Abstract
Objective: Although cisplatin combined with 5-fluorouracil is a common first-line regimen for advanced nasopharyngeal carcinoma (NPC), there are no standard regimens for refractory or relapsed patients. A study of DXD regimen [cisplatin (D), capecitabine (X) and docetaxel (D)] was conducted to evaluate the efficacy and toxicity for patients with refractory or relapsed NPC.
Methods: The regimen was administered as follows: 50 mg/m2 docetaxel and 50 mg/m2 cisplatin on day 1 and 800 mg/m² capecitabine on days 1 – 14, repeated every 3 – 4 weeks.
Results: Thirty patients were enrolled. The overall response and complete remission rate was 46.4 and 21.4%. Median follow-up was 24 months; median overall survival (OS) and progression-free survival (PFS) were 14.0 and 8.0 months. Five-year OS and PFS rates were 14.8 and 13.3%, respectively. Four patients achieved long-term tumor-free survival (range, 53.8 – 125.3 months). Multivariate analysis demonstrated that Epstein–Barr virus DNA status (p = 0.003) and therapeutic effect (p < 0.001) were significant independent factors for OS and PFS. The main grade 3/4 toxicities included neutropenia (26.6%), anemia (13.3%) and thrombocytopenia (10.0%). There were no chemotherapy-related deaths.
Conclusion: The DXD regimen appeared to be effective and well tolerated by patients with refractory or relapsed NPC. Further investigation is warranted.
Acknowledgments
We thank the patients and their families for participation in this study. We also thank Xin-An, for the data collection and Yue-Li Sun for the data analysis. Y Gao and H-Q Huang contributed equally to this work.
Declaration of interest
The authors state no conflict of interest and have received no payment in preparation of this manuscript.