Comparison of weekly versus triweekly cisplatin delivered concurrently with radiation therapy in patients with locally advanced nasopharyngeal cancer: A multicenter randomized phase II trial (KCSG-HN10-02)

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• 作者：Ji Yun Lee^a ; ¹ ; Jong-Mu Sun^a ; ¹ ; Dong Ryul Oh^b ; Sung Hee Lim^a ; Juna Goo^c ; Se-Hoon Lee^a ; Sung-Bae Kim^d ; Keon Uk Park^e ; Hoon-Kyo Kim^f ; Dae Sik Hong^g ; Jun Suk Kim^h ; Seong-Geun Kimⁱ ; Seong Yoon Yi^j ; Hwan Jung Yun^k ; Myung Soo Hyun^l ; Hyo Jung Kim^m ; Sin-Ho Jung^c ; Keunchil Park^a ; Yong Chan Ahn^b ; ^{ahnyc@skku.edu" class="auth_mail" title="E-mail the corresponding author} ; ^{ycahn.ahn@samsung.com" class="auth_mail" title="E-mail the corresponding author} ; Myung-Ju Ahn^a ; ^{silkahn@skku.edu" class="auth_mail" title="E-mail the corresponding author} ; ^{silk.ahn@samsung.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Concurrent chemoradiation therapy ; Nasopharyngeal cancer ; Efficacy ; Toxicity ; Quality of life
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：118
• 期：2
• 页码：244-250
• 全文大小：933 K

文摘

Triweekly delivery of cisplatin concurrent with a course of radiation therapy (RT) has been the standard regimen for treatment of locally advanced nasopharyngeal carcinoma (NPC) despite a high level of concern regarding treatment-related complications. We conducted a randomized phase II study to compare weekly and triweekly cisplatin delivery during RT with respect to efficacy and toxicity profiles.

Material and methods

Patients with locally advanced NPC (stage II–IVb) were randomly assigned to a regimen of either seven doses of cisplatin (40 mg/m²) given once a week or three doses of cisplatin (100 mg/m²) given every 3 weeks concurrently during RT.

Results

Of 109 eligible patients, 53 were assigned to the weekly regimen and 56 to the triweekly regimen. The two groups were comparable with respect to demographic and clinical characteristics. There were no significant differences in mean RT dose (68.3 Gy vs. 67.3 Gy, p = 0.559) and mean cisplatin dose (248.9 mg/m²vs. 256.6 mg/m², p = 0.433) between the two regimens. The primary endpoint was 3-year progression-free survival, which was not different between the regimens (64.9% vs. 63.8%, p = 0.074). Overall, the occurrence of grade 3–4 toxicities was similar between the two arms (47.2% vs. 39.3%, p = 0.443). Quality of life (QoL) related to functional outcomes 3 weeks after treatment completion was better for the weekly regimen.

Conclusions

Although no definitive conclusions can be made, a once-weekly cisplatin regimen appears to be associated with improved QoL and is not inferior to the standard triweekly regimen with respect to efficacy and toxicity profiles.