Clinical value of docetaxel plus cisplatin (TP) induction chemotherapy followed by TP concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma

Abstract

Objective : To investigate the clinical value of induction chemotherapy (IC) with docetaxel plus cisplatin (TP) followed by concurrent chemoradiotherapy (CCRT) with TP in locoregionally advanced nasopharyngeal carcinoma (NPC). Methods : A total of 544 patients with locoregionally advanced NPC that was newly diagnosed from January 2009 to December 2015 were included in this study. Among these patients, 251 were treated with TP induction chemotherapy followed by CCRT with cisplatin (DDP) alone (TP + DDP group), 167 were treated with TP followed by CCRT with TP (TP + TP group), and 126 were treated with docetaxel, DDP and fluorouracil (TPF) followed by CCRT with DDP alone (TPF + DDP group). Overall survival (OS), distant metastasis-free survival (DMFS), progression-free survival (PFS) and locoregional relapse-free survival (LRRFS) were analyzed using the Kaplan-Meier method and a Cox proportional hazards model. Results : Survival analysis showed that the 5-year OS, PFS and DMFS rates in the TP + DDP group were significantly lower than those in the TP + TP group after propensity score matching (PSM). Multivariate analysis revealed that CCRT with TP was an independent prognostic factor for OS, PFS and DMFS. During CCRT, the incidence rates of grade 3/4 nausea/vomiting, oral mucositis, leukocytopenia and neutropenia were significantly increased in the TP + TP group compared with the TP + DDP group (all P < 0.05). To further explore the value of TP + TP, we performed PSM again with the TPF + DDP group. After PSM, there were 100 patients in each group. Survival analysis showed no significant differences in the 5-year OS, PFS, DMFS and LRRFS rates between the two groups. During IC and CCRT, the rate of grade 3/4 nausea/vomiting in the TPF + DDP group was higher than that in the TP+TP group (9.0% vs. 2.0%, P = 0.030; 18.0% vs. 8.0%, P = 0.036, respectively). No significant difference in the incidence of grade 3/4 hematologic toxicity was found between the two groups (all P > 0.05). Conclusion : TP + TP can reduce the distant metastasis of locoregionally advanced NPC and improve OS compared with TP + DDP; TP + TP has the same effect as TPF + DDP and is clinically feasible.

Retrospective Analysis of Induction Chemotherapy Plus Concurrent Chemoradiotherapy under Intensity-Modulated Radiotherapy Mode for Locally Advanced Nasopharyngeal Carcinoma

“…Accordingly, in locally advanced lung cancerand esophageal cancer, the concurrent chemoradiotherapy regimen is the use of double-drug regimen containing platinum (15,16). Recently, a retrospective analysis obtained that the treament with double-drug regimen containing platinum for concurrent chemotherapy for NPC was better than single platinum drug but the side effects increased signi cantly (17). Our results suggests that under the premise of induction chemotherapy, concurrent chemotherapy of single platinum drug for NPC may be su cient but need more studies to con rm.…”

Linc00312 Single Nucleotide Polymorphism as Biomarker for Chemoradiotherapy Induced Hematotoxicity in Nasopharyngeal Carcinoma Patients

“…For example, Zhang et al demonstrated that the IC + CCRT group had a higher incidence than the CCRT group of grade 3/4 neutropenia (28.0% vs. 10.5%), thrombocytopenia (11.3% vs. 1.3%), and anemia (9.6% vs. 0.8%) [ 1 ]. Tao et al reported that the incidence rates of grade 3/4 leukocytopenia and neutropenia were significantly increased in the DP + DP group compared with the DP + DDP group in NPC patients [ 21 ].…”

Retrospective Analysis of Induction Chemotherapy plus Concurrent Chemoradiotherapy under Intensity-Modulated Radiotherapy Mode for Locally Advanced Nasopharyngeal Carcinoma

“…Accordingly, a double-drug regimen containing platinum is used for concurrent chemoradiotherapy in locally advanced lung cancer and esophageal cancer [15,16]. Recently, a retrospective analysis obtained that the treatment with a double-drug regimen containing platinum for concurrent chemotherapy for NPC was better than a single platinum drug, but the side effects increased significantly [17]. Our results suggest that under the premise of induction chemotherapy, concurrent chemotherapy of a single platinum drug for NPC may be sufficient but need more studies to confirm.…”