Oncotarget

Clinical Research Papers:

Neoadjuvant chemotherapy with different dose regimens of docetaxel, cisplatin and fluorouracil (TPF) for locoregionally advanced nasopharyngeal carcinoma: a retrospective study

Ting Jin, Qun Zhang, Feng Jiang, Wei-Feng Qin, Qi-Feng Jin, Cai-Neng Cao, Yong-Feng Piao, Xing-Lai Feng, Wei Luo and Xiao-Zhong Chen _

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Oncotarget. 2017; 8:100764-100772. https://doi.org/10.18632/oncotarget.21992

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Abstract

Ting Jin1,2,*, Qun Zhang3,*, Feng Jiang1,2, Wei-Feng Qin1,2, Qi-Feng Jin1,2, Cai-Neng Cao1,2, Yong-Feng Piao1,2, Xing-Lai Feng1,2, Wei Luo4 and Xiao-Zhong Chen1,2

1Key Laboratory of Radiation Oncology in Zhejiang Province, Hangzhou, Zhejiang 310022, People’s Republic of China

2Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, People’s Republic of China

3Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510060, People’s Republic of China

4Department of Radiation Oncology, Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong 510060, People’s Republic of China

*These authors contributed equally to this work

Correspondence to:

Xiao-Zhong Chen, email: [email protected]

Wei Luo, email: [email protected]

Keywords: nasopharyngeal carcinoma, neoadjuvant chemotherapy, concurrent chemoradiation, cisplatin, docetaxel

Received: March 04, 2017     Accepted: July 12, 2017     Published: October 20, 2017

ABSTRACT

Objective: Compare high- vs. low-dose TPF neoadjuvant chemotherapy with chemoradiotherapy in Chinese patients with locoregionally advanced nasopharyngeal carcinoma (NPC).

Materials and Methods: Retrospective analysis of 210 stage III/IV NPC patients treated between April 1, 2012 and April 1, 2014; 138 received three cycles of high-dose TPF (H-TPF) every 3 weeks at Zhejiang Cancer Hospital and 72, three cycles of low-dose TPF (L-TPF) every 3 weeks at Sun Yat-Sen University Cancer Center. H-TPF was docetaxel (75 mg/m2; 1 h infusion), cisplatin (75 mg/m2; 0.5–3 h), then 5-fluorouracil (600 mg/m2/day; 4 days). L-TPF was docetaxel (60 mg/m2), cisplatin (65 mg/m2), then 5-fluorouracil (550 mg/m2/day; 5 days). All patients received chemoradiotherapy.

Results: During neoadjuvant chemotherapy, treatment delays were more frequent for H-TPF than L-TPF (33.3% vs. 19.4%; P = 0.034). During chemoradiotherapy, grade III–IV anemia, thrombocytopenia and neutropenia were more common for H-TPF than L-TPF (P < 0.001, P < 0.001, P = 0.048). Fewer patients in the H-TPF group finished two cycles of concurrent chemotherapy (81.2% vs. 100%, P < 0.001). Three-year PFS (84.5% vs. 80.6%, P = 0.484) and OS (91.1% vs. 93.5%, P = 0.542) were not significantly different between H-TPF and L-TPF.

Conclusions: L-TPF neoadjuvant chemotherapy has substantially better tolerance and compliance rates and similar treatment efficacy to H-TPF neoadjuvant chemotherapy in locoregionally-advanced NPC.


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