Treatment outcome of cisplatin-based concurrent chemoradiotherapy in the patients with locally advanced nasopharyngeal cancer.
Treatment outcome of cisplatin-based concurrent chemoradiotherapy in the patients with locally advanced nasopharyngeal cancer.
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DOI：
10.4143/crt.2008.40.2.62
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发表时间：
2008-06-01
影响因子：
4.6
通讯作者：
Kang, Jin-Hyoung
中科院分区：
文献类型：
--
作者：
Kim, Tae Hee;Ko, Yoon Ho;Kang, Jin-Hyoung
目的：局部晚期鼻咽癌的标准治疗是同步放化疗(CCRT)，顺铂是目前最常用的化疗药物。但已经提出了许多不同的顺铂剂量和给药时间表，如每天、每周和3周周期。材料与方法：对1996年1月至2007年6月在江南圣玛丽医院接受CCRT一线治疗的55例局部晚期鼻咽癌患者进行回顾性研究。结果：患者平均年龄53岁(19~75岁)。在55例患者中，31例接受顺铂100 mg/周的3周疗程，24例在放疗的同时给予每周30 mg顺铂治疗。21例完全缓解，4例部分缓解，总有效率为71.4%(95%可信区间：59.5，约83.3)。顺铂30 mg组和100 mg组的完全缓解率分别为72.7%(95%CI：54.9约90.5)和54.2%(95%CI：36.7约71.7)(p=0.23)。100 mg顺铂组的CCRT持续时间明显长于30 mg顺铂组(11.1±-2.9w vs.9.0+/-1.2w，p=0.003)。以放疗持续时间延长2周以上为标准的大偏差组的客观有效率显著低于无偏差组(分别为56.3%和84.2%，P=0.002)。主要不良反应为白细胞减少(49.1%)、咽部食管炎(49.1%)、食欲不振(43.6%)、恶心(41.8%)、呕吐(40%)。结论：每周30 mg顺铂为主的CCRT方案对局部晚期鼻咽癌患者是一种切实可行的方案，可减少放疗中断，减少治疗相关的急性毒性反应。
PURPOSE: The standard treatment of locally advanced nasopharyngeal cancer is a concurrent chemoradiotherapy (CCRT), and cisplatin has been used as the most popular chemotherapeutic agent. But many different doses and schedules for cisplatin administration such as daily, weekly and 3 week cycles have been proposed. We compared and analyzed the tumor response, the overall survival, the toxicity and the chemotherapy dose intensity in the patients with locally advanced nasopharyngeal cancer who were treated with CCRT.MATERIALS AND METHODS: We performed a retrospective study on 55 patients with locally advanced nasopharyngeal cancer, and they were treated with CCRT as a front-line treatment from Jan 1996 to Jun 2007 at Kangnam Saint Mary's Hospital.RESULTS: The patients had a median age of 53 years (range: 19 approximately 75 years). Of the total 55 patients, a 3-week cycle of 100mg cisplatin was administered in 31 patients and 30 mg weekly cisplatin was administered in 24 patients combined with radiotherapy. Twenty one patients had a complete response and four patients had a partial response for a response rate of 71.4% (95% CI: 59.5 approximately 83.3) after CCRT and followed by adjuvant chemotherapy. The complete response rates for the 30 mg and 100 mg cisplatin groups were 72.7% (95% CI: 54.9 approximately 90.5) and 54.2% (95% CI: 36.7 approximately 71.7), respectively (p=0.23). The duration of CCRT in the 100mg cisplatin group was significantly longer than that of the 30mg cisplatin group (11.1+/-2.9 weeks vs. 9.0+/-1.2 weeks, p=0.003). The major deviation group, which was defined as prolongation of the radiotherapy duration for more than 2 weeks, had a significantly lower objective response rate than did the non-deviation group (56.3% vs 84.2%, respectively, p=0.002). The major severe toxicities were leucopenia (49.1%), pharyngoesophagitis (49.1%), anorexia (43.6%), nausea (41.8%) and vomiting (40%).CONCLUSIONS: Weekly 30mg cisplatin-based CCRT is a practical, feasible cisplatin schedule for the patients with locally advanced nasopharyngeal cancer in regard to decreasing the interruption of radiation treatment and decreasing the treatment-related acute toxicities.