Short-term Efficacy Of GP And TP Induction Chemotherapy Combined With Concurrent Chemoradiotherapy For Locally Advanced Nasopharyngeal Carcinoma

Objective: Induction chemotherapy combined with concurrent chemoradiation is one of the effective treatments for locally advanced nasopharyngeal carcinoma.This study focuses on the comparison of the toxicities and short-term effects of GP(gemcitabine + cisplatin)and TP(paclitaxel + cisplatin)regimens in the treatment of locally advanced nasopharyngeal carcinoma,in order to evaluate the clinical value of GP,TP induction chemotherapy for locally advanced nasopharyngeal carcinoma.Methods: A retrospective analysis of our hospital's 2015.01-2017.06 treatment of locally advanced nasopharyngeal cancer data.There were 28 cases of GP induction chemotherapy combined with concurrent radiotherapy and chemotherapy,and 33 cases of TP induction chemotherapy combined with concurrent radiotherapy and chemotherapy.All patients received intensity-modulated conformal radiation therapy.Simultaneous chemotherapy was cisplatin monotherapy.The toxicity of induction chemotherapy-related toxicities was collected,and the short-term efficacy(complete remission,partial remission,stability,and progression)after induction chemotherapy and concurrent radiotherapy and chemotherapy were evaluated.SPSS18.0 software was used for efficacy analysis.Results: 1.In terms of toxic side effects,the GP group and TP group occurred III-IV degree of white blood cells,hemoglobin,thrombocytopenia were 25% vs.18.2%,3.6% vs.0%,10.7% vs.0%,occurred in III-IV degree liver function abnormal and digestive tract reactions were 14.3% vs.3%,3.6% vs.9.1%,respectively.The incidence of III-IV digestive tract reaction in the GP group was lower than that in the TP group,but there was no significant difference in hematological toxicity and non-hematological toxicity between the two groups(P>0.05).2.After GP induction chemotherapy,20 cases(71.4%)of nasopharyngeal lesions achieved partial remission(PR),8 cases(28.6%)had stable disease(SD),18 cases of cervical metastatic lymph nodes(64.3%)achieved partial response(PR)and 10 cases(35.7%)had stable disease(SD).After TP induction chemotherapy,22 cases(66.7%)of nasopharyngeal lesions achieved partial response(PR),11 patients(33.3%)had stable disease(SD),14(42.4%)cases of cervical metastatic lymph nodes(64.3%)achieved partial response(PR)and 19(57.6%)had stable disease(SD).There was no significant difference in the remission rates of nasopharyngeal lesions and neck metastatic lymph nodes between the two groups(P> 0.05).3.After induction chemotherapy and concurrent chemoradiotherapy were completed in both groups,the complete remissions in the GP and TP groups were 82.1% and 75.8%,and the partial remissions were 17.9% and 24.2%,respectively.At the end of radiotherapy and chemotherapy,the total effective rates(CR+PR)of the two groups reached 100%.There was no statistical difference in the disease remission between the two groups(P=0.544).Conclusion: 1.In terms of toxicities,the conditions were comparable between the two groups after induction chemotherapy with GP or TP regimen in locally advanced nasopharyngeal carcinoma;however,the GP regimen had a relatively mild gastrointestinal response.2.For locally advanced nasopharyngeal carcinoma,the remission rate of nasopharyngeal lesions and metastatic lymph nodes in the neck after induction chemotherapy in the GP group was higher than that in the TP group,but the two groups are quite effective.3.During the one-year follow-up of GP or TP induction chemotherapy and concurrent chemo-radiotherapy,the two groups are quite effective,and it needs to be further confirmed by increasing the sample size and long-term follow-up.