Dose-escalation trial of lobaplatin weekly plus concurrent radiotherapy for local-regionally advanced nasopharyngeal carcinoma / 中华放射肿瘤学杂志

ABSTRACT

Objective To define the maximum-tolerated dose (MTD) of lobaplatin (LBP) in a weekly regimen combined with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC).Methods A total of 18 cases with stage Ⅲ/Ⅳ A NPC were enrolled.Concurrent chemoradiotherapy was given to all the patients with a dose escalation of LBP.The initial dose of LBP was 15 mg/m2 with an escalating dose of 5 mg/m2.At least 3 patients were assigned into each group.Patients were proceeded into the next dose group if no dose-limiting toxicity (DLT) occurred until the MTD was achieved.Efficacy and toxicity were evaluated regularly.Results Three patients were assigned into the 10 mg/m2,3 into the 15 mg/m2,and 6 into the 20 mg/m2 and 25 mg/m2 groups,respectively.Two patients experienced DLT in the 25 mg/m2 group.Hence,the MTD was determined as 20 mg/m2.At 3 months after corresponding treatment,the remission rate of nasopharyngeal tumors and neck-positive lymph nodes of the patients was 100％.The most common toxicity was reversible bone marrow suppression.Conclusions The MTD of weekly lobaplatin plus concurrent IMRT is 20 mg/m2 for locally advanced NPC.This regimen is reliable and safe,which is worthy of further clinical study.