The Clinical Study Of TP Induction Chemotherapy Followed By Intensity Modulated Radiation Therapy With Concurrent Chemotherapy In Locally Advanced Nasopharyngeal Carcinoma Patients

Objective:Through the comparion with concurrent chemoradiotherapy with or without adjuvant chemotherapy, to observe and evaluate the efficacy of TP induction chemotherapy followed by intensity modulated radiation therapy with concurrent chemotherapy in locally advanced nasopharyngeal carcinoma(NPC)。Materials and Methods:From August 2011 to December 2012 in our hospital, Select 88 patients treated with TP induction chemotherapy followed by IMRT with concurrent chemotherapy for treatment group,123 patients with concurrent chemotherapy alone or with adjuvant chemotherapy were selected for the same period for control group。Trial group treated with 2cycles of induction chemotherapy wih docetaxel 75mg/m2 and cisplatin 80mg-100/m2 every 3 weeks, followed by cisplatin 80-100mg/m2 every 3 weeks for 2-3 cycles。Control group treated with cisplatin 80-100mg/m2 every 3 weeks for 2-3 cycles, in 49 patients received adjuvant chemotherapy, PF regimen (DDP80-100mg/m2,5-Fu500 mg/m2) were repeated every 3 weeks for 2-3 weeks。All patients received intensity-modulated radiotherapy。After treatment, the short-term curative effec、treatment toxicity、survival and prognostic factors were compared between the two groups。Results:The trial group and control group were evaluable for treatment response。The overall response rates(CR+PR)were 100.0%(CR in 84.1%) and 100.0%(CR in 75.6%), respectively in the trial group and in the control group。 There was no significant difference(P>0.05) between two groups。The 3-year overall survival rate,3-year local recurrence-free survival,3-year distant metastasis-free survival rate and 3-year progress-free survival rate between the two groups were 91%and88.6%.93.4%and92%、90.1%and86%、83.4%79.6%, there were no statistical significances (P>0.05)。The treatment-related acute toxicities were mainly myelosuppression、gastrointestinal、mucositis and radioepidermitis, The acute reactions between the two groups had no difference (P>0.05)。Multiple factor analysis exhibited that the N stage was an independent factor on prognosis (P<0.05)。Conclusion:1、Multiple factor analysis exhibited that the N stage was an independent factor on prognosis。2、The short-term efficacy for locally advanced nasopharyngeal carcinoma with TP induction chemotherapy plus IMRT with concurrent chemotherapy was clear, and the toxicity can be tolerated, does not significantly improve the 3-year overall survival rate, the long-term efficacy still needs further research。...