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| Chinese scholars innovate the treatment model of nasopharyngeal carcinoma |
Team of Professor Ma Jun and Sun Ying Photo courtesy of Chen Yun
The team led by Professor Ma Jun and Sun Ying from the Cancer Center of Sun Yat-sen University, together with Xiangya Hospital of Central South University, Union Hospital of Huazhong University of Science and Technology, Affiliated Tumor Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guangxi Medical University, First Affiliated Hospital of Air Force Military Medical University, Central China Tongji Hospital of the University of Science and Technology and other units have jointly completed a large-scale prospective phase 3 clinical trial to establish for the first time a new mode of maintenance therapy with capecitabine after radiotherapy and chemotherapy for nasopharyngeal carcinoma
.
Related research was recently published in The Lancet
Due to the hidden location of nasopharyngeal carcinoma, more than 70% of patients are already locally advanced at the time of treatment, and the treatment effect is poor.
Therefore, a comprehensive treatment strategy of radiotherapy combined with chemotherapy is required
.
Capecitabine is a classic chemotherapeutic drug that has been used clinically for many years.
Jun Ma's team took the lead in launching a multi-center, randomized controlled study of capecitabine administered in a "beat" mode in 2016, recruiting a total of 406 patients with advanced nasopharyngeal carcinoma in high-risk local areas
.
The study was successfully completed this year and achieved encouraging results: the use of capecitabine beat maintenance therapy for one year after radical radiotherapy and chemotherapy improved the 3-year tumor-free survival rate from 75.
"The total cost of capecitabine maintenance treatment for one year is less than 5,000 yuan, and it is oral treatment, which is convenient to use and has a high degree of patient acceptance.
Its cost performance and popularity are self-evident
.
" Ma Jun said that the model is significant While improving the survival of patients, it has low toxic and side effects, is convenient to use and cheap, which is conducive to the promotion and development of treatment at the grassroots level
It is understood that in 1998, international guidelines recommended that patients with locally advanced nasopharyngeal carcinoma receive 3 courses of high-intensity traditional adjuvant chemotherapy after radiotherapy and chemotherapy
.
However, Ma Jun's team believes that the program is highly toxic and difficult for patients to complete.
Regarding when to start chemotherapy, Ma Jun's team proposed that chemotherapy should be carried out before radiotherapy, that is, induction chemotherapy, because a large number of patients had micrometastases in the whole body before radiotherapy, and the patients were in good physical condition before radiotherapy
.
In this regard, Ma Jun's team confirmed the effectiveness of induction chemotherapy through a second study
However, the above-mentioned induction chemotherapy uses a three-drug regimen of docetaxel + cisplatin + fluorouracil.
Although the effect is good, it is highly toxic and difficult to promote in the grassroots
.
How to reduce the incidence of side effects while ensuring the efficacy has become the focus of further research
On this basis, the research further solves the problem of disease progression in patients after radical radiotherapy and chemotherapy
.
In an editorial published in the same journal, Professor Robert Kerbel from the University of Toronto, Canada, believes that this new model of maintenance therapy can change clinical practice.
Related paper information: https://doi.
org/10.
1016/S0140-6736(21)01123-5
org/10.
1016/S0140-6736(21)01123-5 https://doi.
org/10.
1016/S0140-6736(21)01123-5
