Concurrent chemoradiotherapy with nedaplatin plus paclitaxel or fluorouracil for locoregionally advanced nasopharyngeal carcinoma: Survival and toxicity

Xu, Jianhua; He, Xu; Cheng, Kun; Guo, Wenjie; Bian, Xiuhua; Jiang, Xuesong; Zhang, Lanfang; Huang, Shengfu

doi:10.1002/hed.23487

Cited by 21 publications

(16 citation statements)

References 26 publications

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“…The PR rate and CR rate were found to be 71.87% and 28.7%, respectively 21 . Recently, an effective schedule of nedaplatin combined with paclitaxel was reported as a concurrent chemotherapy regimen for NPC 22 .…”

Section: Discussionmentioning

confidence: 99%

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

Zhang

Chen

et al. 2017

Sci Rep

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To assess the feasibility, efficacy and safety of 4 cycles of induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC) patients with N3 disease. ICT consisting of paclitaxel (135 mg/m2) and nedaplatin (80 mg/m2) given every 3 weeks for 4 cycles followed by cisplatin-based CRT was planned. 22 patients completed 4 cycles of TP regimen ICT and the CRT according to the protocol. After 4 cycles of ICT, the ORR of the primary site was 100% (CR 22.7%, PR 77.3%), and that of the cervical lymph nodes was 95.5% (CR 27.3%, PR 68.2%). After the completion of CRT, the ORR of the primary site was 100% (CR 81.8%, PR 18.2%), and that of the cervical lymph nodes also reached 100% (CR 86.4%, PR 3.6%). The main hematological adverse events were grade 1 to 2 (G1/G2) neutropenia/anemia without febrile neutropenia. The most frequent toxicities during CRT were G1/G2 neutropenia, asthenia, oropharyngeal mucositis and skin injury. The median follow-up time was 46.5 (14 to 75) months. The 3-year PFS, DMFS, LRFS and OS were 81.8%, 81.8%, 100%, and 90.9%, respectively. The results suggest that intensive ICT followed by CRT in NPC patients with N3 disease is effective and well tolerated.

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Section: Discussionmentioning

confidence: 99%

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

Zhang

Chen

et al. 2017

Sci Rep

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“…In addition to conventional 3-weekly (100mg/m2) or weekly (30-40mg/m2) schedule of cisplatin, other concurrent agents and regimes combined with radiotherapy have been explored. In a retrospective study by Xu and colleagues [20], the regime of paclitaxel plus nedaplatin was administered, comparable survival to those of the cisplatin-based regimens was found. Besides, considering that many patients with LA NPC demonstrate excessive expression of EGFR, and EGFR overexpression is associated with increased risks of distant metastasis and shorter survival, the strategy of EGFR inhibition seems attractive and has demonstrated encouraging clinical outcomes [21, 22].…”

Section: Discussionmentioning

confidence: 98%

Induction chemotherapy followed by concurrent chemoradiation and nimotuzumab for locoregionally advanced nasopharyngeal carcinoma: preliminary results from a phase II clinical trial

et al. 2016

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Overexpression of epidermal growth factor receptor can be found in more than 80% of patients with locoregionally advanced nasopharyngeal carcinoma and is associated with shorter survival. In this work, we evaluated the feasibility of adding nimotuzumab to chemoradiation in locoregionally advanced nasopharyngeal carcinoma. Twenty-three patients with clinically staged T3-4 or any node-positive disease were enrolled. They were scheduled to receive one cycle of induction chemotherapy followed by intensity-modulated radiotherapy, weekly administration of nimotuzumab and concurrent chemotherapy. Results showed that all patients received a full course of radiotherapy, 19(82.6%)patients completed the scheduled neoadjuvant and concurrent chemotherapy, and 22(95.7%) patients received =6 weeks of nimotuzumab. During the period of concurrent chemoradiation and nimotuzumab, grade 3-4 toxicities occurred in 14(60.9%) patients: 8 (34.8%) had grade 3-4 oral mucositis, 6(26.1%) had grade 3 neutropenia, and 1(4.3%) had grade 3 dermatitis. No acne-like rash was observed. With a median follow-up of 24.1 months, the 2-year progression-free survival and overall survival were 83.5% and 95.0%, respectively. In conclusion, concurrent administration of chemoradiation and nimotuzumab was well-tolerated with good compliance. Preliminary clinical outcome data appear encouraging with favorable normal tissue toxicity results comparing with historical data of concurrent chemoradiation plus cetuximab.

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“…Cisplatin (cis-diamminedichloroplatinum) is a widely used drug in the class of platinum-based chemotherapies, and the adverse effects of cisplatin are significant and include renal toxicity, nerve damage, hearing loss, and bone marrow suppression (5). The efficacy of cisplatin in HNSCC is greatly increased when combined with other chemotherapeutic agents, such as taxanes (paclitaxel and docetaxel) and 5-fluorouracil (5,6). The precise molecular mechanism of cisplatin is unknown, but there is evidence that cisplatin may work through a p16-and p53-dependent mechanism (7).…”

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confidence: 99%

p16 Protein and Gigaxonin Are Associated with the Ubiquitination of NFκB in Cisplatin-induced Senescence of Cancer Cells

Veena

Wilken

Zheng

et al. 2014

Journal of Biological Chemistry

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Background: Molecular mechanism of p16-mediated cellular senescence in cisplatin-treated cells is not known. Results: Cisplatin treatment leads to p16 nuclear transport and association with gigaxonin for the ubiquitination of NFB. Conclusion: A protein associated with neural diseases is involved in cisplatin-mediated cellular senescence. Significance: Nuclear expression of p16 and gigaxonin is a useful marker of cancer cell chemosensitivity.

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Concurrent chemoradiotherapy with nedaplatin plus paclitaxel or fluorouracil for locoregionally advanced nasopharyngeal carcinoma: Survival and toxicity

Abstract: IMRT with concurrent nedaplatin-based chemotherapy achieved comparable survival with acceptable toxicity to those of the cisplatin-based regimens in the treatment of locoregionally advanced NPC.

Cited by 21 publications

References 26 publications

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

Induction chemotherapy followed by concurrent chemoradiation and nimotuzumab for locoregionally advanced nasopharyngeal carcinoma: preliminary results from a phase II clinical trial

p16 Protein and Gigaxonin Are Associated with the Ubiquitination of NFκB in Cisplatin-induced Senescence of Cancer Cells

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