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Phase II trial of neoadjuvant docetaxel and cisplatin followed by intensity-modulated radiotherapy with concurrent cisplatin in locally advanced nasopharyngeal carcinoma

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Abstract

Purpose

To evaluate the feasibility and efficacy of neoadjuvant chemotherapy involving docetaxel and cisplatin followed by intensity-modulated radiotherapy (IMRT) with concurrent cisplatin in patients with newly diagnosed stage III to IVB nasopharyngeal carcinoma (NPC).

Methods

Docetaxel (75 mg/m2 on day 1) and cisplatin (75 mg/m2 on day 1) were administered on a 3-week cycle for 2 courses, followed by radical IMRT (72 Gy/33F/6.5–7 W) with concurrent cisplatin (75 mg/m2, on day 1) every 3 weeks for 2 cycles.

Results

From June 2008 to October 2010, forty-six patients were recruited in this trial. Forty-five patients completed neoadjuvant setting, and all patients completed planned concurrent chemoradiotherapy (CCRT). The complete and partial response rates were 28.3 and 56.5 % after neoadjuvant chemotherapy, and 91.3, 8.7 % after CCRT, respectively. After median follow-up of 26 months (range 12–39 months), one patient experienced local recurrence and 4 patients developed distant metastasis. The 3-year overall survival and progression-free survival rate were 94.1 and 72.7 %, respectively. Neutropenia (37.0 %) and vomiting (28.3 %) were the most common Grade 3–4 adverse effects during neoadjuvant course, while mucositis (30.4 %), xerostomia (30.4 %) and radiodermatitis (21.7 %) were the most common Grades 3 acute toxicities during CCRT. Xerostomia (73.9 %), dysphagia (56.5 %), hear loss (30.4 %) and skin reaction (21.7 %) were the common Grade 1–2 late effects. There were no Grades 3–4 late toxicities.

Conclusions

The protocol of neoadjuvant docetaxel and cisplatin followed by IMRT with concurrent cisplatin was well tolerated, with outstanding compliance and efficacy in locally advanced NPC, which deserved further follow-up.

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Acknowledgments

We thank M.D. Jia De Lu for critical review of the manuscript. This study was supported by the Science and Technology Planning Project of Hubei Province, China (2009BCC005).

Conflict of interest

All the authors disclosed no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Radio-Chemotherapy, Zhongnan Hospital of Wuhan University, No 169 Donghu Road, Wuhan, 430071, China

    Ya Hua Zhong, Jing Dai, Xiao Yong Wang, Cong Hua Xie, Gang Chen & Yun Feng Zhou

  2. Hubei Clinical Cancer Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, No 169 Donghu Road, Wuhan, 430071, China

    Ya Hua Zhong, Jing Dai, Xiao Yong Wang, Cong Hua Xie, Gang Chen & Yun Feng Zhou

  3. Hubei Key Laboratory of Tumor Biological Behaviors, No 169 Donghu Road, Wuhan, Wuchang District, 430071, China

    Lei Zeng

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  1. Ya Hua Zhong
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Correspondence to Yun Feng Zhou.

Additional information

Ya Hua Zhong and Jing Dai contributed equally to this work.

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Zhong, Y.H., Dai, J., Wang, X.Y. et al. Phase II trial of neoadjuvant docetaxel and cisplatin followed by intensity-modulated radiotherapy with concurrent cisplatin in locally advanced nasopharyngeal carcinoma. Cancer Chemother Pharmacol 71, 1577–1583 (2013). https://doi.org/10.1007/s00280-013-2157-2

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  • DOI: https://doi.org/10.1007/s00280-013-2157-2

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