Cancer Chemotherapy and Pharmacology

, Volume 84, Issue 1, pp 155–161 | Cite as

Gemcitabine plus cisplatin versus fluorouracil plus cisplatin as a first-line concurrent chemotherapy regimen in nasopharyngeal carcinoma: a prospective, multi-institution, randomized controlled phase II study

  • Xiang-Yun Kong
  • Jian-Xun Lu
  • Xin-Wen Yu
  • Jian Zhang
  • Qian-Lan Xu
  • Rong-Jun Zhang
  • Jing-Lin Mi
  • Shu-Fang Liao
  • Jin-Fang Fan
  • Xiao-Li Qin
  • Da-Cheng Yao
  • Hua-Ying Tang
  • Wei JiangEmail author
Original Article



The objective of this study was to evaluate the efficacy and safety of gemcitabine plus cisplatin concurrent chemoradiotherapy (CCRT) in patients with nasopharyngeal carcinoma.


Patients with NPC were randomly assigned to the gemcitabine plus cisplatin (GP) group or fluorouracil plus cisplatin (PF) group. Primary end-point was disease-free survival (DFS); secondary endpoints: overall survival, distant metastasis-free survival (DMFS), locoregional relapse-free survival, and treatment-related adverse events.


Seventy-six patients were prospectively enrolled and the median follow-up time was 41 months (9–61 months). Three-year DFS were similar between the GP and PF groups (73.7% vs. 60.5%, HR 0.66, 95% CI 0.30–1.44; P = 0.30). Distant metastasis was the most common failure form in PF compared with GP (P = 0.034). Three-year DMFS was significantly better in the GP group than PF group (89.5% vs. 71.1%, P = 0.045). Grade 3–4 gastrointestinal toxicities (vomiting and diarrhea) were significantly more common in the PF group; grade 3–4 neutropenia and thrombocytopenia were more common in the GP group.


Gemcitabine plus cisplatin could be used as an alternative regimen in CCRT for nasopharyngeal carcinoma.


Nasopharyngeal carcinoma Concurrent chemoradiotherapy Gemcitabine Cisplatin Chemotherapy regimen 



This work was supported by the National Natural Science Foundation of China (Nos. 81560443, 81760546) and the Scientific Research and Technology Development Program of Guilin (No.20170109-22).

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest for this manuscript.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Xiang-Yun Kong
    • 1
  • Jian-Xun Lu
    • 3
    • 6
  • Xin-Wen Yu
    • 4
  • Jian Zhang
    • 5
  • Qian-Lan Xu
    • 1
  • Rong-Jun Zhang
    • 1
  • Jing-Lin Mi
    • 1
  • Shu-Fang Liao
    • 1
  • Jin-Fang Fan
    • 1
  • Xiao-Li Qin
    • 1
  • Da-Cheng Yao
    • 1
  • Hua-Ying Tang
    • 1
  • Wei Jiang
    • 1
    • 2
    Email author
  1. 1.Department of Radiation OncologyAffiliated Hospital of Guilin Medical UniversityGuilinPeople’s Republic of China
  2. 2.College of International Education of Guilin Medical UniversityGuilinPeople’s Republic of China
  3. 3.Department of OncologyThe Affiliated Hospital of Youjiang Medical University for NationalitiesBaisePeople’s Republic of China
  4. 4.Department of Radiation OncologyThe Second People’s Hospital of YulinYulinPeople’s Republic of China
  5. 5.Department of OncologyThe People’s Hospital of LaibinLaibinPeople’s Republic of China
  6. 6.Department of OncologyThe First People’s Hospital of NanningNanningPeople’s Republic of China

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