Paclitaxel with cisplatin in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma
Paclitaxel with cisplatin in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma
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DOI：
10.1007/s00405-009-1112-7
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发表时间：
2010-05-01
影响因子：
2.6
通讯作者：
Liu, Tai-Fu
中科院分区：
文献类型：
--
作者：
He, Xia-Yun;Hu, Chao-Su;Liu, Tai-Fu
本研究的目的是评价紫杉醇和顺铂同步放疗治疗局部晚期鼻咽癌的疗效和毒性，并观察这种方案是否比大剂量顺铂加氟尿嘧啶在中国患者中更好地耐受。入选31例局部晚期鼻咽癌患者。患者计划接受两个疗程的伴随化疗，在放疗期间从第1天和第28天开始（7-7.5周内35-38次，70-76戈伊）。化疗采用静脉滴注，紫杉醇120 mg/m2 3 h，顺铂75 mg/m2（25 mg/m2，第1-3天）。放疗后第3、6、9周分别给予紫杉醇135 mg/m2，3 h，顺铂75 mg/m2（25 mg/m2，第1-3天）辅助治疗。所有患者均完成了放疗，但同期放化疗中，31例患者中有20例完成了2个周期的化疗，另11例患者因各种原因只能接受1个周期的化疗。中位随访40个月，2例患者出现局部复发，其中1例在颈部淋巴结，另1例在鼻咽部。3年总生存率为83.9%，3年远处转移率为13.6%。3-4级毒性反应为中性粒细胞减少症12.9%、贫血6.45%、血小板减少症3.22%、严重心律失常3.2%和超敏反应3.2%。结论：紫杉醇联合顺铂同步放化疗治疗局部晚期鼻咽癌是可行的，安全的，并可能提高中国患者的区域控制率和生存率。
The aim of this study was to evaluate the efficacy and the toxicity of paclitaxel and cisplatin in patients in concurrent radiotherapy for locally advanced nasopharyngeal carcinoma, and to see whether such a regime would be better tolerated than high dose cisplatin plus fluoracil in Chinese patients. Thirty-one patients with locally advanced nasopharyngeal carcinoma were enrolled. Patients were scheduled to receive two courses of concomitant chemotherapy, starting on day 1 and then day 28 during radiotherapy (70-76 Gy in 35-38 fractions in 7-7.5 weeks). Chemotherapy was given by intravenous infusion, paclitaxel 120 mg/m(2) in 3 h, cisplatin 75 mg/m(2) (25 mg/m(2) days 1-3). Adjuvant therapy was paclitaxel 135 mg/m(2) in 3 h, cisplatin 75 mg/m(2) (25 mg/m(2) days 1-3) on weeks 3, 6, 9 after radiotherapy. All patients completed radiotherapy, but for concomitant chemoradiotherapy, 20 of the 31 patients completed the 2 cycles of chemotherapy, while the other 11 could only receive 1 cycle due to various reasons. The median follow-up was 40 months, 2 patients developed locoregional recurrences, one of whom in the cervical lymph nodes, the other in the nasopharynx. The 3-year overall survival rate was 83.9% and the distant metastasis rate at 3 years was 13.6%. Grade 3-4 toxicities were neutropenia 12.9%, anaemia 6.45%, thrombocytopenia 3.22%, severe arrhythmia 3.2%, and hypersensitivity reaction 3.2%. In conclusion, paclitaxel with cisplatin as concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma is feasible, safe, and might improve regional control and survival rates in Chinese patients.