Clinical Study Of Different Chemotherapy Regimens For Metastatic Nasopharyngeal Carcinoma

Objective: The aim of this study was to analyse the response of chemotherapy andoutcomes for treating nasopharyngeal carcinoma (NPC) patients who developeddistant metastasis after radical radiotherapy, and to provide evidence for deliveringappropriate salvage chemotherapy.Methods: Clinical data of NPC patients who presented with distant metastasis afterradical radiotherapy was retrospectively reviewed. Kaplan-Meier curve was used forthe survival calculation. The chi-square test was used for analyzing the differences ofthe response rate(RR) between cisplatin and oxaliplatin based two-drug combinedchemotherapy, and between taxolplusplatinum regimen and gemcitabineplusplatinumregimen. Log-rank test was used for analyzing the difference of treatment to theprogression of time (TTP).Results: Ten patients were lost among all the114patients in this study, and thefollow-up rate was91.2%. The median follow-up time was20months (3-83months).Ninety patients died, and the median follow-up time was53.5months(10-83months)for the survived24.The median survival time was20months for the whole group, andthe1-year,2-year,3-year actuarial survival rates were66.5%,41.2%,27.2%,respectively. Overall,511cycles of chemotherapy were given for the whole group.TheRR was73.4%and84.0%in cisplatin based chemotherapy group and oxaliplatinbased group, respectively. No significant difference was observed (P=0.136). Themedian TTP of the two groups was the same8months. The RR was87.1%and86.0%for patients treated with taxolplusplatinum regimen and gemcitabineplusplatinumregimen, respectively. The difference was also of no significance (P=0.865). Themedian TTP was7months and12months for these two groups, respectively. And nosignificant difference was found (P=0.497).Conclusion: As for the NPC patients who developed distant metastasis while abtained good local and regional control after curative radiotherapy, no significant differencewas seen in RR or TTP between cisplatin based chemotherapy regimen andoxaliplatin based two-drug regimen. There was also no significant difference of RR orTTP between taxolplusplatinum regimen and gemcitabineplusplatinum regimen.