title: Triplet combination with paclitaxel, cisplatin and 5-FU is effective in metastatic and/or recurrent nasopharyngeal carcinoma.
abstract: OBJECTIVE
  Platinum-based chemotherapy is the recognized first-line treatment for metastatic nasopharyngeal carcinoma (NPC). However, no standard treatment regimens have been established. This phase II study was designed to evaluate the efficacy and safety of a paclitaxel, cisplatin and 5-FU combination in metastatic and/or recurrent NPC.
  
  
  METHODS
  Patients with evaluable metastatic and/or recurrent NPC were entered into this study. Treatment consisted of paclitaxel at a dose of 135 mg/m(2) on day 1, cisplatin 25 mg/m(2)/day from day 1 to day 3 and 5-FU-continuous infusion for 120 h at a variable dosage from 600 to 1,000 mg/m(2)/day according to prior radiation. This regimen was repeated every 3 weeks.
  
  
  RESULTS
  A total of 95 patients were enrolled; 92 patients were evaluable for response. The overall response and disease control rates were 78.9 and 93.6 %, respectively. At a median follow-up of 24.8 months, the respective median overall survival (OS) and progression-free survival were 22.7 months (95 % CI 18.6-26.9 months) and 8.6 months (95 % CI 7.7-9.5 months). Toxicities were moderate and manageable. Grade 3/4 toxicities included leucopenia (14.7 %), neutropenia (17.9 %), anemia (3.2 %), thrombocytopenia (6.4 %), nausea (4.2 %), vomiting (9.5 %), stomatitis (9.5 %), diarrhea (3.2 %), aminotransferase (2.2 %) and sensory neuropathy (3.2 %).
  
  
  CONCLUSIONS
  Triplet combination chemotherapy with paclitaxel, cisplatin and 5-FU is an effective and safe option in the front-line treatment for recurrent and/or metastatic NPC. The encouraging results with high response rate and long OS suggest that this regimen might be especially considered where tumor shrinkage is required.
authors.affiliation: Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 651 Dongfeng East Road, Guangzhou 510060, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Chen
authors.forename: Feng-hua
authors.initials: FH
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: An
authors.forename: Hui-yan
authors.initials: HY
authors.lastname: Luo
authors.forename: Zhi-qiang
authors.initials: ZQ
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Liang
authors.forename: Le
authors.initials: L
authors.lastname: Zhang
authors.forename: Yu-hong
authors.initials: YH
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D011379:Prognosis
chemical_list: D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil