Phase I study of TPF neoadjuvant chemotherapy followed by radical radiotherapy in advanced nasopharyngeal carcinoma

Abstract

Chinese Journal of Cancer 窑Nasopharyngeal Carcinoma Column窑 Combined chemotherapy and radiotherapy is the standard treatment for advanced nasopharyngeal carcinoma (NPC). Prospective studies have shown that neoadjuvant chemotherapy with PF or PFB regimen for NPC achieves a response rate of more than 75%, but a relatively low complete remission (CR) rate of only about 20% 1,2. In recent years, TPF regimen [taxotere, cisplatin (DDP) and 5fluorouracil (5FU)] yields a better efficacy than PF regimen in head and neck cancer including NPC, with a CR rate doubled and a total response rate up to 93% 3. However, hematological toxicities with TPF, especially neutropenia, significantly increased compared with PF 3,4 , and the recommended dose by Western clinical trials may not be suitable for Orientals. So we conducted a phase I study to explore the doselimiting toxicity (DLT) and maximum tolerated dose (MTD) of TPF in the treatment of advanced nasopharyngeal carcinoma and observe its shortterm efficacy.

Analysis of Postsurgical Health-Related Quality of Life and Quality of Voice of Patients With Laryngeal Carcinoma

“…A prospective study completed in China has recommended decreased drug dosages in TPF neoadjuvant chemotherapy against late-staged head–neck cancers (Taxotere 60 mg/m 2 d1, DDP 60 mg/m 2 d1, 5-FU 600 mg/m 2 d1–5 repeated in 3-week cycles), which seems safer, more efficient, and more appropriate for easterners. 23 It is suggested that besides efficacy, the impact of postoperative chemotherapy on HRQOL be also taken into consideration with dosages appropriate for easterners so as to improve HRQOL by reducing adverse effects.…”

A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy

“…The fact that the patients who underwent chemotherapy lost more weight further substantiates that chemoradiotherapy can be intensive and can be associated with severe acute toxicity, especially in patients with head and neck tumors. This fact, as well as nausea and vomiting, may contribute to increasing weight loss in patients undergoing radiotherapy[13],[21]. Currently, there is a lack of evidence-based data regarding toxicities in elderly patients, especially in the field of radiotherapy[22].…”

Concurrent chemoradiotherapy with/without induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma: Long‐term results of phase 3 randomized controlled trial

“…For IC, TPF was administered as 60 mg/m 2 docetaxel intravenously on day 1, 60 mg/m 2 cisplatin intravenously on day 1, and 600 mg/m 2 /d fluorouracil as continuous infusion on days 1-5; three cycles were administered at intervals of 3 weeks. 11,12 For CCRT, 100 mg/m 2 cisplatin was administered intravenously every 3 weeks on days 1, 22, and 43 concurrently with radiotherapy. During the induction and concurrent phases, chemotherapy was withheld until nadir values were ≥ 1500/μL for neutrophils and ≥ 100,000/μL for platelets.…”