Abstract: Objective To evaluate the short⁃term efficacy, survival outcomes, and adverse effects of TPF regimen (docetaxel，cisplatin，and 5⁃fluorouracil) in comparison to the GP  regimen (gemcitabine and cisplatin) when used as induction chemotherapy in conjunction with concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma. Methods This retrospective cohort study enrolled patients with locally advanced nasopharyngeal carcinoma who received induction chemotherapy with either the TPF or GP regimen, followed by concurrent chemoradiotherapy, at the Guangxi Medical University Cancer Hospital from January 2016 to December 2018. The χ² test was used to assess differences the short⁃term efficacy and adverse effects between the two treatment groups. The Log⁃rank test and Cox proportional hazards regression model were applied to compare overall survival (OS), progression⁃free survival (PFS), local recurrence⁃free survival (LRFS), and distant metastasis⁃free survival (DMFS) between the groups. Results A total of 273 patients were included in the analysis, with 56 in the GP group and 217 in the TPF group. Following induction chemotherapy or concurrent chemoradiotherapy, the objective response rates did not differ significantly between the TPF and GP groups (all P>0.05). Similarly, no significant differences were observed between the groups in 1⁃, 3⁃, and 5⁃year OS, PFS, LRFS, and DMFS (all P>0.05). These results remained consistent after adjusting for covariates using the Cox proportional hazards regression model. In terms safety, the GP group demonstrated a significantly higher incidence of anemia (grade Ⅰ-Ⅱ: 80.4%  vs 50.7%; grade Ⅲ-Ⅳ: 8.9% vs 2.8%) and thrombocytopenia (grade Ⅰ-Ⅱ: 10.7% vs 1.4%; grade Ⅲ-Ⅳ: 5.4% vs 0) during induction chemotherapy compared to the TPF group (all P<0.05). During concurrent chemoradiotherapy, grade Ⅲ-Ⅳ thrombocytopenia was more prevalent in the GP group than in the TPF group (17.9% vs 3.7%, P<0.001). Conclusions In patients with locally advanced nasopharyngeal carcinoma, induction chemotherapy utilizing either the TPF or GP regimen followed by concurrent chemoradiotherapy had comparable therapeutic efficacy. However, it is noteworthy that the GP regimen was associated with a higher incidence of hematologic toxicity.

Key words: Nasopharyngeal carcinoma, Induction chemotherapy, Radiotherapy, Adverse effects, Prognosis