Efficiency of high cumulative cisplatin dose in high‐ and low‐risk patients with locoregionally advanced nasopharyngeal carcinoma

Jiang, Yuting; Chen, Kaihua; Yang, Jie; Liang, Zhong‐Guo; Li, Ling; Qu, Song; Zhu, Xiao‐Dong

doi:10.1002/cam4.4477

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…On the contrary, some studies have revealed a better survival benefit with a higher cumulative dose of cisplatin. Jiang et al revealed higher 3-year PFS and DMFS in > 200 mg/ m 2 cumulative dose of cisplatin than that in ≤ 200 mg/m 2 cumulative dose in concurrent radiochemotherapy [25].…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma: a retrospective study

Yang,

Zuo,

Liu

et al. 2023

BMC Cancer

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Purpose We aimed to investigate the efficacy and side effects of concurrent chemoradiotherapy, with or without nimotuzumab, for the treatment of locally advanced nasopharyngeal carcinoma after neoadjuvant chemotherapy. Methods This study retrospectively enrolled 109 patients with NPC from our hospital from July 2019 to May 2021.All patients were treated with docetaxel, cisplatin, and fluorouracil(TPF) neoadjuvant chemotherapy for 2 cycles, and concurrent chemoradiotherapy was performed 2 weeks after chemotherapy. According to whether nimotuzumab was added in concurrent chemoradiotherapy, they were divided into the nimotuzumab group and the control group, with 52 cases in the nimotuzumab group and 57 cases in the control group.The efficacy and adverse reactions of the two groups were retrospectively analyzed. Results The objective remission and complete remission rates in the nimotuzumab and control groups were 100% vs 98.2% (p = 1.000), and 92.3% vs 78.9% (p = 0.049), respectively. The 3-year distant metastasis-free survival of the nimotuzumab and control groups was 91.6% and 77.3% (p = 0.047), respectively.The 3-year progression-free survival, locoregional relapse-free survival, and overall survival of the nimotuzumab and control groups were 87.6% vs 75.5% (p = 0.110), 90.5% vs 86.9% (p = 0.566), and 94.5% vs 87.1% (p = 0.295), respectively. In the nimotuzumab group, subgroup analysis showed that patients aged < 60 years (hazard ratio [HR] = 0.350, 95% confidence interval [CI]: 0.131–0.934, p = 0.036) and those with a neutrophil-to-lymphocyte ratio (neutrophil/lymphocyte ratio) ≤ 4 (HR = 0.365, 95% CI: 0.144–0.923, p = 0.033) achieved a better result. Additionally, multivariate analysis demonstrated that neutrophil/lymphocyte ratio was an independent risk factor for disease progression (HR = 7.485, p = 0.012) and distant metastasis (HR = 17.540, p = 0.009).No grade 4 adverse reactions were observed in either group. Grade 3 oral mucosal reactions, as well as pharyngeal and esophageal reactions were slightly higher in the nimotuzumab group than in the control group, but the difference was not statistically significant. No significant differences were observed in the incidence of adverse reactions such as leukopenia, HB reduction, thrombocytopenia between the two groups (P > 0.05). Conclusion The concurrent chemoradiotherapy plus nimotuzumab after neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma achieved a higher complete remission rate and significantly improved distant metastasis-free survival compared with concurrent chemoradiotherapy alone. Additionally, an increasing trend was observed in progression-free survival, and the incidence of side effects was similar in both groups.

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Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma: a retrospective study

Yang,

Zuo,

Liu

et al. 2023

BMC Cancer

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show abstract

“…On the contrary, some studies have revealed a better survival bene t with a higher cumulative dose of cisplatin. Jiang et al revealed higher 3-year PFS and DMFS in > 200 mg/m 2 cumulative dose of cisplatin than that in ≤ 200 mg/m 2 cumulative dose in concurrent radiochemotherapy [23] .…”

Section: Discussionmentioning

confidence: 99%

The efficiency of Liposomal paclitaxel versus docetaxel in neoadjuvant chemotherapy on locally advanced nasopharyngeal carcinoma: a retrospective study

Yang¹,

Zuo²,

Liu³

et al. 2023

Preprint

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Purpose This retrospective study aimed to explore the efficiency and untoward reaction of liposomal paclitaxel versus docetaxel for locally advanced nasopharyngeal carcinoma (NPC). Methods This study retrospectively enrolled 115 patients with NPC from our hospital from January 2018 to December 2021. Patients were divided into the liposomal paclitaxel (n = 71) and docetaxel groups (n = 44) following the neoadjuvant chemotherapy protocol. Objective response rate (ORR), progression-free survival (PFS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were compared between the two groups. Results ORR was significantly improved in the liposomal paclitaxel group than in the docetaxel group (62.0% versus 40.9%, P = 0.028). The 3-year PFS (PFS: 84.4% versus 77.5%, P = 0.303), LRFS (95.8% versus 94.4%, P = 0.810), DMFS (87.2% versus 84.9%, P = 0.648), and OS (90.7% versus 88.8%, P = 0.306) revealed no significance. The neutrophil-to-lymphocyte ratio (hazard ratio [HR]: 3.510; P = 0.039) and distant metastasis (HR: 4.384; P = 0.035) were regarded as the risk factors using multivariate regression analysis. Moreover, the incidence of leukopenia at levels 1–2 in the liposomal paclitaxel group was significantly lower than in the docetaxel group (28.1% versus 79.5%, P < 0.05). Conclusions Liposomal paclitaxel had better efficacy in terms of short-term effects and lower incidence of leukopenia at levels 1–2 compared with the docetaxel group.

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“…A meta-analysis showed a significant difference in completing all concomitant chemotherapy cycles in the CRT alone group compared to the IC group (9). Specifically, a cumulative CDDP dose of 200 mg/m 2 was enough to achieve significantly better locoregional control and survival than those without this dose (11)(12)(13). Based on this result, we initially set a target CDDP dose at CRT following IC of 240 mg/m 2 (80 mg/m 2 , 3 cycles) as a reasonable and wellbalanced threshold with regard to both efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

“…Further, IC-TPF as a CDDP-containing triplet regimen sometimes raises concerns about treatment-related toxicity, such as renal impairment related to repeated administration of CDDP over time and increased myelosuppression. Moreover, despite several studies suggesting that compliance with cisplatin during CRT is a critical factor in maximizing its efficacy (11)(12)(13), compliance with concomitant chemotherapy with RT following IC is generally impaired due to the adverse effects of the prior IC (9).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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Efficiency of high cumulative cisplatin dose in high‐ and low‐risk patients with locoregionally advanced nasopharyngeal carcinoma

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 7 publications

References 38 publications

Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma: a retrospective study

Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma: a retrospective study

The efficiency of Liposomal paclitaxel versus docetaxel in neoadjuvant chemotherapy on locally advanced nasopharyngeal carcinoma: a retrospective study

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

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