target of Rapamycin (mTOR)/PI3K/AKT Pathway, Reactive Oxygen Species (ROS) Production, and Autophagy Induction

“…Nasopharyngeal cancer is a common form of neck and head cancer [10]. The treatment of nasopharyngeal carcinoma is limited by early metastasis and the adverse effects of available chemotherapeutic agents [11]. Moreover, development of multi-drug resistance in nasopharyngeal cancer patients makes it challenging to treat [12,13].…”

Comparing three induction chemotherapy regimens for patients with locoregionally advanced nasopharyngeal carcinoma based on TNM stage and plasma Epstein–Barr virus DNA level

“…One report [16] demonstrated that the TP regimen may be sufficient for patients receiving a CCD ≥ 200 mg/m 2 , while TPF may be superior to TP and PF for patients receiving a CCD < [36], the TPF regimen yielded better long-term survival for patients with locoregionally advanced NPC in comparison with the PF regimen. In another study [37], TPF showed an improved early response of lymph node size reduction in comparison with the PF and TP regimens. These findings support the results of the present study, in which IC with TPF showed the best short-term tumor response and provided survival benefits compared with those of TP in all cases of locally advanced nasopharyngeal carcinoma.…”

Liposomal paclitaxel versus docetaxel in induction chemotherapy using Taxanes, cisplatin and 5-fluorouracil for locally advanced nasopharyngeal carcinoma

“…There is increasing evidence that IC can facilitate eradication of micro-metastatic lesions and reduce the risk of distant metastasis [7–9], so IC is being used widely in clinical settings. Based on studies that have established its superiority over the standard PF regimen for lowering the prevalence of distant metastasis and improving OS prevalence, TPF has emerged as the effective IC regimen [10–12].…”

“…Studies have shown that taxanes, cisplatin and 5-fluorouracil (TPF) is the effective IC regimen for reducing the risk of treatment failure and improving overall survival (OS) in patients with high risk NPC [10–12]. In comparison with the standard cisplatin and fluorouracil (PF) regimen, regimens involving taxanes (microtubule-stabilizing drugs) have been used widely for the treatment of different types of malignancies for decades [13].…”