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Efficacy of intensity-modulated radiotherapy with concurrent carboplatin in nasopharyngeal carcinoma

机译:调强放疗联合卡铂治疗鼻咽癌的疗效

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Background. The aim of the prospective phase II study was to evaluate the efficacy and toxicities of concurrent carboplatin with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma (NPC). Patients and methods. Between October 2005 and November 2011, 73 stage IIa€’IVB NPC patients received IMRT 70 Gy concurrently with three cycles of carboplatin (AUC 5) every three weeks, followed by three cycles of adjuvant carboplatin (AUC 5) and 5-FU (1,000 mg/m2/day for four days) every four weeks. All patients were evaluated for tumour response using response evaluation criteria in solid tumour (RECIST) criteria, survival analysis using Kaplan-Meier methods, and toxicities according to common terminology criteria for adverse events (CTCAE) version 4.0. Results. At three months after chemoradiation, 82.2% and 17.8% of patients achieved complete and partial response, respectively. With a median follow-up of 48.1 months (1.3a€’97.8 months), 9.6% and 17.8% had local recurrence and distant metastasis, respectively. The median survival was not reached. A three-year overall survival was 83.6% and a progression-free survival was 65.3%. Regarding treatment compliance, 97.2%, 68.5% and 69.8% completed radiation treatment, concurrent carboplatin and adjuvant chemotherapy, respectively. Grade 3a€’4 acute toxicities were oral mucositis (16.4%), dysphagia (16.4%), xerostomia (15.1%) and haematotoxicity (6.8%). Conclusions. Carboplatin concurrently with IMRT provided excellent tumour response, manageable toxicities and good compliance. This should be considered as an alternative treatment for NPC patients.
机译:背景。前瞻性II期研究的目的是评估同时用卡铂联合调强放疗(IMRT)治疗鼻咽癌(NPC)的疗效和毒性。患者和方法。在2005年10月至2011年11月之间,有73名IIa,IVB期NPC鼻咽癌患者接受IMRT 70 Gy治疗,并每三周接受三个周期的卡铂(AUC 5),随后三个周期的辅助卡铂(AUC 5)和5-FU(1,000每四周一次mg / m2 /天,共四天)。使用实体瘤反应评估标准(RECIST),使用Kaplan-Meier方法进行生存分析以及根据不良事件的通用术语标准(CTCAE)4.0版评估毒性,评估所有患者的肿瘤反应。结果。化学放疗后三个月,分别有82.2%和17.8%的患者获得了完全和部分缓解。中位随访时间为48.1个月(1.3a到97.8个月),分别有9.6%和17.8%的患者出现局部复发和远处转移。未达到中位生存期。三年总生存率为83.6%,无进展生存率为65.3%。在治疗依从性方面,分别完成放射治疗,同时进行卡铂和辅助化疗的占97.2%,68.5%和69.8%。 3a-4级急性毒性为口腔粘膜炎(16.4%),吞咽困难(16.4%),口腔干燥症(15.1%)和血液毒性(6.8%)。结论。卡铂与IMRT联用可提供出色的肿瘤反应,可控制的毒性和良好的依从性。这应被视为NPC患者的替代疗法。

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