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Efficacy of induction chemotherapy combined with chrono-chemotherapy and intensity-modulated radiotherapy on locally advanced nasopharyngeal carcinoma.

PURPOSE
The purpose of this study was to compare the efficacy and safety of induction chemotherapy combined with chrono-chemotherapy or conventional chemotherapy and intensity-modulated radiotherapy (IMRT) in locally advanced nasopharyngeal carcinoma.


METHODS
150 patients with locally advanced nasopharyngeal carcinoma were divided into two groups: chrono-chemotherapy group (n=75, receiving induction chemotherapy combined with chrono-chemotherapy and IMRT, and control group (n=75, receiving induction chemotherapy combined with conventional chemotherapy and IMRT. Besides, the levels of T lymphocyte subsets in peripheral blood before and after treatment were compared, and the long-term survival and disease progression were followed up and recorded.


RESULTS
After treatment, the short-term efficacy of patients was evaluated. The overall response rate was 94.7% (71/75) in chrono-chemotherapy group and 96.0% (72/75) in control group. Moreover, the levels of cluster of differentiation (CD)3+, CD4+, CD8+, CD4+/CD8+, CD16+CD56+ and CD19+ T cells in peripheral blood of patients at 6 months after treatment were significantly lower than those before treatment. The level of posttreatment CD16+CD56+ T cells in chrono-chemotherapy group was significantly higher than that in control group. Furthermore, the follow-up results showed that the 3-year overall survival (OS) was 73.3% and 69.3%, and the 3-year progression-free survival (PFS) was 60.0% and 62.7% in chrono-chemotherapy group and control group, respectively. Finally, Log-rank test showed no significant differences in OS and PFS between the two groups of patients.


CONCLUSIONS
As a new treatment mode, chrono-chemotherapy combined with induction chemotherapy and IMRT can reduce the incidence rate and severity of treatment-related adverse reactions and improve immunosuppression without reducing clinical efficacy, which is worthy of clinical promotion and application.