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Phase Ⅱ Trial of Docetaxel and Cisplatin Neoadjuvant Chemotherapy Followed by Intensity-modulated Radiotherapy with Concurrent Cisplatin in Locally Advanced Nasopharyngeal Carcinoma Yahua Zhong Department of Chemo-radiotherapy Oncology Zhongnan Hospital, Wuhan University Hubei Cancer Study Center, China
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Objective To evaluate the feasibility and efficacy of docetaxel and cisplatin neoadjuvant chemotherapy followed by intensity-modulated radiotherapy with concurrent cisplatin in patients with locally advanced nasopharyngeal carcinoma
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Eligibility Criteria Previously untreated Patients with histologically confirmed stage Ⅲ –IVB(1997 American Joint Committee on Cancer Staging) NPC ECOG 0 or 1 Age ≥ 18 years Normal bone marrow, hepatic and renal function
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Materials and Methods W1W3W2W5W4W7W6W8W11W1 0 W9W1 2 W1 3 2 cycles of DCIMRT with concurrent DDP Docetaxel 75mg/m 2 Cisplatin 75mg/m 2 IMRT 72Gy/2.18Gy/33F/ Cisplatin 75mg/m 2
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Results Among 46 patients, 45 completed 2 cycles schedule neoadjuvant chemotherapy All patients completed the IMRT and 2 cycles concurrent DDP chemotherapy on schedule
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Table 1. The incidence of acute toxicities during neoadjuvant chemotherapy
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Table 2. The incidence of acute toxicities during concurrent chemo-radiotherpy
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Table 3. The incidence of later toxicities
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Table 4. The tumor objective response
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Results Median follow-up time of 26 months, One patients experienced nasopharyngeal recurrence and four patients developed distant metastasis The 3-year overall survival rate and progression-free survival rate were 94.1% and 72.7%, respectively
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Conclusion Neoadjuvant docetaxel/cisplatin followed by IMRT with concurrent cisplatin was well feasible and effective in treating locally advanced nasopharyngeal carcinoma. Further investigation to test this strategy is warranted
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