Phase Ⅱ study of gemcitabine plus cisplatin chemotherapy combined with intensity modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma

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Author:
OU Dan(Department of Radiation Oncology, Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University,Shanghai 200032,China)
HE Xia-yun(Department of Radiation Oncology, Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University,Shanghai 200032,China)
HU Chao-su(Department of Radiation Oncology, Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University,Shanghai 200032,China)
YING Hong-mei(Department of Radiation Oncology, Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University,Shanghai 200032,China)
ZHU Guo-pei(Department of Radiation Oncology, Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University,Shanghai 200032,China)
Journal Title:
Chinese Journal of Radiation Oncology
Issue:
Volume 21, Issue 05, 2012
DOI:
10.3760/cma.j.issn.1004-4221.2012.05.003
Key Word:
Nasopharyngeal neoplasms/chemotherapy;Chemotherapy, cisplatin and gemcitabine;Nasopharyngeal neoplasms/radiotherapy;Radiotherapy, intensity-modulated;Prognosis

Abstract: Objective To evaluate the efficacy and toxicity of gemcitabine plus cisplatin (GP)chemotherapy combined with intensity-modulated radiation therapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (NPC).Methods 71 patients (Stage Ⅲ:41,Stage ⅣA:30) with locoregionally advanced NPC were entered this study.Neoadjuvant chemotherapy was consisted of cisplatin 25 mg/m2 intravenously on d1-3 and gemcitabine 1000 mg/m2 in 30 minutes intravenous infusion on days 1 and 8,every 3 weeks for 2 cycles.Adjuvant chemotherapy consisted of 2 cycles of the same GP regimen was given at 28 days after the end of radiotherapy.The prescription doses was 66.0-70.4 Gy to the gross tumor volume,66 Gy to positive neck nodes,60 Gy to the high-risk clinical target volume,54 Gy to the low-risk clinical target volume.Results The overall response rate to neoadjuvant chemotherapy was 91.2%,acute toxicity was mainly grade 1-2 myleosuppression.All patients completed IMRT.The median follow-up duration was 38 months.The 3-year nasopharyngeal local control,regional control,distant metastasis-free survival rate and overall survival rate were 93%,99%,91%,90%,respectively.Severe late toxicities included grade 3 trismus in 1 patient,grade 3 hearing impairment in 2 patients and cranial nerve palsy in 2 patients,respectively.No grade 4 late toxicities were observed.Conclusions The combination of GP chemotherapy and IMRT for locoregionally advanced nasopharyngeal carcinoma is well-tolerated,convenient,effective,and warrants further studies of more proper cycles of GP regimen.

  • [1]Chen CY.Han F,Zhao C,et al.Treatment results and late complication of 556 patients with locally advanced nasopharyngeal carcinoma treated with radiotherapy alone.Br J Radial,2009,82:452-458.
  • [2]Lee AW,Tung SY, Chua DT, et al.Randomized trial of radiotherapy plus concurrent-adjuvant chemotherapy vs radiotherapy alone for regionally advanced nasopharyngeal carcinoma.J Natl Cancer Inst,2010,102:1188-1198.
  • [3]Yi JL,Gao L,Huang XD,et al.Nasopharyngeal carcinoma treated by radical radiotherapy alone:ten-year experience of a single institution.Int J Radiat Oncol Biol Phys,2006,65:161-168.
  • [4]Bae WK, Hwang JE, Shim HJ, et al.Phase Ⅱ study of docetaxel,cisplatin,and 5-Fu induction chemotherapy followed by chemoradiotherapy in locoregionally advanced nasopharyngeal cancer.Cancer Chemother Pharmacol,2010,65:589-595.
  • [5]Ngan RK,Yiu HH,Lau WH,et al.Combination gemcitabine plus cisplatin chemotherapy for metastatic or recurrent nasopharyngeal carcinoma:report of a phase Ⅱ study.Ann Oncol,2002,13:1252-1258.
  • [6]Chua DT, Sham JS, Au GK.Induction chemotherapy with cisplatin and gemcitabine followed by reirradiation for locally recurrent nasopharyngeal carcinoma,Am J Clin Oncol,2005,28:464-471.
  • [7]Jiang Y,Wei YQ,Luo F,et al.Gemcitabine and cisplatin in advanced nasopharyngeal carcinoma:a pilot study.Cancer Invest,2005,23:123-128.
  • [8]Yau TK,Lee AW,Wong DH,et al.Treatment of stage Ⅳ(A-B)nasopharyngeal carcinoma by induction-concurrent chemoradiotherapy and accelerated fractionation: impact of chemotherapy schemes.Int J Radiat Biol Phys,2006,66:1004-1010.
  • [9]Al-Sarraf M,LeBlanc M, Giri PG,et al.Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer:phase Ⅲ randomized Intergroup study 0099.J Clin Oncol,1998,16:1310-1317.
  • [10]Lee AW,Tung SY,Ngan RK,et al.Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma:combined analyses of NPC-9901 and NPC-9902 trials.Eur J Cancer,2011,47:656-666.
  • [11]Lin S,Lu JJ, Han L,et al.Sequential chemotherapy and intensity modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma:experience of 370 consecutive cases.BMC Cancer,2010,10:30.
  • [12]Tham IW,Hee SW,Yeo RM,et al.Treatment of nasopharyngeal carcinoma using intensing-modulted radiotherapy-the national cancer centre Singapore experience.Int J Radiat Oncol Biol Phys,2009,75:1481-1486.
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