TPS-1诱导化疗对局部晚期鼻咽癌的长期疗效观察★

Long-term efficacy of TPS-1 induction chemotherapy in locally advanced nasopharyngeal carcinoma★

摘要:

目的 评估多西他塞+顺铂+替吉奥（TPS-1）诱导化疗方案在局部晚期鼻咽癌（LANPC）中的长期疗效及安全性，并探讨其替代TPF方案的可能性。方法 回顾性分析2018年1月—2019年12月在本院接受TPS-1方案诱导化疗并完成根治性放化疗的71例LANPC患者的资料，采用Kaplan-Meier法对患者生存情况进行分析，并记录不良反应。结果 全组患者的客观缓解率（ORR）为97.2%，中位随访时间68个月，5年总生存（OS）率、局部无复发生存（LRFS）率、区域无复发生存（RRFS）率和无远处转移生存（DMFS）率分别为91.3%、86.7%、90.0%和79.8%。TPS-1方案诱导化疗后不良反应发生率低，全组无4级不良反应，3级不良反应发生率为4.2%。结论 TPS-1诱导化疗方案对LANPC患者显示出良好的短期疗效和长期生存获益，且安全性良好，但其在远处转移控制方面仍有待改善。该方案作为TPF替代方案的可行性仍需进一步随机对照研究验证。

Abstract:

Objective To evaluate the long-term efficacy and safety of the TPS-1 (docetaxel + cisplatin + S-1) induction chemotherapy regimen in locally advanced nasopharyngeal carcinoma (LANPC) and to explore its potential as an alternative to the TPF regimen.Methods A retrospective study was conducted on 71 patients with LANPC treated at our center between January 2018 and December 2019. These patients received TPS-1 induction chemotherapy and completed radical chemoradiotherapy (with or without concurrent chemotherapy). Survival outcomes were analyzed using the Kaplan-Meier method, and the adverse events were recorded.Results The overall objective response rate (ORR) of the patients was 97.2%. With a median follow-up of 68 months, the 5-year overall survival (OS) rate, local recurrence-free survival (LRFS) rate, regional recurrence-free survival (RRFS) rate, and distant metastasis-free survival (DMFS) rate were 91.3%, 86.7%, 90.0%, and 79.8%, respectively. TPS-1 regimen had a low incidence of adverse events, with no grade 4 adverse events observed and a grade 3 adverse event rate of 4.2%.Conclusion The TPS-1 induction chemotherapy demonstrates promising short-term efficacy and long-term survival benefits for LANPC patients, with an acceptable safety profile. However, its efficacy in controlling distant metastasis still needs to be improved. Further randomized controlled trials are still required to verify the feasibility of this regimen as an alternative to TPF.