Neoadjuvant chemotherapy with different dose regimens of docetaxel, cisplatin and fluorouracil (TPF) for locoregionally advanced nasopharyngeal carcinoma: a retrospective study

// Ting Jin 1, 2, * , Qun Zhang 3, * , Feng Jiang 1, 2 , Wei-Feng Qin 1, 2 , Qi-Feng Jin 1, 2 , Cai-Neng Cao 1, 2 , Yong-Feng Piao 1, 2 , Xing-Lai Feng 1, 2 , Wei Luo 4 and Xiao-Zhong Chen 1, 2 1 Key Laboratory of Radiation Oncology in Zhejiang Province, Hangzhou, Zhejiang 310022, People’s Republic of China 2 Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, People’s Republic of China 3 Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510060, People’s Republic of China 4 Department of Radiation Oncology, Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong 510060, People’s Republic of China * These authors contributed equally to this work Correspondence to: Xiao-Zhong Chen, email: chenxiaozhongfy@163.com Wei Luo, email: luowei2@mail.sysu.edu.cn Keywords: nasopharyngeal carcinoma, neoadjuvant chemotherapy, concurrent chemoradiation, cisplatin, docetaxel Received: March 04, 2017      Accepted: July 12, 2017      Published: October 20, 2017 ABSTRACT Objective: Compare high- vs. low-dose TPF neoadjuvant chemotherapy with chemoradiotherapy in Chinese patients with locoregionally advanced nasopharyngeal carcinoma (NPC). Materials and Methods: Retrospective analysis of 210 stage III/IV NPC patients treated between April 1, 2012 and April 1, 2014; 138 received three cycles of high-dose TPF (H-TPF) every 3 weeks at Zhejiang Cancer Hospital and 72, three cycles of low-dose TPF (L-TPF) every 3 weeks at Sun Yat-Sen University Cancer Center. H-TPF was docetaxel (75 mg/m 2 ; 1 h infusion), cisplatin (75 mg/m 2 ; 0.5–3 h), then 5-fluorouracil (600 mg/m2/day; 4 days). L-TPF was docetaxel (60 mg/m 2 ), cisplatin (65 mg/m 2 ), then 5-fluorouracil (550 mg/m 2 /day; 5 days). All patients received chemoradiotherapy. Results: During neoadjuvant chemotherapy, treatment delays were more frequent for H-TPF than L-TPF (33.3% vs. 19.4%; P = 0.034). During chemoradiotherapy, grade III–IV anemia, thrombocytopenia and neutropenia were more common for H-TPF than L-TPF ( P < 0.001, P < 0.001, P = 0.048). Fewer patients in the H-TPF group finished two cycles of concurrent chemotherapy (81.2% vs. 100%, P < 0.001). Three-year PFS (84.5% vs. 80.6%, P = 0.484) and OS (91.1% vs. 93.5%, P = 0.542) were not significantly different between H-TPF and L-TPF. Conclusions: L-TPF neoadjuvant chemotherapy has substantially better tolerance and compliance rates and similar treatment efficacy to H-TPF neoadjuvant chemotherapy in locoregionally-advanced NPC.