Clinical Observation of Concurrent Radio-Chemotherapy Combined with Adjuvant Chemotherapy in Treating Locoregionally Advanced Nasopharyngeal Carcinoma

Cancer Biology & Medicine

关键词: nasopharyngeal carcinoma;    locoregionally advanced;    paclitaxel;    cisplatin;    concurrent radiochemotherapy;    adjuvant chemotherapy.;   

DOI  :  10.1007/s11805-010-0039-5

来源: DOAJ

【 摘 要 】

OBJECTIVETo investigate the efficacy and side effects of concurrent radiochemotherapy using the TP regimen (paclitaxel and cisplatin) combined with adjuvant treatment in treating patients with locoregionally advanced nasopharyngeal carcinoma (NPC). METHODSA total of 82 patients with a confirmed diagnosis of locoregionally advanced stage-III and IVa NPC were randomly divided into 2 groups: the treatment group (TG) with concurrent radiochemotherapy combined with adjuvant chemotherapy (n = 44) and the control group (CG) with simple radiotherapy (RT) (n = 38). A total dose of 68 - 74 Gy of conformal radiation (X-ray, 4 MV or 8 MV) was given to patients in both groups. In the TG, a regimen of paxlitaxel and cisplatin was given via intravenous infusion in the 1st and 6th week concurrently with RT. After a 2-week intermission following RT, these patients received 2 cycles of the same chemotherapeutic regimen triweekly. RESULTSThe effective rates of the treatment were, respectively, 71.1% and 76.3% in the CG, and 88.6% and 95.5% in the TG, at the end of treatment and 3 months thereafter. The differences in the therapeutic efficacy between the 2 groups were statistically significant (P < 0.05). The 1- and 2-year survival rates were 81.1% and 73%, and 95.2% and 90.5%, respectively in the CG and the TG, and the differences between the 2 groups were statistically significant (P < 0.05). The grade I-II reactions in the gastrointestinal tract, skin and oral mucosa were higher in patients receiving concurrent radiochemotherapy combined with adjuvant chemotherapy than in patients receiving simple radiotherapy (P < 0.05). The difference in the occurrence of grade III-IV side effects including gastrointestinal, dermal and oral mucosal discomfort, other side effects, and late radioactive damage between the 2 groups were not statistically significant.CONCLUSIONConcurrent radiochemotherapy combined with adjuvant chemotherapy in treating patients with locoregionally advanced NPC can further improve short-term therapeutic effects and the overall survival. However, there is an increased trend in toxicity secondary to treatment.

【 授权许可】

Unknown