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

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An Erratum to this article was published on 12 February 2015

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.

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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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Authors and Affiliations

  1. Department of Medical Oncology, Zhejiang Cancer Hospital, 38 Guang Ji Road, Hangzhou, China

    Ying Jin

  2. State Key Laboratory of Oncology in South China, Guangzhou, China

    Yu-Chen Cai

  3. Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Ying Jin, Xiu-Yu Cai, Yan-Xia Shi, Xi-Ya Xia & Wen-Qi Jiang

  4. Department of Good Clinical Practice, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Ye Cao

  5. Department of Radiology, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Wei-Dong Zhang

  6. Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Wei-Han Hu

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  1. Ying Jin
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Corresponding authors

Correspondence to Wei-Han Hu or Wen-Qi Jiang.

Additional information

Xiu-Yu Cai, Ying Jin contributed equally to this work.

An erratum to this article is available at http://dx.doi.org/10.1007/s00432-015-1926-1.

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Jin, Y., Cai, XY., Shi, YX. et al. Comparison of five cisplatin-based regimens frequently used as the first-line protocols in metastatic nasopharyngeal carcinoma. J Cancer Res Clin Oncol 138, 1717–1725 (2012). https://doi.org/10.1007/s00432-012-1219-x

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  • DOI: https://doi.org/10.1007/s00432-012-1219-x

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