Comparison of GP and TP induction chemotherapy combined with concurrent radiochemotherapy for locally advanced nasopharyngeal carcinoma in the non-endemic of Northwest China: A prospective single center phase Ⅱ clinical study / 西安交通大学学报(医学版)

ABSTRACT

Objective: To explore the curative effect and adverse reactions of GP induction chemotherapy combined with chemoradiation contrast TP induction for local advanced nasopharyngeal carcinoma in the non-endemic of Northwest China, our center conducted the prospective, single-center, randomized controlled clinical research so as to clarify GP regimenvalue of induction chemotherapy in local advanced nasopharyngeal carcinoma treatment. Methods: We randomly assigned patients with newly diagnosed stage III-b patients to GP regimen of induction chemotherapy in combination with concurrent chemoradiotherapy and TP. Induction chemotherapy was given 2-3 cycles. Cisplatin regimen chemotherapy was given every 3 weeks and 1-3 cycles during radiotherapy. We compared the differences in tumor shrinkage and survival between the two groups and evaluated the toxicity and compliance of the two induction chemotherapy regimens. Results: A total of 72 patients were enrolled in this study, including 34 patients in GP group and 38 patients in TP group. The general clinical data of the two groups were balanced. Short-term efficacy evaluation showed no difference between the TP group and the GP group in terms of nasopharyngeal disease and ORR of cervical lymph nodes either after induction or concurrent chemoradiotherapy. The median follow-up time of the whole group was 74.8 months(0.8-108.9 months), and the 5-year DMFS of the GP group and the TP group was 83.9% and 76.5% (χ2=4.140, P=0.042), respectively. The difference was statistically significant. During the induction chemotherapy, the incidence of neutropenia, leukopenia and thrombocytopenia in the GP group was higher than that in the TP group (P<0.05). There was no difference between the two groups in other acute or late toxic or side effects. Results: In local advanced nasopharyngeal carcinoma in non-endemic regions of Northwest China, long-term efficacy of GP chemotherapy is better than that of TP chemotherapy. During the treatment, acute hematological toxicity of GP regimen group was heavier than that of TP group, but the compliance of subsequent chemoradiotherapy was not affected after symptomatic treatment. The late toxicity was equivalent to that of the two groups, and the treatment tolerance was acceptable.