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Comparación de tres regímenes de inducción para el carcinoma nasofaríngeo: un análisis de emparejamiento por

Jinxuan Dai¹, Yu Pan¹, Yuanyuan Liu²

¹Department of Radiation Oncology, The Second Affiliated Hospital of Guilin Medical University, Guilin, China.

Therapeutic advances in medical oncology

|January 26, 2026

Resumen

La quimioterapia de inducción con gencitabina más cisplatino (GP) muestra una supervivencia global superior para el carcinoma nasofaríngeo localmente avanzado (LA-NPC). El régimen de GP ofrece un perfil de seguridad favorable, lo que lo convierte en una opción clínicamente ventajosa en comparación con los regímenes TPF y TP.

Área de la Ciencia:

Oncología
Investigación Médica
Ensayos Clínicos

Sus antecedentes:

El carcinoma nasofaríngeo localmente avanzado (LA-NPC) es un diagnóstico desafiante.
Los regímenes de quimioterapia de inducción (CI), que incluyen gencitabina más cisplatino (GP), docetaxel más cisplatino más fluorouracilo (TPF) y paclitaxel más cisplatino (TP), son opciones de tratamiento establecidas.

Objetivo del estudio:

Comparar la eficacia y toxicidad de los regímenes de quimioterapia de inducción GP, TPF y TP en pacientes con LA-NPC.
Evaluar los resultados de supervivencia y las toxicidades agudas asociadas con estos regímenes de CI.

Principales métodos:

Un estudio retrospectivo multicéntrico en el que participaron 722 pacientes con LA-NPC en estadio III-IVA.
Se utilizó el emparejamiento por puntuación de propensión (PSM) para equilibrar las características basales antes de comparar los resultados.
Los criterios de valoración de la supervivencia incluyeron la supervivencia global (SG), la supervivencia libre de progresión (SLP), la supervivencia libre de recurrencia local (SLRL) y la supervivencia libre de metástasis a distancia (SLMD).

Principales resultados:

Tras el emparejamiento por puntuación de propensión (PSM), el grupo GP demostró una tasa de supervivencia global (SG) a 3 años significativamente mejor en comparación con el grupo TP (p=0,019).
No se observaron diferencias significativas en la SG a 3 años entre los grupos GP y TPF, ni entre los grupos TPF y TP.
No hubo diferencias significativas en las tasas de supervivencia libre de progresión (SLP), supervivencia libre de recurrencia local (SLRL) o supervivencia libre de metástasis a distancia (SLMD) a 3 años entre los tres regímenes.
Los perfiles de toxicidad fueron generalmente aceptables y manejables.

Conclusiones:

El régimen de inducción con gencitabina más cisplatino (GP) presenta una eficacia superior en la supervivencia global en pacientes con LA-NPC.
El GP ofrece un perfil de seguridad favorable, posicionándolo como una opción de tratamiento clínicamente más ventajosa en comparación con los regímenes TPF y TP.

Palabras clave:

docetaxel fluorouracilo gencitabina quimioterapia de inducción carcinoma nasofaríngeo paclitaxel

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