| Objective To compare the effecacy and toxicity of concurrent Nedaplatin and Cisplatin-based chemoradiotherapy for locally advanced nasopharyngeal carcinoma(NPC). Methods Eghty-five fist treated NPC confirmed by histopathology were randomized into Nedaplatin group(n=45) and Cisplatin group(n=40). Patients in both groups were received instensity modutated radiation therapy.All patients positioning under enhanced CT simulated locator,then for instensity modutated radiation therapy,the prescription does was 70 Gy for the gross tumor volume in the nasopharynx(GTV),70 Gy for the positive neck lymphnodes(GTVnd),60-66 Gy for the clinical target volume of the hight risk regions,and 50-54 Gy for the clinical target volume of the low risk regions,2Gy every time,5 times every week.Patients in Nedaplatin group were received Nedaplatin 80mg/m2,ivgtt,at the day1,22,43. Patients in the Cisplatin group were similar to that in the Ne da platin group,e xc e pt that Neda platin wa s replac ed by C i s p l a t i n, o t h e r w i s e f u l l y h y d r a t e d c h e m o t h e r a p y w i t h C i s p l a t i n.Results 1 short term effectThe gross tumor in forty-five NPC ptients in Nedaplatin group,CR:thirty-nine cases,PR:six cases,total remission rate(RR)=100%. In Cisplatin group,CR: thirty-five cases,PR:five cases, total remission rate(RR)=100%.For the positive lymphnode in i forty-five NPC ptients in Nedaplatin group,CR:twenty-five cases,PR:sixteen cases, RR=100%(four cases are negative lymphnode). In Cisplatin group,CR: twenty-two cases,PR:thirteen cases, SD:one cases, RR=97.2%(four cases are negative lymphnode),without statistically significant difference among two groups.2 long term effect Local control suirival at 1,2years in Nedaplatin group and Cisplatin group were 100%,100%and97.8%,97.5%(p>0.05);overall survival at 1,2years in Nedaplatin group and Cisplatin group were 97.8%,95.0%and 91.1%,92.5%(p>0.05);distane metastasis free suirvival at 1,2year s were95.6%,95.0% and 88.8%,87.5%( p>0.05).3 adevere reaction. Incidence of nausea was 87.5%vs33.3%(p=0.000), incidence of vomiting was 87.5%vs33.3%(p=0.000),incidence of anorexia was 95.0%vs 64.4%(p=0.000),incidence of losing of body weight was 85.0%vs55.6%(p=0.004), with significant in that four acute toxicity reaction,however,incidence of while bloodcells,platelets,hemoglobin,oralmucositis and radiothermitis were similar between Nedaplatin group and Cisplatin group.The late reactions in two groups were xerastomia,otitis media with effusion and sensori-neural hearing loss,without significant differenc in the late reations.Conclusion The efficacy of concurrent nedaplatin and cisplatin based chemoradiotherapy for locally advaced nasopharyngeal carcinoma,howere,the nedaplatin group group has a lower rate of nausea,vomiting,anovexia and losing of body weight than the cisplation group, without significant differenc in the late reations.The present study was small cases and short follow-up visit,more results can confirm through large sample and long follow-up visit. |
