Ann Oncol：中山大学张力发现放疗结合奥沙利铂治疗局部晚期鼻咽癌结局较好

在2013年5月9日在线出版的《肿瘤学年鉴》(Annals of Oncology)杂志上，刊登了我国中山大学华南肿瘤学国家重点实验室张力教授等人的一项临床III期研究结果。根据结果，放疗(RT)结合奥沙利铂疗法可增加局部晚期鼻咽癌(NPC)晚期患者在2年时的生存率。该文则对该疗法的长期疗效及晚期毒副作用数据进行了研究。
研究人员于2001年1月至2003年1月期间，对115例局部复发的非角化性/未分化晚期NPC患者进行了随机治疗，患者单纯接受RT治疗(n= 56)或同时接受为每周70 mg/m2，共6个周期的奥沙利铂联合治疗(n = 59)。
经过中位时间为114个月(范围，18-139个月)的随访后发现，同步放化疗(CCRT)组在5年总生存率(OS)及无转移生存率(MFS)方面均优于单纯RT组。但CCRT并未显著改善患者的无局部复发生存率。亚组分析表明，CCTR的优越性主要存在于T3-4N0-1亚组患者中。两组间3/4级晚期毒性结果类似。
以上长期随访数据证实了CCRT在治疗局部晚期NPC中的作用。研究人员认为，鉴于奥沙利铂具有高效低毒的特点，可将其视为针对此类患者的另一种治疗方案。

Long-term follow-up of a phase III study comparing radiotherapy with or without weekly oxaliplatin for locoregionally advanced nasopharyngeal carcinoma.
BACKGROUND
Previous results from our trial showed that adding oxaliplatin to radiotherapy (RT) increased survival in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) at 2 years. Here, we present the data of long-term efficacy and late toxic effects.
PATIENTS AND METHODS
Between January 2001 and January 2003, 115 Patients with nonkeratinizing/undifferentiated locoregionally advanced NPC were randomly to receive either RT alone (n = 56) or plus concurrent oxaliplatin 70 mg/m2 weekly for six cycles (n = 59).
RESULTS
After a median follow-up of 114 months (range 18-139 months), the 5-year overall survival (OS) and metastasis-free survival (MFS) rates in the concurrent chemoradiotherapy (CCRT) group were significantly higher than those observed in the RT-alone group (OS, 73.2% versus 60.2%, P = 0.028; MFS, 74.7% versus 63.0%, P = 0.027). However, CCRT did not improve locoregional failure-free survival significantly. Subgroup analyses showed that the superiorities of CCRT mainly existed in the T3-4N0-1 stage subgroup (OS: HR = 0.394, P = 0.034). The grade 3/4 late toxic effects were similar in the two groups.
CONCLUSION(S)
The long-term follow-up data confirms the role of CCRT as a treatment of locoregionally advanced NPC. Oxaliplatin can be considered as an alternative optional therapeutic regimen for these patients due to its high efficiency and low toxic effect.