Radiation therapy concurrent with weekly cisplatin therapy for loco-regionally advanced nasopharyngeal carcinoma:outcomes of a clinical trial

作     者：Daiyuan Ma Chunqiao Fu Bangxian Tan Mi Liu Xianfu Li Yeqin Zhou 

作者机构：Department of Radiation Oncology 1st Affiliated Hospital of North Sichuan Medical College Nanchong 637000China 

出 版 物：《The Chinese-German Journal of Clinical Oncology》 (中德临床肿瘤学杂志（英文版）)

年 卷 期：2011年第10卷第4期

页      面：187-191页

学科分类：090603[农学-临床兽医学] 1002[医学-临床医学] 08[工学] 09[农学] 0906[农学-兽医学] 0803[工学-光学工程] 

基　　金：Supported by grants from the Science and Technology Board Foundation of the Nanchong City (No. 2008-SF009) Nursery Foundation of North Sichuan Medical College (No. L-08) 

主　　题：nasopharyngeal carcinoma(NPC) cisplatin/treatment chemotherapy radiotherapy concurrent treatment dose escalating 

摘      要：Objective:The purpose of this study was to define the maximum tolerated dose(MTD) by describing the doselimiting toxicity(DLT) of weekly cisplatin concurrently with conventional plus 3-dimensional conformal radiotherapy(CT + 3DCRT) in patients with loco-regionally advanced nasopharyngeal carcinoma(NPC).Methods:Patients with loco-regionally advanced NPC(III/IVa stage) were enrolled into a dose-escalating *** was graded according to Common Terminology Criteria for Adverse Events version 3.0(CTCAE v3.0).MTD was defined when 2 of 6 patients developed *** starting dose of cisplatin was 15 mg/m2/w,with a subsequent dose escalation of 5 mg/m2/w in cohorts of 3 new *** + 3DCRT was given to the nasopharynx and the upper neck;the lower neck was treated by a single anterior field *** prescription dose was 70-80 Gy by 35-40 fractions to the nasopharynx gross tumor,and 66-70 Gy by 33-35 fractions to the positive neck lymph ***:From Jun.2008 to Sep.2009,24 patients received complete chemoradiotherapy,and all of them were eligible for toxicity *** the first five dose levels of 15 mg/m2/w and 35 mg/m2/w,no patient experienced *** the next dose level of 40 mg/m2/w,1 patient experienced DLT of grade 3 myelosuppression for 1.4 weeks,and among the additional 3 patients,no one developed *** the seventh dose level of 45 mg/m2/w,all the patients developed grade 3 myelosuppression for more than 1 weeks,and the dose-escalating trial *** 23(95.8%) patients achieved clinical complete remission(CR) in the local site;22(91.7%) achieved CR in the regional site,and all patients got CR 3 months *** a median follow-up of 16.4 months,1 patient developed liver metastases 2 months later,1 patient developed bone metastases 10 months later and 22 kept disease-free ***:The MTD of cisplatin weekly with concurrent CT + 3DCRT for local advanced NPC is 40 mg/m2/w,with myelosuppression as DLT.