Kết quả hóa chất dẫn đầu phác đồ TCF theo sau bởi hóa xạ trị ung thư vòm mũi họng giai đoạn III - IVA tại Bệnh viện K
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Tóm tắt
Ung thư vòm mũi họng là bệnh lý ung thư vùng đầu cổ thường gặp tại Việt Nam. Hóa xạ đồng thời triệt căn theo sau hóa chất dẫn đầu phác đồ TCF đang là một hướng điều trị mới giúp làm tăng tỷ lệ đáp ứng cũng như giảm tỷ lệ tử vong do di căn xa ở giai đoạn xâm lấn tại chỗ, tại vùng. Đây là nghiên cứu trên 40 bệnh nhân ung thư vòm mũi họng giai đoạn III - IVA điều trị hóa chất dẫn đầu TCF theo sau bởi hóa xạ trị tại Bệnh viện K từ 01/2019 đến 12/2020. Nghiên cứu ghi nhận tuổi trung bình là 45 ± 13, tỷ lệ nam/nữ = 3/1, giai đoạn III, IV chiếm tỷ lệ lần lượt là 60% và 40%. Về kết quả điều trị, tỷ lệ đáp ứng sau hóa chất dẫn đầu đạt 87,5%. Tỷ lệ sống thêm bệnh không tiến triển và sống thêm toàn bộ tại thời điểm 3 năm lần lượt là 77,5% và 87,5%. Ít gặp các tác dụng phụ cấp tính độ 3 trở lên. Nghiên cứu cho thấy đây là phác đồ điều trị mang lại kết quả khả quan và khả năng dung nạp tương đối tốt. Tuy nhiên, vẫn cần thêm các nghiên cứu để đánh giá về hiệu quả và tác dụng phụ lâu dài của điều trị.
Chi tiết bài viết
Từ khóa
Ung thư vòm mũi họng, hóa chất dẫn đầu, hóa xạ trị đồng thời, TCF
Tài liệu tham khảo
1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024; 74(3): 229-263. doi:10.3322/caac.21834.
2. Salehiniya H, Mohammadian M, Mohammadian-Hafshejani A, Mahdavifar N. Nasopharyngeal cancer in the world- epidemiology, incidence, mortality and risk factors.
3. OuYang PY, Su Z, Ma XH, Mao YP, Liu MZ, Xie FY. Comparison of TNM staging systems for nasopharyngeal carcinoma, and proposal of a new staging system. Br J Cancer. 2013; 109(12): 2987-2997. doi:10.1038/bjc.2013.659.
4. Sun Y, Li WF, Chen NY, et al. Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial. Lancet Oncol. 2016; 17(11): 1509-1520. doi:10.1016/S1470-2045(16)30410-7.
5. Peng H, Chen B, He S, Tian L, Huang Y. Efficacy and Toxicity of Three Induction Chemotherapy Regimens in Locoregionally Advanced Nasopharyngeal Carcinoma: Outcomes of 10-Year Follow-Up. Front Oncol. 2021; 11: 765378. doi:10.3389/fonc.2021.765378.
6. Liu GY, Lv X, Wu YS, et al. Effect of induction chemotherapy with cisplatin, fluorouracil, with or without taxane on locoregionally advanced nasopharyngeal carcinoma: a retrospective, propensity score-matched analysis. Cancer Commun Lond Engl. 2018; 38(1): 21. doi:10.1186/s40880-018-0283-2.
7. Chen YP, Ismaila N, Chua MLK, et al. Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline. J Clin Oncol Off J Am Soc Clin Oncol. 2021; 39(7): 840-859. doi:10.1200/JCO.20.03237.
8. Yu H, Yin X, Mao Y, Chen M, Tang Q, Yan S. The global burden of nasopharyngeal carcinoma from 2009 to 2019: an observational study based on the Global Burden of Disease Study 2019. Eur Arch Otorhinolaryngol. 2022; 279(3): 1519-1533. doi:10.1007/s00405-021-06922-2.
9. Xie SH, Yu ITS, Tse LA, Mang OW kong, Yue L. Sex difference in the incidence of nasopharyngeal carcinoma in Hong Kong 1983–2008: Suggestion of a potential protective role of oestrogen. Eur J Cancer. 2013; 49(1): 150-155. doi:10.1016/j.ejca.2012.07.004.
10. Colevas AD, Busse PM, Norris CM, et al. Induction chemotherapy with docetaxel, cisplatin, fluorouracil, and leucovorin for squamous cell carcinoma of the head and neck: a phase I/II trial. J Clin Oncol Off J Am Soc Clin Oncol. 1998; 16(4): 1331-1339. doi:10.1200/JCO.1998.16.4.1331.
11. Bae WK, Hwang JE, Shim HJ, et al. Phase II study of docetaxel, cisplatin, and 5-FU induction chemotherapy followed by chemoradiotherapy in locoregionally advanced nasopharyngeal cancer. Cancer Chemother Pharmacol. 2010;65(3):589-595. doi:10.1007/s00280-009-1152-0
12. Takamizawa S, Honma Y, Murakami N, et al. Short-term outcomes of induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) in locally advanced nasopharyngeal carcinoma. Invest New Drugs. 2021;39(2):564-570. doi:10.1007/s10637-020-00999-y
13. Pan JJ, Ng WT, Zong JF, et al. Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer. 2016;122(4):546-558. doi:10.1002/cncr.29795
14. Zhang Y, Chen L, Hu GQ, et al. Gemcitabine and Cisplatin Induction Chemotherapy in Nasopharyngeal Carcinoma. N Engl J Med. 2019;381(12):1124-1135. doi:10.1056/NEJMoa1905287
15. Peng H, Chen L, Zhang Y, et al. The Tumour Response to Induction Chemotherapy has Prognostic Value for Long-Term Survival Outcomes after Intensity-Modulated Radiation Therapy in Nasopharyngeal Carcinoma. Sci Rep. 2016;6:24835. doi:10.1038/srep24835
16. Ou D, Blanchard P, El Khoury C, et al. Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy or chemoradiotherapy alone in locally advanced non-endemic nasopharyngeal carcinoma. Oral Oncol. 2016;62:114-121. doi:10.1016/j.oraloncology.2016.10.011
17. Yang SS, Guo JG, Liu JN, et al. Effect of Induction Chemotherapy in Nasopharyngeal Carcinoma: An Updated Meta-Analysis. Front Oncol. 2021;10:591205. doi:10.3389/fonc.2020.591205
18. Zheng Y, Han F, Xiao W, et al. Analysis of late toxicity in nasopharyngeal carcinoma patients treated with intensity modulated radiation therapy. Radiat Oncol. 2015;10(1):17. doi:10.1186/s13014-014-0326-z
19. Shim HJ, Kim HJ, Hwang JE, et al. Long term complications and prognostic factors in locally advanced nasopharyngeal carcinoma treated with docetaxel, cisplatin, 5-fluorouracil induction chemotherapy followed by concurrent chemoradiotherapy. Medicine (Baltimore). 2020;99(49):e23173. doi:10.1097/MD.0000000000023173
2. Salehiniya H, Mohammadian M, Mohammadian-Hafshejani A, Mahdavifar N. Nasopharyngeal cancer in the world- epidemiology, incidence, mortality and risk factors.
3. OuYang PY, Su Z, Ma XH, Mao YP, Liu MZ, Xie FY. Comparison of TNM staging systems for nasopharyngeal carcinoma, and proposal of a new staging system. Br J Cancer. 2013; 109(12): 2987-2997. doi:10.1038/bjc.2013.659.
4. Sun Y, Li WF, Chen NY, et al. Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial. Lancet Oncol. 2016; 17(11): 1509-1520. doi:10.1016/S1470-2045(16)30410-7.
5. Peng H, Chen B, He S, Tian L, Huang Y. Efficacy and Toxicity of Three Induction Chemotherapy Regimens in Locoregionally Advanced Nasopharyngeal Carcinoma: Outcomes of 10-Year Follow-Up. Front Oncol. 2021; 11: 765378. doi:10.3389/fonc.2021.765378.
6. Liu GY, Lv X, Wu YS, et al. Effect of induction chemotherapy with cisplatin, fluorouracil, with or without taxane on locoregionally advanced nasopharyngeal carcinoma: a retrospective, propensity score-matched analysis. Cancer Commun Lond Engl. 2018; 38(1): 21. doi:10.1186/s40880-018-0283-2.
7. Chen YP, Ismaila N, Chua MLK, et al. Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline. J Clin Oncol Off J Am Soc Clin Oncol. 2021; 39(7): 840-859. doi:10.1200/JCO.20.03237.
8. Yu H, Yin X, Mao Y, Chen M, Tang Q, Yan S. The global burden of nasopharyngeal carcinoma from 2009 to 2019: an observational study based on the Global Burden of Disease Study 2019. Eur Arch Otorhinolaryngol. 2022; 279(3): 1519-1533. doi:10.1007/s00405-021-06922-2.
9. Xie SH, Yu ITS, Tse LA, Mang OW kong, Yue L. Sex difference in the incidence of nasopharyngeal carcinoma in Hong Kong 1983–2008: Suggestion of a potential protective role of oestrogen. Eur J Cancer. 2013; 49(1): 150-155. doi:10.1016/j.ejca.2012.07.004.
10. Colevas AD, Busse PM, Norris CM, et al. Induction chemotherapy with docetaxel, cisplatin, fluorouracil, and leucovorin for squamous cell carcinoma of the head and neck: a phase I/II trial. J Clin Oncol Off J Am Soc Clin Oncol. 1998; 16(4): 1331-1339. doi:10.1200/JCO.1998.16.4.1331.
11. Bae WK, Hwang JE, Shim HJ, et al. Phase II study of docetaxel, cisplatin, and 5-FU induction chemotherapy followed by chemoradiotherapy in locoregionally advanced nasopharyngeal cancer. Cancer Chemother Pharmacol. 2010;65(3):589-595. doi:10.1007/s00280-009-1152-0
12. Takamizawa S, Honma Y, Murakami N, et al. Short-term outcomes of induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) in locally advanced nasopharyngeal carcinoma. Invest New Drugs. 2021;39(2):564-570. doi:10.1007/s10637-020-00999-y
13. Pan JJ, Ng WT, Zong JF, et al. Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer. 2016;122(4):546-558. doi:10.1002/cncr.29795
14. Zhang Y, Chen L, Hu GQ, et al. Gemcitabine and Cisplatin Induction Chemotherapy in Nasopharyngeal Carcinoma. N Engl J Med. 2019;381(12):1124-1135. doi:10.1056/NEJMoa1905287
15. Peng H, Chen L, Zhang Y, et al. The Tumour Response to Induction Chemotherapy has Prognostic Value for Long-Term Survival Outcomes after Intensity-Modulated Radiation Therapy in Nasopharyngeal Carcinoma. Sci Rep. 2016;6:24835. doi:10.1038/srep24835
16. Ou D, Blanchard P, El Khoury C, et al. Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy or chemoradiotherapy alone in locally advanced non-endemic nasopharyngeal carcinoma. Oral Oncol. 2016;62:114-121. doi:10.1016/j.oraloncology.2016.10.011
17. Yang SS, Guo JG, Liu JN, et al. Effect of Induction Chemotherapy in Nasopharyngeal Carcinoma: An Updated Meta-Analysis. Front Oncol. 2021;10:591205. doi:10.3389/fonc.2020.591205
18. Zheng Y, Han F, Xiao W, et al. Analysis of late toxicity in nasopharyngeal carcinoma patients treated with intensity modulated radiation therapy. Radiat Oncol. 2015;10(1):17. doi:10.1186/s13014-014-0326-z
19. Shim HJ, Kim HJ, Hwang JE, et al. Long term complications and prognostic factors in locally advanced nasopharyngeal carcinoma treated with docetaxel, cisplatin, 5-fluorouracil induction chemotherapy followed by concurrent chemoradiotherapy. Medicine (Baltimore). 2020;99(49):e23173. doi:10.1097/MD.0000000000023173