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

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Author:
No author available
Journal Title:
Chinese Journal of Radiation Oncology
Issue:
5
DOI:
10.3760/cma.j.issn.1004-4221.2012.05.003
Key Word:
鼻咽肿瘤/化学疗法;鼻咽肿瘤/放射疗法;化学疗法,吉西他滨和顺铂;放射疗法,调强;预后;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.

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