Induction chemotherapy treatment for nasopharyngeal carcinoma (NPC) is controversial. The aim of this study was to evaluate the treatment outcomes and toxicities between two induction chemotherapy regimens, with both followed by concurrent chemoradiotherapy.
A retrospective study of 113 patients with eligible NPC (stage III–IV NPC with non-distant metastases) treated at the West China Hospital Cancer Center between May 2009 and Dec 2014 was conducted. Among them, 58 patients received cisplatin, fluorouracil, and docetaxel (TPF) and 55 received gemcitabine and cisplatin (GP) induction chemotherapy. Both groups received CCRT incorporating IMRT and cisplatin-based chemotherapy.
The average follow-up time was 51.4 (16.8–98.3) months. Ninety-four patients (83.2%) were alive after 36-months follow-up. The median overall survival (OS) and progression-free survival (PFS) time were 48.3 and 39.7 months, respectively. The 3-year OS for the TPF regimen was 87.9% and 87.4% with GP chemotherapy(P = 0.928). The 3-year PFS of the TPF treatment was 84.5%, while it was 83.5% for the GP group(P = 0.551). OS (Log-Rank P = 0.928) and PFS (Log-Rank P = 0.551) did not differ significantly between the two groups. Patients in the TPF induction chemotherapy plus CCRT group, did not show better LRFS outcomes in comparison to those in the GP induction group (Log-Rank P = 0.073). Furthermore, DMFS rates were not different between the treatment groups (Log-Rank P = 0.892).
There were no significant differences in adverse toxicities or treatment efficacy between the chemotherapy regimens in the treatment of locoregionally advanced NPC. Furthermore, the adverse toxicities were similar and could be tolerated. However, the TPF group had a high proportion of grade 3 or 4 adverse reactions.
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