1055 - A Multicenter, Randomized Controlled Phase III Trial of TPF Induction Chemotherapy vs. PF Adjuvant Chemotherapy Combined with Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Carcinoma: Long-Term Follow-up Analysis
Presenter(s)
F. Jin1, H. Wu2, Q. He3, Y. Li4, J. Long5, X. Luo6, X. Gong7, W. Wu8, X. Chen5, L. Liu9, Z. Li10, and C. Zhao3; 1Department of Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, China, 2Department of Oncology,the Affiliated Tumor Hospital of Guizhou Medical University, guiyang, China, 3Department of Oncology, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China, 4Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, China, 5Affiliated Tumor Hospital of Guizhou Medical University, Guizhou Province, China, 6The Affiliated Hospital of Guizhou Medical University, Guiyang, China, 7The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China, 8Guizhou Cancer Hospital, Guiyang, China, 9Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China, 10Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, China
Purpose/Objective(s):
To investigate whether TPF induction chemotherapy combined with concurrent chemoradiotherapy (CCRT) can provide greater survival benefits compared to CCRT followed by PF adjuvant chemotherapy,and to evaluate the safety of both regimens.
Materials/Methods:
Patients with newly diagnosed locally advanced nasopharyngeal carcinoma (NPC) treated at the Affiliated Tumor Hospital of Guizhou Medical University,the Second Affiliated Hospital of Guizhou Medical University,the Second Affiliated Hospital of Zunyi Medical University,and Guiyang Hospital of Guizhou Aviation.Each group included 133 patients.The experimental group received 3 cycles of TPF induction chemotherapy (docetaxel 75mg/m²,intravenous infusion,Day 1;cisplatin 75mg/m²,continuous intravenous infusion over 5 days,10:00–22:00 daily;fluorouracil 750mg/m²/day,continuous intravenous infusion over 5 days,22:00–10:00 daily) followed by 2–3 cycles of concurrent chemotherapy (cisplatin 100mg/m²,continuous intravenous infusion over 2 days,10:00–22:00 daily). The control group received PF adjuvant chemotherapy (cisplatin 80mg/m²,continuous intravenous infusion over 5 days,10:00–22:00 daily;fluorouracil 800mg/m²/day,continuous intravenous infusion over 5 days,22:00–10:00 daily) combined with 2–3 cycles of concurrent chemotherapy (same as induction chemotherapy).Both groups underwent intensity-modulated radiotherapy (IMRT),with total doses of 69.96 Gy for T1–T2 primary lesions,72.6 Gy for T3–T4 lesions,and 69.96 Gy for positive lymph nodes.Data were analyzed using SPSS 26.0.Differences in 5-year progression-free survival (PFS),overall survival (OS),locoregional recurrence-free survival (LRFS),distant metastasis-free survival (DMFS),and adverse events were compared between the two groups.
Results:
No significant differences were observed between the two groups in age,sex,KPS score,T stage,N stage,or overall stage (P > 0.05),indicating comparable baseline characteristics.At a median follow-up of 58 months,the 5-year PFS in both the intention-to-treat and per-protocol populations was similar between the induction chemotherapy (IC) and adjuvant chemotherapy (AC) groups (66.6%vs66.0%,P= 0.589;75.3%vs69.9%,P=0.471).The 5-year OS,LRFS,and DMFS rates were 73.0%vs71.3%(P=0.582),87.4%vs90.8%(P=0.508),and76.9%vs72.6%(P=0.267),resp-ectively,with no significant differences..No significant differences were observed in long-term radiotherapy-related toxicities such as xerostomia,tinnitus,dysphagia,neck fibrosis,trismus,or radiation caries.
Conclusion:
The TPF induction chemotherapy group showed better treatment compliance. Both groups had similar 5-year PFS,OS,LRFS,DMFS,and long-term toxicity profiles.