Clinical observation of TPF scheme induction with S-1 concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma

JIANG Yingqiang; ZHONG Hui; LI Ming; SONG Gaoping

Abstract：Objective To evaluate the safety and clinical effects of TPF scheme induction chemotherapy with S?1 concurrent chemotherapy combined with intensity?modulated radiotherapy( IMRT) in the treatment of locally advanced nasopharyngeal carcinoma. Methods Induction chemotherapy with concurrent chemoradiotherapy combined with IMRT in the treatment of 38 patients with locally advanced nasopharyngeal carcinoma. The induction chemotherapy was used by the TPF scheme:paclitaxel 135 mg/m2 , intravenous in?fusion d1;DDP 80 mg/m2, intravenous infusion,d1;5?fluorouracil 750 mg/(m2·d), continuous venous pumping,d1?d5(120 hours). 21 days as a cycle for 2 cycles. The concurrent chemotherapy was used by 40 mg/m2 of S?1, taken orally, twice a day,d1?d14 . 2l days as a cycle for 2?3 cycles. The concurrent radiotherapy was PGTVnx(69. 96?73. 92) Gy/33 f, PGTVnd 69. 96 Gy/33 f, PTV1 60. 06 Gy/33 f, PTV2 50. 96 Gy/28 f, PTVnd 50. 96 Gy/28 f, once a day, 5 times a week. Results All of 38 patients completed the induc?tion chemotherapy for 2 cycles and concurrent chemoradiotherapy for 2?3 cycles. The immediate effects was evaluated after the treat?ment. There were 29 cases of CR, 8 PR, 1 SD with 97. 4% of the response rate( RR) . The short?term effecacy was evaluated in three months after the treatment. There were 33 cases of CR, 5 PR with RR of 100%. The main side effects of induction chemotherapy were nausea, leukocyte and hemoglobin decrease, those of concurrent chemoradiotherapy were oral mucositis, dermatitis in the radiation field and odynophagia. Among them, the grade 3 mucositis ( 7. 9%) , dermatitis in the radiation field ( 2. 6%) and odynophagia ( 2. 6%) were occurred, without grade 4?5 toxicity. Conclusion TPF scheme inducing chemotherapy with S?1 concurrent chemoradio?therapy combined with IMRT in the treatment of nasopharyngeal carcinoma, has a great short?term effects and less side effects, which is an effective, tolerable and safe comprehensive treatment scheme.