Liposomal paclitaxel versus docetaxel in induction chemotherapy using Taxanes, cisplatin and 5-fluorouracil for locally advanced nasopharyngeal carcinoma

• Published in: BMC cancer Vol. 18; no. 1; p. 1279
• Main Authors: Liu, Sai-Lan, Sun, Xue-Song, Li, Xiao-Yun, Chen, Qiu-Yan, Lin, Huan-Xin, Wen, Yue-Feng, Guo, Shan-Shan, Liu, Li-Ting, Xie, Hao-Jun, Tang, Qing-Nan, Liang, Yu-Jing, Yan, Jin-Jie, Lin, Chao, Yang, Zhen-Chong, Tang, Lin-Quan, Guo, Ling, Mai, Hai-Qiang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.12.2018; BioMed Central; BMC
• Subjects: 5-Fluorouracil; Adolescent; Adult; Aged; Cancer patients; Cancer therapies; Cell Line, Tumor; Chemotherapy; Cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; Comparative analysis; Deoxyribonucleic acid; Disease-Free Survival; DNA; Docetaxel; Docetaxel - administration & dosage; Docetaxel - adverse effects; Dosage and administration; Drug therapy; Drug-Related Side Effects and Adverse Reactions - classification; Drug-Related Side Effects and Adverse Reactions - physiopathology; Epstein-Barr virus; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Health aspects; Herpesvirus 4, Human - genetics; Humans; Induction chemotherapy; Leukopenia; Liposomal paclitaxel; Liposomes - chemistry; Liposomes - pharmacology; Lung cancer; Male; Medical imaging; Metastases; Metastasis; Middle Aged; Multivariate analysis; Nasopharyngeal cancer; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - drug therapy; Nasopharyngeal Carcinoma - epidemiology; Nasopharyngeal Carcinoma - pathology; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neutropenia; Neutropenia - chemically induced; Neutropenia - physiopathology; Paclitaxel; Paclitaxel - administration & dosage; Paclitaxel - adverse effects; Safety and security measures; Survival; Taxanes; Taxoids - administration & dosage; Taxoids - adverse effects; Throat cancer; China; Nasopharyngeal carcinoma; Induction chemotherapy; Liposomal paclitaxel; Docetaxel
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-018-5192-x

We wished to evaluate the efficacy and safety of liposomal paclitaxel and docetaxel for induction chemotherapy (IC) for nasopharyngeal carcinoma (NPC). A total of 1498 patients with newly-diagnosed NPC between 2009 and 2017 treated with IC plus concurrent chemotherapy were included in our observational study. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS) and grade-3-4 toxicities were compared between groups using propensity score matching (PSM). In total, 767 patients were eligible for this study, with 104 (13.6%) and 663 (86.4%) receiving a liposomal paclitaxel-based and docetaxel-based taxanes, cisplatin and 5-fluorouracil (TPF) regimen, respectively. PSM identified 103 patients in the liposomal-paclitaxel group and 287 patients in the docetaxel group. There was no significant difference at 3 years for OS (92.2% vs. 93.9%, P = 0.942), PFS (82.6% vs. 81.7%, P = 0.394), LRFS (94.7% vs. 93.3%, P = 0.981) or DMFS (84.6% vs. 87.4%, P = 0.371) between the two groups after PSM. Significant interactions were not observed between the effect of chemotherapy regimen and sex, age, T stage, N stage, overall stage, or Epstein-Barr virus DNA level in the subgroup multivariate analysis. The prevalence of grade-3-4 leukopenia and neutropenia in the liposomal-paclitaxel group was significantly lower than that of the docetaxel group (P < 0.05 for all). Compared with docetaxel, liposomal paclitaxel has identical anti-tumor efficacy, but causes fewer and milder adverse reactions in IC for NPC.