Clinical Evaluation Of Efficacy And Safety Of Tp Induction Chemotherapy For Locally Advanced Nasopharyngeal Carcinoma

Objective:To observe the reduction of tumor bulk and the occurrence of adverse effect, and evaluate the efficacy and safety of TP induction chemotherapy in the treatment of locally advanced nasopharyngeal carcinomaMethods:From March2011to December2011,26patients with Stage Ⅲ、 Ⅳa locally advanced nasopharyngeal carcinoma were treated with TP (docetaxol+cisplatin) induction chemotherapy. The simulation CT scan was acquired before induction chemotherapy. A second simulation CT scan was acquired after2cycles of TP induction chemotherapy. The gross tumor volume (GTV) was contoured on CT scan images in accordance with MRI. The reduction of tumor bulk and the occurrence of adverse effect were observed.Results:The primary GTV after induction chemotherapy (GTVnx2) was significantly smaller than the primary GTV before induction chemotherapy(GTVnx2)(36.04cm3vs45.25cm3, P<0.001), and the lymph nodes GTV after induction chemotherapy (GTVnd2) was significantly smaller than the lymph nodes GTV before induction chemotherapy(GTVnd2)(7.68cm3vs13.77cm3, P<0.001), the overall GTVnx was reduced by20.33%and the overall GTVnd was reduced by44.24%after induction chemotherapy. The major adverse effect induction chemotherapy of is myelosuppression and gastrointestinal toxicities. In general, TP induction chemotherapy was well tolerable and only one patient delayed the second cycle induction chemotherapy because of neutropenia.Conclusion:The tumor bulk obviously reduced after TP induction chemotherapy; TP induction chemotherapy is well tolerable, safe and effective in the treatment of locally advanced nasopharyngeal carcinoma.