Experience with combination of docetaxel, cisplatin plus 5-fluorouracil chemotherapy, and intensity-modulated radiotherapy for locoregionally advanced nasopharyngeal carcinoma.

Abstract

BACKGROUND:

Our aim was to evaluate the efficacy and toxicity of cisplatin, fluorouracil, and docetaxel chemotherapy plus intensity-modulated radiotherapy (IMRT) for locoregionally advanced nasopharyngeal carcinoma (NPC).

METHODS:

Sixty patients with locoregionally advanced NPC were enrolled. Patients received IMRT plus three courses of neoadjuvant chemotherapy and two courses of adjuvant chemotherapy consisting of docetaxel (60 mg/m(2)/day on day 1), cisplatin (25 mg/m(2)/day on days 1-3), and 5-fluorouracil (500 mg/m(2)/day on days 1-3).

RESULTS:

The overall response rate to neoadjuvant chemotherapy was 89 %. Three months after the completion of radiotherapy, 53 (93 %) patients achieved complete regression, 3 (5 %) achieved partial response (PR), and 1 experienced liver metastasis. However, among the 3 PR patients, 2 patients had no evidence of relapse in the follow-up. With a median follow-up of 27 months (range, 6-43), the 2-year estimated locoregional failure-free survival, distant failure-free survival, progression-free survival, and overall survival were 96.6, 93.3, 89.9, and 98.3 %, respectively. Leukopenia was the main adverse effect in chemotherapy; 14 patients experienced grade 3 or grade 4 neutropenia, and 1 patient developed febrile neutropenia. The nonhematological adverse events included alopecia, nausea, vomiting, anorexia, and diarrhea. The incidence of grade 3 acute radiotherapy-related mucositis was 28.3 %; no grade 4 acute mucositis was observed. No grade 3 or grade 4 hematological toxicity occurred during radiotherapy. None of the patients had interrupted radiotherapy. The common late adverse effects included xerostomia and hearing impairment.

CONCLUSIONS:

Neoadjuvant-adjuvant chemotherapy using cisplatin, fluorouracil, plus docetaxel combined with IMRT was an effective and well-tolerated alternative for advanced NPC.

• Authors: Chengrun Du, Hongmei Ying, Junjun Zhou, Chaosu Hu, Youwang Zhang
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 18 Issue 3 Pg. 464-71 (Jun 2013) ISSN: 1437-7772 [Electronic] Japan
• PMID: 22527846 (Publication Type: Journal Article)

Chemical References

• Taxoids
• Docetaxel
• Cisplatin
• Fluorouracil

Topics

• Adult
• Aged
• Carcinoma
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Disease-Free Survival
• Docetaxel
• Drug-Related Side Effects and Adverse Reactions (classification, pathology)
• Female
• Fluorouracil (administration & dosage)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Nasopharyngeal Carcinoma
• Nasopharyngeal Neoplasms (drug therapy, pathology, radiotherapy)
• Neoplasm Recurrence, Local (drug therapy, radiotherapy)
• Radiotherapy, Intensity-Modulated
• Taxoids (administration & dosage)
• Treatment Outcome