ANN ONCOL:诱导化疗后序贯同步放化疗治疗鼻咽癌

2018-09-29 MedSci MedSci原创

治疗局部晚期鼻咽癌(NPC)时,同步放化疗(CCRT)效果优于单独放疗。加入诱导化疗(IC)是否可以进一步改善治疗效果尚需研究。ANN ONCOL近期发表了一篇文章研究这一问题。

治疗局部晚期鼻咽癌(NPC)时,同步放化疗(CCRT)效果优于单独放疗。加入诱导化疗(IC)是否可以进一步改善治疗效果尚需研究。ANN ONCOL近期发表了一篇文章研究这一问题。

研究纳入IVA期或IVB期NPC的患者。患者随机分组,一组进行IC后接受CCRT(I-CCRT)治疗,另一组患者仅接受CCRT治疗。I-CCRT组患者接受三个周期的丝裂霉素C,表柔比星,顺铂和5-氟尿嘧啶/亚叶酸钙(MEPFL)治疗。所有患者在放疗期间每周接受顺铂30 mg / m 2治疗。患者接受放疗的总剂量为70 Gy或更高,肿瘤侵犯颈部时放疗剂量为66-70 Gy。主要的研究终点为无病生存(DFS)情况。最终共240名患者随机分配到CCRT组,239名患者随机分配到I-CCRT组。诱导化疗期间最主要的毒性是白细胞减少症(3级和4级:47%和12%)和血小板减少症(3级和4级:24%和3%)。在放疗期间,严重的粘膜炎是两组间的主要不良反应。 I-CCRT组患者中有更多患者出现骨髓抑制,因此顺铂停药更为常见。中位随访72.0个月后,I-CCRT组的DFS明显优于CCRT组。

文章最后认为,在CCRT之前用MEPFL进行诱导化疗耐受性良好,并显着改善了IVA期和IVB期NPC患者的DFS,总生存期没有改善。

原始出处:

R L Hong  C F Hsiao,et al.Final results of a randomized phase III trial of induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in patients with stage IVA and IVB nasopharyngeal carcinoma-Taiwan Cooperative Oncology Group (TCOG) 1303 Study.ANN ONCOL.September 2018 doi: https://doi.org/10.1093/annonc/mdy249

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    2018-11-12 minlingfeng
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    2018-10-01 yzh399
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