Sun Xueming,Wu Hui,Lu Xiaoxu,et al.Comparison of nedapaltin and cispaltin chemotherapy combined with intensity modulated radiotherpy for locally advanced nasopharygeal carcinoma patients in unendemic area[J].Chinese Journal of Radiological Medicine and Protection,2018,38(11):836-841
Comparison of nedapaltin and cispaltin chemotherapy combined with intensity modulated radiotherpy for locally advanced nasopharygeal carcinoma patients in unendemic area
Received:July 25, 2018  
DOI:10.3760/cma.j.issn.0254-5098.2018.11.007
KeyWords:Nasopharygeal neoplasms  Concurrent chemoradiotherapy  Intensity-modulated radiotherapy  Adjuvant chemotherapy  Prognosis
FundProject:河南省科技攻关计划项目(152102310156)
Author NameAffiliationE-mail
Sun Xueming Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
Wu Hui Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China wuhui7008@126.com 
Lu Xiaoxu Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
Xu Jing Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
Wang Shujuan Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
Cheng Xinyu Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
Yan Zhumin Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
Huang Rong Department of Radiation Oncology, The Affiliated Tumor Hospital of Zhengzhou University, Tumor Hospital of Henan Province, Zhengzhou 450008, China  
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Abstract::
      Objective To compare the efficacy and toxicity of nedaplatin and cispaltin chemotherapy combined with intensity modulated radiotherpy (IMRT) in the treatment of locally advanced nasopharygeal carcinoma (NPC) patients in unendemic area. Methods From January 2014 to July 2016, sixty-two pairs of patients with stage Ⅲ-ⅣB NPC patients who underwent radical radiotherapy were selected for pair analysis (nedaplatin group and cisplatin group, 62 cases for each group). The nedaplatin group was treated with IMRT concurrent with nedaplatin at a dose of 100 mg/m2 every three-weeks for 2-3 cycles, and sequential adjuvant chemotherapy of nedaplatin + fluorouracil regimen for 2 to 3 courses. The cisplatin group was treated with IMRT concurrent with cisplatin at a dose of 80 mg/m2 every three-weeks for 2-3 cycles, and sequential adjuvant chemotherapy of cisplatin + fluorouracil regimen for 2 to 3 courses. Results The 2-year overall survival (OS) of nedaplatin group and cisplatin group was 89.9% and 91.1%, local recurrence free survival (LRFS) 90.5% and 93.5%, regional recurrence free survival (RRFS) 96.4% and 96.0%, and distant metastasis free survival (DMFS) 85.9% and 90.3%, respectively. There were no significant differences between nedaplatin group and cisplatin group(P>0.05). In the occurrence of acute toxicity, during concurrent chemoradiotherapy and adjuvant chemotherapy, the incidence of grade 3-4 vomiting in nedaplatin group was significantly lower than that in cisplatin group. During adjuvant chemotherapy, the incidence of grade 3-4 thrombocytopenia in nedaplatin group was significantly higher than that in cisplatin group. Conclusions For NPC patients with stage Ⅲ-ⅣB in unendemic area, the 2-year survival rates of nedaplatin group was silimiar to cisplatin group, while the incidence of grade 3-4 vomiting was significantly lower than that in cisplatin group. Nedaplatin maybe an alternative chemotherapy for patients who cannot tolerate cisplatin chemotherapy.
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