Clinical Observation Of Docetaxel Combined With Nedaplatin In The Treatment Of Locally Mid-late Nasopharyngeal Carcinoma

Objective :At present,there are many comprehensive treatment modes for local mid-late advanced nasopharyngeal carcinoma.In the treatment mode of concurrent chemoradiotherapy combined with adjuvant chemotherapy,this study aims to compare TP(docetaxel combined with nedaplatin)and P(traditional platinum-based single drug-based)in the compliance,short-term treatment efficacy,treatment-related near-distance toxic side effects,survival differences,to further explore the clinical value of TP,and analyze the prognostic factors affecting disease-free survival.Methods:The differences in compliance between the two chemotherapy regimens were compared by analyzing the treatment of all newly diagnosed and treated patients in our department.The clinical data of 86 patients with locally advanced nasopharyngeal carcinoma were retrospectively analyzed,and the prognosis was obtained by follow-up of outpatient and telephone interviews.According to the treatment plan,they were divided into two groups: 43 cases of single-agent nedaplatin group(P group),43 cases of docetaxel combined with nedaplatin group(TP group),and both groups completed IMRT concurrent chemoradiotherapy and adjuvant chemotherapy.Statistical methods were used to compare the recent toxic and side effects during concurrent chemoradiotherapy and the imaging changes after 3 months after the end of concurrent chemoradiotherapy,and the long-term toxicity after adjuvant chemotherapy.Comparison of the two groups 1,3,5 Differences in annual overall survival(OS),disease-free survival(DFS),no local recurrence rate(LRFS),and no distant metastasis rate(DMFS),while univariate and multivariate analysis were used to analyze the effects of DFS Factors.Results:(1)The treatment compliance of the TP group was better than that of the P group,P<0.05,and there was a statistically significant difference.(2)The effective response rate of primary tumor in TP group was 100%(43/43),and the effective response rate of primary tumor in group P was 90.7%(39/43),P<0.05,there was statistically significant difference;The effective response rate of TP group lymph node was 95.3%(41/43),and the effective response rate of lymph node in group P was 88.4%(38/43),P>0.05.No significant statistical difference was found.(3)Compared with group P,the acute response of TP group was slightly heavier in leukopenia,but P>0.05,there was no statistical difference;in the long-term toxicity,neurotoxicity was observed,P<0.05,there was statistically significant.Differences,the rest did not see significant differences.(4)In 86 patients,5 patients had local recurrence(2 in TP group,5 in P group);10 patients had distant metastasis(3 in TP group,7 in P group);10 patients died(TP group)4 cases,6 cases in group P),P>0.05,no statistically significant difference.(5)There were significant statistical differences between the two groups in1,3,5DMFS and DFS(the DMFS of the TP group and the P group were 100% vs95.2%,86.7% vs 75.6%,86.7%Vs70.2% respectively,DFS of 1,3,5 years were 97.4%vs 95.2%,87.8% vs 58.6%,59.1% vs 33.6% respectively),although OS and LRFS were also different,P>0.05,no statistically significant difference.(6)By univariate analysis of clinical factors affecting DFS,it was found that TNM staging(P<0.05),N staging(P<0.05),and the agent of concurrent chemotherapy(P<0.05)affected DFS of local mid-late nasopharyngeal carcinoma.(7)Multivariate analysis showed that N(P<0.05)and the agent of concurrent chemotherapy(P<0.05)were independent prognostic factors affecting DFS of local mid-late nasopharyngeal carcinoma.Conclusions:During the concurrent chemoradiotherapy,compared with the traditional platinum-based single-agent 6-cycle weekly radiotherapy sensitization program,the two-cycle combination of docetaxel and nedaplatin had better compliance and little difference in recent toxicity and side effects.The overall nutritional status of the patient is less affected,the patient can tolerate,the long-term neurotoxicity is more obvious,but the patient can be tolerated after the supportive treatment;the short-term effective response rate in the primary tumor is remarkable;the 5-year DMFS,DFS difference is large,and the benefit is significant;The choice of N-stage and concurrentchemotherapy regimens is an independent prognostic factor for patients with locally mid-late nasopharyngeal carcinoma.