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Journal of Cancer Research and Clinical Oncology

, Volume 138, Issue 10, pp 1717–1725 | Cite as

Comparison of five cisplatin-based regimens frequently used as the first-line protocols in metastatic nasopharyngeal carcinoma

  • Ying Jin
  • Xiu-Yu Cai
  • Yan-Xia Shi
  • Xi-Ya Xia
  • Yu-Chen Cai
  • Ye Cao
  • Wei-Dong Zhang
  • Wei-Han HuEmail author
  • Wen-Qi JiangEmail author
Original Paper

Abstract

Background and objective

No randomized trial has been reported comparing different chemotherapy regimens on disseminated nasopharyngeal carcinoma (NPC). This study aims to compare five cisplatin-based regimens including cisplatin + 5-fluororacil (PF), paclitaxel + cisplatin (TP), gemcitabine + cisplain (GP), paclitaxel + cisplatin + 5-fluororacil (TPF), and bleomycin + cisplatin + 5-fluororacil (BPF) regimen most frequently used as the first-line protocols for metastatic NPC retrospectively.

Methods

Eight hundred and twenty-two patients with metastatic NPC were divided into five groups according to the regimen they received. Then, their response rate, toxicity, and long-term survival outcome as well as the prognostic factors were analyzed.

Results

The higher response rates in GP and TPF regimens comparing to PF regimen were achieved (Χ 2 = 4.57, P = 0.033; Χ 2 = 7.04, P = 0.008), as well as in TPF regimen comparing to TP regimen (Χ 2 = 5.579, P = 0.018). The occurrence rate of the major III–IV grade toxicity was significantly different between the five groups. However, no statistically significant difference was observed in progression-free survival (PFS; P = 0.247) and overall survival (P = 0.127) among the five groups. Cox multivariate analysis identified the following independent prognostic factors: liver metastases, plasma Epstein Barr Virus (EBV)-DNA level, cycles of chemotherapy, and second-line chemotherapy.

Conclusions

PF, TP, and GP are all effective regimens as the first-line chemotherapy for metastatic NPC, which can be well tolerated. Over four cycles of chemotherapy are recommended under no contraindication. Patients should transfer to the second-line regimen after the treatment failure of the first-line chemotherapy.

Keywords

Comparison of five cisplatin-based regimens Metastatic nasopharyngeal carcinoma Overall survival Palliative chemotherapy Progression-free survival 

Notes

Acknowledgments

This work was supported by the National—Eleventh Five Technology Major Project [2008ZX09312-002]; and the Research Award Fund for Outstanding Young Researchers in Sun Yat-sen Cancer Center. Sponsors of the study supported the fees to data collecting and will support the publication of the paper.

Conflict of interest

All authors state that they have no conflicts of interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ying Jin
    • 1
    • 3
  • Xiu-Yu Cai
    • 3
  • Yan-Xia Shi
    • 3
  • Xi-Ya Xia
    • 3
  • Yu-Chen Cai
    • 2
  • Ye Cao
    • 4
  • Wei-Dong Zhang
    • 5
  • Wei-Han Hu
    • 6
    Email author
  • Wen-Qi Jiang
    • 3
    Email author
  1. 1.Department of Medical OncologyZhejiang Cancer HospitalHangzhouChina
  2. 2.State Key Laboratory of Oncology in South ChinaGuangzhouChina
  3. 3.Department of Medical OncologySun Yat-Sen University Cancer CenterGuangzhouChina
  4. 4.Department of Good Clinical PracticeSun Yat-Sen University Cancer CenterGuangzhouChina
  5. 5.Department of RadiologySun Yat-Sen University Cancer CenterGuangzhouChina
  6. 6.Department of RadiotherapySun Yat-Sen University Cancer CenterGuangzhouChina

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