| Objective: To compare the safety and efficacy of NF regimen(Nidaplatin+5-fluorouracil)and TPF regimen(Docetaxel+Cisplatin+5-fluorouracil)induction chemotherapy combined with concurrent chemoradiotherapy.Materials and methods:A retrospective analysis was performed on 150 patients with locally advanced nasopharyngeal carcinoma who were initially treated by histopathology from January 2012 to December 2015 in the tumor hospital affiliated to Guangxi Medical University,all of whom received induction chemotherapy combined with concurrent chemoradiotherapy,including 40 patients in the NF group and 110 patients in the TPF group.NF regimen consisted of nedaplatin combined with 5-fluorouracil,while TPF regimen consisted of docetaxel combined with cisplatin combined with5-fluorouracil for induction chemotherapy,with a cycle of 21 days.Single drugcisplatin was used for concurrent chemotherapy during radiotherapy,with a cycle of 21 days.IMRT was used in all the radiotherapy,and single drug cisplatin concurrent chemotherapy was used during the radiotherapy,with a cycle of 21 days.Six factors including gender,age,KPS,T stage,N stage and clinical stage were modeled for the unbalanced and mixed bias factors among the control groups,and 1:1 pairings were conducted using propensity score matching.After matching successfully,there were 40 cases in the NF group and 40 cases in the TPF group.After 1:1 propensity score matchin,we compared with the short-term efficacy,adverse reactions,survival and prognostic factors of the NF group and the TPF group.Results:1.After 1:1 propensity score matching of all cases in the whole group,the short-term efficacy results showed that the effective rate(CR+PR)in the NF group was 100%(CR was 90%),and the effective rate(CR+PR)in the TPF group was 100%(CR was 91.1%),and the difference between the two groups was not statistically significant(P>0.05).2.The median follow-up time was 52.6 months(6-85 months)in NF group and 50.8 months(7-75 months)in TPF group.The 3-year OS of the NF and TPF groups was 84.2% vs.92.2%(P=0.342),the 3-year LRFS was 94.9% vs.97.3%(P=0.548),and the 3-year DMFS was 88.3% vs.89.2%(P=0.728),the 3-year PFS was 81.8% vs.81.7%(P=0.531),and the difference between the two groups was not statistically significant.The OS survival curve showed that the overall survival rate of the TPF group was much better than that of the NF group,but more clinical cases and longer observation time were needed.3.The incidence of hyponatremia in patients with NF and TPF was 37.5% and 77.5%,the difference was statistically significant(P=0.001).The incidence of III-IV vomiting in NF and TPF groups was 10.0% and 17.5%,the difference between the two groups was statisticallysignificant(P=0.009).The two groups had no statistical significance in leukopenia,neutropenia,anemia,thrombocytopenia,liver damage,hypokalemia,and acute stomatitis(P>0.05).4.Multivariate analysis showed that clinical stage and age were the independent prognostic factors of OS and PFS.Conclusion:1.There was no difference in short-term efficacy between NF group and TPF group.The hyponatremia and severe vomiting reactions in the NF group were lighter than those in the TPF group,and the adverse reactions in both groups were within the controllable range.2.There was no statistically significant difference between the NF group and the TPF group in the 3-year OS,LRFS,DMFS,and PFS,but the OS survival curve showed that the TPF group was better than the NF group.Compared with the NF group,whether the TPF group can really meaningfully improve the OS,it still need more clinical cases and observation time to verify.3.Multivariate analysis of the whole group showed that clinical stage and age were the independent prognostic factors of OS and PFS. |
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