A randomized trial of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy for locoregionally advanced nasopharyngeal carcinoma
A randomized trial of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy for locoregionally advanced nasopharyngeal carcinoma
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诱导化疗加同步放化疗与诱导化疗加放疗治疗局部晚期鼻咽癌的随机试验
DOI：
10.1016/j.oraloncology.2012.04.006
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发表时间：
2012-10-01
期刊：
影响因子：
4.8
通讯作者：
Hong, Ming-Huang
中科院分区：
文献类型：
--
作者：
Huang, Pei-Yu;Cao, Ka-Jia;Hong, Ming-Huang
本研究的目的是比较诱导化疗加同步放化疗（IC + CCRT）与诱导化疗加放疗（IC + RT）治疗局部晚期鼻咽癌的疗效。2002年8月至2005年4月，408例患者随机分为两组：IC + CCRT组和IC + RT组。两组患者接受相同的诱导化疗：2个周期的阿糖胞苷（FuDR）+卡铂（FuDR，750 mg/m2，d1-5;卡铂，曲线下面积[AUC] = 6）。诱导化疗结束后1周开始放疗。IC + CCRT组患者在放疗第7、28和49天也接受卡铂（AUC = 6）。8例患者不符合入选标准，其余400例病例进行分析。IC + CCRT组和IC + RT组中分别有28.4%和13.1%的患者出现III或IV级毒性（P <0.001）。IC + CCRT组和IC + RT组的5年总生存率分别为70.3%和71.7%（P = 0.734）。两组之间的无失败生存率、局部控制和远程控制没有显着差异。与IC + RT方案相比，本研究中使用的IC + CCRT方案并没有提高局部晚期鼻咽癌患者的总生存期和无失败生存期。同步化放疗中使用卡铂不适合鼻咽癌。(C)2012爱思唯尔有限公司保留所有权利。
The aim of this randomized study was to compare the efficacy of induction chemotherapy plus concurrent chemoradiotherapy (IC + CCRT) versus induction chemotherapy plus radiotherapy (IC + RT) for patients with locoregionally advanced nasopharyngeal carcinoma. From August 2002 to April 2005, 408 patients were randomly divided into two groups: an IC + CCRT group and an IC + RT group. Patients in both groups received the same induction chemotherapy: two cycles of floxuridine (FuDR) + carboplatin (FuDR, 750 mg/m(2), d1-5; carboplatin, area under the curve [AUC] = 6). The patients received radiotherapy 1 week after they finished the induction chemotherapy. The patients in the IC + CCRT group also received carboplatin (AUC = 6) on days 7, 28, and 49 of radiotherapy. Eight patients did not meet the inclusion criteria, and the remaining 400 cases were analyzed. Grade III or IV toxicity was found in 28.4% of the patients in the IC + CCRT group and 13.1% of those in the IC + RT group (P < .001). Five-year overall survival rates were 70.3% and 71.7% (P = 0.734) in the IC + CCRT and IC + RT groups, respectively. No significant differences in failure-free survival, locoregional control, and distant control were found between the two groups. Compared with the IC + RT program, the IC + CCRT program used in the present study did not improve the overall survival and failure-free survival in patients with locoregionally advanced nasopharyngeal carcinoma. Using carboplatin in the concurrent chemoradiotherapy was not suitable for nasopharyngeal carcinoma. (C) 2012 Elsevier Ltd. All rights reserved.