[Analysis of responses and prognostic factors in different chemotherapy regimens for metastatic nasopharyngeal carcinoma: a report of 171 cases].

ABSTRACT

OBJECTIVE: The aim of this study was to compare the results of different combined chemotherapy regimens and to find the best regimen for metastatic nasopharyngeal carcinoma (NPC), and determine its prognostic factors. METHODS: The clinical data of 171 patients with pathologically proven metastatic NPC were retrospectively analyzed. Of them, 26 were treated with best support care (BSC group), 92 with platinum-based regimen of two drugs (FP group 5-Fu and cisplatin; TP group paclitaxel and cisplatin; DP group docetaxel and cisplatin), and 53 with platinum-based regimen of three-drugs (TFP group FP plus paclitaxel, DFP group FP plus doxtale). RESULTS: The response rate (RR) in the three-drug regimens was significantly higher than that in the two-drug regimen (84.9% vs. 52.2%, P = 0.000), however, grade III approximately IV myelosuppression in the three-drug regimen group was also significantly higher than that in the two-drug regimen (58.5% vs. 27.2%, P = 0.000). Among the groups treated with platinum-based combination regimens of either two drugs or three drugs, no significant differences were observed in RR (P = 0.967, P = 0.400) or median survival time (MST) (P = 0.278, P = 0.413). The MST and one-year survival rate were 4.0 months, 13.2 months and 15.0 months, 24.0%, 64.1% and 70.3% in the BSC group, two-drug group and three-drug group, respectively. The MST in the chemotherapy group was significantly longer than that in BSC group (P = 0.000). Cox multivariate regression analysis showed that Karnovsky performance scores, time to progression or chemotherapy cycles were independent prognostic factors (P < 0.05). CONCLUSION: Chemotherapy can improve the survival of metastatic NPC. Platinum-based combination regimen with two drugs is still the standard treatment. The combination regimens with three drugs can increase the RR, but no survival benefit can be achieved for its high toxicity.