Addition of 5-fluorouracil to docetaxel/cisplatin does not improve survival in locoregionally advanced nasopharyngeal carcinoma
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Wang Fangzheng1,2,*, Jiang Chuner3,*, Sun Quanquan1,2, Ye Zhimin1,2, Liu Tongxin1,2, Liu Jiping4, Masoto Sakamoto5, Wu Peng6, Shi Kaiyuan7, Qin Weifeng1,2, Fu Zhenfu1,2 and Jiang Yangming8
1Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China
2Key Laboratory of Radiation Oncology of Zhejiang Province, Hangzhou 310022, People’s Republic of China
3Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China
4Department of Physics, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China
5Department of Radiology, Fukui Red Cross Hospital, Fukui 918-8501, Japan
6Department of Pathology, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China
7Department of Ultrasonography, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China
8Department of Digital Earth, Institute of Remote Sensing and Digital Earth, CAS, Beijing 100101, People’s Republic of China
*These authors have contributed equally to this work
Jiang Yangming, email: [email protected]
Wang Fangzheng, email: [email protected]
Keywords: nasopharyngeal carcinoma; induction chemotherapy; concurrent chemoradiotherapy; intensity-modulated radiotherapy; toxicity
Received: September 22, 2017 Accepted: December 04, 2017 Published: December 14, 2017
Addition of induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) is a potentially effective approach for treating locoregionally advanced nasopharyngeal carcinoma (NPC). In this study, we compared the efficacy and toxicity of IC regimens consisting of docetaxel plus cisplatin with (TPF) or without (TP) 5-fluorouracil followed by CCRT in these patients. Clinical data from 245 propensity score-matched pairs of newly diagnosed non-metastatic NPC patients who received either TPF or TP IC before CCRT were retrospectively reviewed. After a median follow-up of 60 months, 5-year locoregional relapse-free, distant metastasis-free, progression-free, and overall survival rates were 95.6%, 94.7%, 90.4%, and 92.9% in TPF arm patients and 96.7%, 94.2%, 91.7%, and 91.0% in TP arm patients, respectively. There were thus no differences in survival between the two arms. Multivariate analysis revealed that IC regimen was not an independent prognostic factor for any of the survival outcomes. However, patients who received TP experienced lower incidences of grade 3/4 toxicities than those who received TPF. These results indicate that omission of 5-fluorouracil from TPF-based IC did not affect survival outcomes, but was associated with reduced toxicity, in patients with locoregionally advanced NPC.
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