Table_2_Induction chemotherapy with paclitaxel, carboplatin and cetuximab for locoregionally advanced nasopharyngeal carcinoma: A single-center, retrospective study.docx

BackgroundThe addition of induction chemotherapy (IC) before chemoradiotherapy (CRT) has improved survival over CRT alone in locoregionally advanced nasopharyngeal cancer (LA-NPC). Nevertheless, this population would benefit from further development of a novel IC regimen with satisfactory efficacy and a more favorable safety profile.
MethodsWe retrospectively assessed 29 LA-NPC patients who received the combination of paclitaxel (PTX), carboplatin (CBDCA), and cetuximab (Cmab) (PCE) as IC (IC-PCE) at the National Cancer Center Hospital East between March 2017 and April 2021. IC-PCE consisted of CBDCA area under the plasma concentration-time curve (AUC) = 1.5, PTX 80 mg/m2, and Cmab with an initial dose of 400 mg/m2 followed by 250 mg/m2 administered weekly for a maximum of eight weeks.
ResultsPatient characteristics were as follows: median age, 59 years (range 24–75); 0, 1 performance status (PS), 25, 4 patients; and clinical stage III/IVA/IVB, 6/10/13. The median number of PCE cycles was 8(1-8). After IC-PCE, 26 patients received concurrent cisplatin and radiotherapy (CDDP-RT), one received concurrent carboplatin/5-fluorouracil and radiotherapy (CBDCA/5-FU-RT), and two received RT alone. The % completion of CDDP-RT was 88.5%. The response rate was 75.9% by IC and 100% at completion of CRT. The 3-year recurrence-free survival, locoregional failure-free survival, distant recurrence-free survival, and overall survival were 75.9%, 79.3%, 84.3%, and 96.3%, respectively. The incidence of adverse events of grade 3/4 was 34.5% during IC and 44.8% during CRT.
ConclusionIC-PCE is feasible and effective for LA-NPC and may be a treatment option for this disease.

背景：在局部区域晚期鼻咽癌（locoregionally advanced nasopharyngeal cancer, LA-NPC）患者中，放化疗（chemoradiotherapy, CRT）前加用诱导化疗（induction chemotherapy, IC）相较单纯放化疗可改善患者生存结局。然而，该群体仍需开发兼具优异疗效与更优安全性的新型诱导化疗方案，以进一步提升获益。方法：本研究回顾性分析了2017年3月至2021年4月于日本国立癌症研究中心东医院接受紫杉醇（paclitaxel, PTX）、卡铂（carboplatin, CBDCA）联合西妥昔单抗（cetuximab, Cmab）方案（PCE）作为诱导化疗（IC-PCE）的29例LA-NPC患者。IC-PCE方案具体参数为：卡铂的血药浓度-时间曲线下面积（area under the plasma concentration-time curve, AUC）=1.5，紫杉醇剂量为80 mg/m²；西妥昔单抗初始剂量为400 mg/m²，后续每周予以250 mg/m²，最长给药时长为8周。结果：患者基线特征如下：中位年龄59岁（范围24~75岁）；体能状态（performance status, PS）评分0分、1分者分别为25例、4例；临床分期Ⅲ期、ⅣA型、ⅣB期者分别为6例、10例、13例。PCE方案的中位给药周期数为8个（范围1~8个）。IC-PCE治疗完成后，26例患者接受了顺铂同步放化疗（concurrent cisplatin and radiotherapy, CDDP-RT），1例接受卡铂/5-氟尿嘧啶（5-fluorouracil, 5-FU）同步放化疗（CBDCA/5-FU-RT），2例仅接受单纯放射治疗。CDDP-RT的治疗完成率为88.5%。诱导化疗阶段的客观缓解率为75.9%，放化疗完成时的客观缓解率达100%。患者3年无复发生存期、局部区域无失败生存期、远处无复发生存期及总生存期分别为75.9%、79.3%、84.3%及96.3%。诱导化疗期间3/4级不良事件发生率为34.5%，放化疗期间为44.8%。结论：IC-PCE方案用于LA-NPC患者的治疗兼具可行性与有效性，或可成为该疾病的可选治疗方案之一。