Efficacy of Spiral Tomographic Radiotherapy Combined with TPF Induction Chemotherapy for Locally Advanced Oropharyngeal Cancer and Logistic Regression of Its Influencing Factors

doi:10.13701/j.cnki.kqyxyj.2021.07.014

Abstract

Abstract: Objective: To investigate the efficacy of spiral tomographic radiotherapy combined with TPF induction chemotherapy (docetaxel + cisplatin + 5-fluorouracil) in the treatment of locally advanced oropharyngeal cancer and logistic regression equation analysis of its influencing factors. Methods: The clinical data of 56 patients with locally advanced oropharyngeal cancer treated with spiral tomographic radiotherapy combined with TPF chemotherapy in our hospital from January 2015 to Oct 2017 were selected and retrospectively studied. The short-term curative effect, long-term curative effect, and the occurrence of toxic and side effects of 56 patients were statistically observed, and the factors affecting the short-term and long-term curative effect were analyzed by multivariate Logistic and Cox. Results: The ORR of spiral tomographic radiotherapy combined with TPF chemotherapy for locally advanced oropharyngeal cancer patients was 53.57%, and the 1, 3, and 5-year survival rates were 83.93%, 64.29%, and 39.29%, respectively. Univariate analysis showed that the ORR and 5-year survival rate of patients with locally advanced oropharyngeal cancer of different ages, clinical stages, and degree of differentiation were statistically significant (P<0.05). Multivariate analysis showed that with the increase of age, clinical stage, and degree of differentiation, the short-term and long-term efficacy of locally advanced oropharyngeal cancer patients gradually decreased (P<0.05). During the treatment, the incidence of white blood cell decline ≥ grade Ⅲ was 21.43%, the incidence of platelet decline ≥ grade Ⅲ was 1.79%, the incidence of oral mucositis ≥ grade Ⅲ was 7.14%, and the incidence of radiation dermatitis ≥ grade Ⅲ was 8.93%. Conclusion: Spiral tomographic radiotherapy combined with TPF chemotherapy is effective in the treatment of locally advanced oropharyngeal cancer. The toxic and side effects are mostly within the tolerable range. Age, clinical stage, and degree of differentiation are influencing factors for its short-term and long-term efficacy, and sufficient clinical attention should be paid.

Key words: locally advanced oropharyngeal cancer, spiral tomographic radiotherapy, TPF chemotherapy, curative effect, influencing factors, toxic and side effects

JIANG Cuihong, WU Xiangwei, XIAO Shuai, HE Lili. Efficacy of Spiral Tomographic Radiotherapy Combined with TPF Induction Chemotherapy for Locally Advanced Oropharyngeal Cancer and Logistic Regression of Its Influencing Factors[J]. Journal of Oral Science Research, 2021, 37(7): 641-645.

References

[1] 郑歆,陈晓品.我国口咽癌与HPV的关系[J].国际肿瘤学杂志,2020,47(3):164-168.
[2] Chimenos-Küstner E, Marques-Soares MS, Schemel-Suárez M. Aetiopathology and prevention of oropharyngeal cancer [J]. Semergen, 2019, 45(7):497-503.
[3] Feng L, Qi S, Lin M. Efficacy and survival rate of intensity-modulated radiotherapy combined with chemotherapy for elderly patients with locally advanced oropharyngeal cancer [J]. Exp Ther Med, 2018, 15(3):2475-2479.
[4] 常威,刘海鸿.全程IMRT和西妥昔单抗、同期顺铂化疗治疗44例局部晚期口咽癌的效果对比[J].中外医疗,2019,38(16):132-134.
[5] 罗秀玲,金风,毕婷,等.TPF方案诱导化疗不同给药方式联合调强放疗治疗局部晚期鼻咽癌的中期疗效及预后分析[J].中华放射医学与防护杂志,2018,38(8):595-601.
[6] 徐露,蔡汉飞,方美芳,等.鼻咽癌螺旋断层放疗与固定野静态调强放疗的剂量学比较[J].深圳中西医结合杂志,2020,30(23):7-8.
[7] 王孔成,李双双,刘娟,等.鼻咽癌螺旋断层放疗与常规调强放疗剂量学及对唾液腺保护的分析[J].肿瘤学杂志,2019,25(2):166-168.
[8] 尚伟,郑家伟.口腔及口咽癌新版TNM分期与NCCN诊治指南部分解读[J].中国口腔颌面外科杂志,2018,16(6):58-71.
[9] 尚伟,郑家伟.2019年NCCN口腔口咽癌诊疗指南更新解读[J].中国口腔颌面外科杂志,2019,17(6):481-485.
[10] 陆赛全,王佳舟,彭佳元,等.放射治疗肿瘤协作组规范下的加速器质量保证经验[J].中国癌症杂志,2018,28(4):308-314.
[11] Moro JDS, Maroneze MC, Ardenghi TM, et al. Oral and oropharyngeal cancer: epidemiology and survival analysis [J]. Einstein (Sao Paulo),2018,16(2):eAO4248.
[12] 陈卓,孟小平,任永会,等.水溶性铂类抗肿瘤药的合成与体外抗肿瘤活性评价[J].中国药学杂志,2020,55(1):13-18.
[13] Wei Y, Yang P, Cao S, et al. The combination of curcumin and 5-fluorouracil in cancer therapy [J]. Arch Pharm Res, 2018, 41(1):1-13.
[14] 杨佑琦,区晓敏,周鑫,等.GP、PF及TPF方案化疗联合调强适形放疗治疗鼻咽癌的临床疗效[J].中国癌症杂志,2018,28(8):602-608.
[15] Inhestern J, Schmalenberg H, Dietz A, et al. A two-arm multicenter phase Ⅱ trial of one cycle chemoselection split-dose docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy before two cycles of split TPF followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1) [J]. Ann Oncol,2017,28(8):1917-1922.
[16] Saw CB, Katz L, Gillette C, et al. 3D treatment planning on helical tomotherapy delivery system [J]. Med Dosim, 2018, 43(2):159-167.
[17] 张晋建,李志强,文婷,等.肺癌螺旋断层放疗计划设计中应用Block减少肺低剂量区的研究[J].中国医学物理学杂志,2019,36(2):34-38.
[18] 常娜,钱立庭,张朋,等.直肠癌术前静态调强放疗和螺旋断层放疗剂量学比较[J].中华肿瘤防治杂志,2019,26(11):794-798.
[19] 徐裕金,李浦,胡晓,等.螺旋断层、容积旋转调强和固定野调强在食管癌放疗剂量对比分析[J].中华医学杂志,2019,99(41):3260-3265.
[20] 李卉,巴雅力格,闫佳丽,等.埃克替尼对敏感突变型非小细胞肺癌患者疗效的影响因素分析[J].肿瘤药学,2019,9(1):86-89,111.
[21] 高立明,朱莹莹,师晓华,等.倾向性评分匹配分析口咽癌PD-L1的表达与HPV感染及预后的相关性研究[J].中国实验诊断学,2020,24(4):595-599.