Comparison Of The Clinical Efficiacy Of TPF Induction Chemotherapy With Different Dose Intense For Locally Advanced Nasopharyngeal Carcinoma

Purpose:To compare the efficacy and adverse reactions between high dose and low dose of cisplatin,fluorouracil,and docetaxel(TPF)induction chemotherapy for locally advanced nasopharyngeal carcinoma.Methods: 221 patients with locally advanced nasopharyngeal carcinoma were recruited in this multicentre,randomised controlled trial recruited between January,2015 to December,2017,which were randomly assigned to L-TPF(low dose TPF)group(docetaxel 60mg/m2/d,d1+cisplatin 60mg/m2/d,d1+fluorouracil 600mg/m2/d,d1-5,once every three weeks for 2-3 courses)and H-TPF(high dose TPF)group(docetaxel 75mg/m2/d,d1+cisplatin 75mg/m2/d,d1+fluorouracil 750mg/d).M2/d,d1-4,once every 3 weeks,totaling 2-3 courses.The adverse reactions and short-term efficacy of chemotherapy during induction chemotherapy were observed in the two groups.Results: Among the 221 patients,two groups had 1 cases out of each group,and there were 217 cases of adverse reactions and curative effects.In L-TPF group,the incidence of grade 3 leukocyte inhibition decreased by 8%,grade 4 neutrophil inhibition by 6.6%,grade 3 gastrointestinal adverse reactions by 11.5%,and the objective remission rate of tumors did not decrease after induction chemotherapy(97.3% VS97.2%).There is no significant difference in3-year LRFS rate(97.6 vs 93.3%),3-year RRFS rate(97.6 vs 97.0%),3-year OS rate(94.9 vs 86.6%)and 3-year DMFS rate(91.3 vs 87.0%)between L-TPF and H-TPF(P > 0.05).Conclusion: The international recommended dose of TPF induction chemotherapy regimen for locally advanced nasopharyngeal carcinoma after20% reduction does not reduce the short-term efficacy of chemotherapy,and the adverse reactions are significantly reduced.