Treatment outcomes of alternating chemoradiotherapy for nasopharyngeal carcinoma: a single-center safety and efficacy study

Abstract Objective To evaluate the efficacy and safety of Alternating Chemoradiotherapy (ACRT) using cisplatin and 5-Fluorouracil (5-FU) in patients with nasopharyngeal carcinoma. Methods This was a retrospective study in which patients’ clinical records were reviewed to identify patients with a new diagnosis of nasopharyngeal carcinoma at our institution between January 2005 and January 2019. Thirty-seven eligible patients were identified; of these, the clinical details of 27 patients treated with ACRT were evaluated. Patient outcomes, including overall survival and progression-free survival, and adverse events were assessed. Results Of these initial 37 patients, 1, 10, 13, 10, and 3 were staged as I, II, III, IVA, and IVB, respectively, as defined by the 8th edition of the TNM classification system. Twenty-seven patients received ACRT comprising sequential administration of chemotherapy, radiotherapy (wide field), chemotherapy, radiotherapy (shrinking field), and chemotherapy. The 5-year overall survival and progression-free survival rates were 83.7% and 88.9%, respectively. Treatment compliance was 93%, which is comparable to that of previous reports. Conclusion ACRT using cisplating and 5-fluorouracil was well tolerated with acceptable efficacy. Level of Evidence IVa摘要 目的：评估采用顺铂（cisplatin）联合5-氟尿嘧啶（5-Fluorouracil，5-FU）的交替放化疗（Alternating Chemoradiotherapy，ACRT）治疗鼻咽癌患者的有效性与安全性。 方法：本研究为回顾性研究，回顾了2005年1月至2019年1月期间本机构新确诊鼻咽癌患者的临床病历。最终筛选出37例符合入组标准的患者，其中27例接受ACRT治疗的患者的临床细节被纳入本次分析。本研究对患者的总生存期、无进展生存期等转归指标以及不良事件发生情况进行了评估。 结果：初始纳入的37例患者中，依据第8版TNM分期系统（TNM classification system），分期为I、II、III、IVA、IVB期的患者分别有1、10、13、10、3例。27例患者接受的ACRT方案为化疗-大范围照射野放疗-化疗-缩野放疗-化疗的序贯给药模式。患者的5年总生存率与无进展生存率分别为83.7%与88.9%。治疗依从性为93%，与既往相关研究报道的结果相当。 结论：采用顺铂联合5-氟尿嘧啶的交替放化疗耐受性良好，疗效可接受。证据等级IVa