Gemcitabine Versus Docetaxel Plus Cisplatin as Induction Chemotherapy in Nasopharyngeal Carcinoma

Abstract

Objectives: To compare tumor volume reduction after induction chemotherapy (IC) with gemcitabine plus cisplatin (GP) and docetaxel plus cisplatin (DP) and to evaluate the influence on subsequent radiotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC).Study Design: Retrospective clinical study. Methods: Patients who received GP or DP IC followed by concurrent chemoradiotherapy (CCRT) were retrospectively enrolled. Propensity score matching (PSM) was adopted to control the balance between the GP and DP groups.Results: A total of 41 patients treated with GP and 53 patients treated with DP were enrolled. After matching, 33 subpairs of 66 patients were generated in the post-PSM cohort. As compared with DP, GP was superior in its gross tumor volume of the nasopharynx (GTVnx) reduction (28.88% vs. 18.73%; P = .014) but equivalent in its gross tumor volume of the lymph nodes (GTVnd) reduction (37.58% vs. 29.79%; P = .229). Univariate and multivariate analyses confirmed that the chemotherapy regimen was an independent factor associated with the reduction in GTVnx (P = .011). The GP group exhibited advantages in the dosimetric parameters of the planning target volume of high-risk volume and low-risk volume (PTV1 and PTV2), lenses, temporal lobes, and parotid glands. Univariate and multivariate analyses confirmed that chemotherapy regimen was an independent factor associated with the dosimetric parameters of PTV1, PTV2, lenses, temporal lobes, and parotid glands.Conclusion: GP regimen achieves a greater GTVnx reduction than DP regimen and has an advantage in the dosimetry of subsequent CCRT.

Volumetric modulated arc therapy versus tomotherapy for late T-stage nasopharyngeal carcinoma

“…The calculations of HI and CI were described in a previous study ( 7 ). To investigate the differences between VMAT and tomotherapy in protecting OARs, the followings parameters were compared between the two groups: the maximum dose (Dmax) and the maximum dose encompassing 1cc (D1cc) of the spinal cord, brainstem, spinal cord PRV, and brainstem PRV; the Dmax of optic nerves, optic chiasm, temporal lobes, and lenses PRV; and the relative volume receiving more than 30 Gy (V30Gy) and the mean dose (Dmean) of the parotid glands ( 17 ). Univariate and multivariate analyses were used to confirm the influence of the radiotherapy modality on dosimetric parameters.…”