Induction chemotherapy for locally advanced nasopharyngeal carcinoma: Efficacy and safety of the TPC regimen compared to GP and TPF

IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Oral oncology Pub Date : 2024-11-25 DOI:10.1016/j.oraloncology.2024.107119
Chang Yan , Runzhi Wang , Chaojun Zhang , Guoxiang Lin , Youqing Du , Meiwen Chen , Fushuang Liu , Ling Li , Song Qu , XiaoDong Zhu
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Abstract

Background and objectives

Gemcitabine plus cisplatin (GP) and docetaxel plus cisplatin plus fluorouracil (TPF) are induction chemotherapy (IC) regimens for locally advanced nasopharyngeal carcinoma (LA-NPC). The oral convenience of capecitabine presents its potential as a fluorouracil substitute in the TPF regimen, which has yet to be thoroughly investigated. This study aims to compare the efficacy and safety of the docetaxel, cisplatin, and capecitabine (TPC) with GP and TPF in LA-NPC.

Methods

A retrospective analysis was conducted on newly diagnosed stage III-IVa nasopharyngeal carcinoma patients who received GP, TPC, or TPF induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) between February 2019 and December 2021. A comparison of the prognostic outcomes and associated adverse reactions among patients receiving different IC regimens. Multivariate Cox regression was applied to analyze independent prognostic factors, and subgroup survival analyses were conducted based on these factors.

Results

A total of 291 LA-NPC patients were included, with 70 receiving TPC, 119 receiving GP, and 102 receiving TPF. Kaplan-Meier survival analysis indicated no significant differences in OS, PFS, LRFS, and DMFS among the 3 groups. Multivariate Cox regression identified T classification and clinical stage as independent prognostic factors. Subgroup analyses revealed no significant differences in OS and PFS between the 3 groups across T1-2 and T3-4 classifications or III and IVa stages.The TPC group exhibited lower incidence rates of treatment-related acute toxicity reactions, including grade 3–4 toxicities.

Conclusion

The TPC induction chemotherapy regimen demonstrates comparable efficacy to GP and TPF, while maintaining a favorable safety profile.
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局部晚期鼻咽癌诱导化疗:TPC 方案与 GP 和 TPF 方案的疗效和安全性比较
背景和目的吉西他滨加顺铂(GP)和多西他赛加顺铂加氟尿嘧啶(TPF)是局部晚期鼻咽癌(LA-NPC)的诱导化疗(IC)方案。卡培他滨口服方便,具有在TPF方案中替代氟尿嘧啶的潜力,但这一潜力还有待深入研究。本研究旨在比较多西他赛、顺铂和卡培他滨(TPC)与GP和TPF在LA-NPC中的疗效和安全性。方法对2019年2月至2021年12月期间接受GP、TPC或TPF诱导化疗后同时接受化放疗(CCRT)的新诊断的III-IVa期鼻咽癌患者进行回顾性分析。比较接受不同诱导化疗方案的患者的预后结果和相关不良反应。结果 共纳入291例LA-NPC患者,其中70例接受TPC治疗,119例接受GP治疗,102例接受TPF治疗。Kaplan-Meier生存分析表明,3组患者的OS、PFS、LRFS和DMFS无明显差异。多变量 Cox 回归确定 T 分类和临床分期为独立的预后因素。亚组分析显示,3组患者的OS和PFS在T1-2和T3-4分级或III和IVa分期之间无显著差异。TPC组的治疗相关急性毒性反应(包括3-4级毒性反应)发生率较低。
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来源期刊
Oral oncology
Oral oncology 医学-牙科与口腔外科
CiteScore
8.70
自引率
10.40%
发文量
505
审稿时长
20 days
期刊介绍: Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.
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