Analysis Of Follow-Up Results Of Chronotherapy And Conventional Chemotherapy Combined With IMRT For Locally Advanced Nasopharyngeal Carcinoma

Abstract

To compare the long-term side effects and survival rates of Intensity modulated radiation therapy combined with chemotherapy in the treatment of advanced Nasopharyngeal carcinoma, and It is expected to reduce the long-term toxic response without reducing the survival, to find a more reasonable treatment for locally advanced Nasopharyngeal carcinoma. 160 patients with locally advanced nasopharyngeal carcinoma were randomly divided into a Time group and conventional group using a professional statistical randomized list (1:1) for treatment. Time group induced chronotherapy with TPF regimen, docetaxel 75 mg/m2 ivgtt, execution in d1 03:30-04:30. Cisplatin 75mg/m2 civ, completed in 5 days, every day from 10:00 to 22:00.5-FU 750mg/m2/d civ, completed in 5 days, every day from 22:00 to 10:00, 2 cycles/21 day. IMRT combined with cisplatin chemotherapy after 3 weeks of induction chemotherapy 100mg/m2 civ, completed at 10:00-22:00,3cycles/21day.In the conventional group, the conventional TPF regimen chemotherapy docetaxel 75mg/m2 ivgtt starts at 10:00.Cisplatin 75mg/m2 civ, begins after the end of docetaxel.5-FU 750mg/m2/d civ, completed in 5 days, executed 24 hours a day, 2cycles/21day.IMRT combined with cisplatin chemotherapy after 3 weeks of induction chemotherapy 100mg/m2 ivgtt starts at 10:00,3cycles/21day.Observation of long-term toxic and 1,3 years of survival situation. The incidence of hearing loss in the time group and the conventional group was 22.7% vs 39.1%, the incidence of dysphagia was 0% vs 8.6%, and the incidence of neck fibrosis was 4.5% vs 15%. The difference was statistically significant (P<0.05). Results of 1,3-year survival of patients in the two groups: The overall survival of time group and conventional group is 97.0% vs 92.8%、80.3% vs 81.2%,not statistically significant (P>0.05), the progression-free survival of time group and conventional group is 95.50% vs 87.0%、71.2% vs 73.9%,not statistically significant(P>0.05),the local recurrence-free survival of time group and conventional group is 97.0% vs 95.7%、92.4% vs 92.8%, not statistically significant(P>0.05) and the distant metastasis-free survival of time group and conventional group is 97.0% vs 98.6%、90.9% vs 91.3%, not statistically significant(P>0.05) When chronotherapy and intensity modulated radiation therapy were combined, the toxicity and side effects of patients were decreased without decreasing survival. Chronotherapy combined with intensity modulation radiotherapy is a recommended mode in the treatment of locally advanced nasopharyngeal carcinoma.