A triplet chemotherapy regimen of cisplatin, fluorouracil and paclitaxel for locoregionally recurrent nasopharyngeal carcinoma cases contraindicated for re-irradiation/surgery.
OBJECTIVE
Salvage treatment for locoregionally recurrent nasopharyngeal carcinoma remains a significant challenge. The present study was conducted to evaluate the efficacy, toxicity and prognostic factors of a triplet chemotherapy regimen involving cisplatin, fluorouracil and paclitaxel (TPF) for locoregionally recurrent nasopharyngeal carcinoma (NPC) cases contraindicated for re-irradiation/surgery.


METHODS
Patients with locoregionally recurrent NPC unsuitable for re-irradiation/surgery were treated with TPF therapy. The chemotherapy drugs were administered as follows: 135 mg/m(2) paclitaxel on day 1, 25 mg/m(2)/day cisplatin on days 1-3, followed by continuously infused intravenous fluorouracil for 120 h at a variable dosage from 600 to 800 mg/m(2)/day, depending on prior radiation.


RESULTS
Twenty-seven patients were enrolled. The overall response was 66.7%. The median progression-free survival (PFS) and overall survival (OS) were 8.5 and 27.2 months, respectively. Toxicity was mild to moderate. Neutropenia and leukopenia were the primary grade 3-4 chemotherapy toxicities. 6 patients who regained the potential for re-radiotherapy or surgery showed significantly better outcomes than those treated with chemotherapy alone (median PFS: 20.8 vs. 7.1 months, P = 0.005; median OS: 54.2 vs. 20.6 months, P = 0.021).


CONCLUSIONS
TPF triplet chemotherapy showed a high response rate for locoregionally recurrent NPC with an acceptable toxicity profile.
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Yun
Y
Wang
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Zhi-Qiang
ZQ
Wang
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Yuan-Xue
YX
Jiang
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Feng-Hua
FH
Wang
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Hui-Yan
HY
Luo
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Ying
Y
Liang
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
De-Shen
DS
Wang
a State Key Laboratory of Oncology in South China , Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine , Guangzhou , P.R. China.|b Department of Medical Oncology , Sun Yat-sen University Cancer Center , Guangzhou , P.R. China.
Yu-Hong
YH
Li
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007970:Leukopenia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D009503:Neutropenia / Q000209:etiology; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D011379:Prognosis; D000069475:Re-Irradiation; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil
Cisplatin; fluorouracil; nasopharyngeal carcinoma; paclitaxel