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The results of three different treatment modalities in patients with locally advanced nasopharyngeal carcinoma

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Abstract

The aim of the study was to evaluate the toxicity and efficacy of 62 patients with locally advanced nasopharyngeal carcinoma (NPC) (stage III, IVA, IVB) treated by three different modalities. Cisplatin was given weekly 35 mg/m2/day or every 3 weeks 100 mg/m2/day during radiotherapy (RT) in all patients. Patients were classified into following three groups: The patients in the group 1 (n = 23) were treated only with concurrent chemoradiotherapy (CCRT). In the group 2 (n = 15), before the CCRT, neoadjuvant chemotherapy, consisting of intravenous cisplatin and docetaxel on day 1, every 3 weeks treatment cycles was administered. In the group 3 (n = 24), adjuvant chemotherapy, consisting of cisplatin on day 1 and 5-flourouracil on day 1 to 5 every 3 weeks was used after CCRT. Three arms were treated with the same RT technique and dose. There was no difference for age, sex, and stage among the groups. Radiotherapy was administered in planned dose for all patients. A total of 82% patients completed planned chemotherapy concurrent with RT. The treatment related adverse effects were mild or moderate in intensity. There was no statistical difference between the groups regarding the treatment responses. Complete response rate of RT was 73.9%, 86.7%, and 87.5%, respectively. Median progression free survival (PFS) and overall survival (OS) were 13, 12, 9 months and 22, 20, 15 months for groups 1, 2, 3, respectively. No difference was observed in median OS and PFS among three groups. In our study, the efficacy and toxicity of neoadjuvant and/or adjuvant chemotherapy with CCRT and CCRT alone were found similar.

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References

  1. Al-Sarraf M, et al. Chemoradiotherapy vs radiotherapy in patients with locally advanced nasopharyngeal carcinoma: phase III randomized intergroup study (0099). (SWOG 8892, RTOG 8817, ECOG 2388). J Clin Oncol 1998;16:1310–7.

    PubMed  CAS  Google Scholar 

  2. Liu MT, et al. Prognostic factors affecting the outcome of nasopharyngeal carcinoma. Jpn J Clin Oncol 2003;33(10):501–8.

    Article  PubMed  Google Scholar 

  3. Isobe K, et al. Concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: is intergroup study 0099 feasible in Japanese patients? Jpn J Clin Oncol 2003;33(10):497–500.

    Article  PubMed  Google Scholar 

  4. Kawashima M, et al. A multi-institional survey of the effectiveness of chemotherapy combined with radiotherapy for patients with nasopharyngeal carcinoma. Jpn J Clin Oncol 2004;34(10):569–83.

    Article  PubMed  Google Scholar 

  5. Lee AWM, et al. Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976–1985: overall survival and patients of failure. Int J Radiat Oncol Biol Phys 1997;37:985–96.

    Google Scholar 

  6. Sanguinetti G, et al. Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of local control and regional control. Int J Radiat Oncol Biol Phys 1997;37:985–96.

    Google Scholar 

  7. Wong ZW, et al. Chemotherapy with or without radiotherapy in patients with locoregionally recurrent nasopharyngeal carcinoma. Head Neck 2000;6:549–54.

    Google Scholar 

  8. El-Weshi A, et al. Neoadjuvant chemotherapy plus conventional radiotherapy or accelerated hyperfractionation stage III and IV nasopharyngeal carcinoma. Acta Oncol 2001;40(5):574–81.

    Article  PubMed  CAS  Google Scholar 

  9. PH JL, et al. Induction chemotherapy followed by concurrent chemoradiotherapy in the treatment oflocoregionallly advanced nasopharyngeal carcinoma. Ann Oncol 2003;14:564–569.

    Article  Google Scholar 

  10. Chua DT, et al. Preliminary report of the Asian-Oceanian Clinical Oncology Assosiation randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment with locoregionally advanced nasopharyngeal carcinoma. Asian-Oceanian Clinical Oncology Assosiation Nasopharynx Cancer Study Group. Cancer 1998;83:2270–83.

    Article  PubMed  CAS  Google Scholar 

  11. Lee N, et al. Intensity modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 1997;37:985–96.

    Google Scholar 

  12. Hunt MA, et al. Treatment planning and delivery of intensity modulated radiation therapy for primary nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2001;49:623–32.

    PubMed  CAS  Google Scholar 

  13. Al-Amro A, et al. Neoadjuvant chemotherapy followed by concurrent chemo-radiation therapy in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2005;62(2):508–13.

    PubMed  Google Scholar 

  14. Lin JC, Liang WM, Jan JS, Jiang RS, Lin AC. Another way to estimate outcome of advanced nasopharyngeal carcinoma is concurrent chemoradiotherapy adequate? Int J Radiat Oncol Biol Phys 2004;60(1):156–64.

    PubMed  Google Scholar 

  15. Tan EH, et al. Concurrent chemoradiotherapy followed by adjuvant chemotherapy in asian patients with nasopharyngeal carcinoma: toxicities and preliminary results. Int J Radiat Oncol Biol Phys 1999;43(3):597–601.

    Google Scholar 

  16. Mizowaki T, et al. Concurrent chemotherapy and radiotherapy with low dose cisplatin for nasopharyngeal carcinoma. Am J Clin Oncol 2003;26(2):155–158.

    Article  PubMed  CAS  Google Scholar 

  17. International Nasopharyngeal Carcinoma Study Group VIT. Preliminary results of a randomized trial comparing neodjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy vs radiotherapy alone in stage IV (3N2,M0) undifferentiated nasopharyngeal carcinoma: A positive effect on progression-free survival. Int J Radiat Oncol Biol Phys 1996;35:463–9.

    Google Scholar 

  18. Ma J, Mai H, Hong M. Results of prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol 2000;5:1350–7.

    Google Scholar 

  19. Hong RL, et al. Induction chemotherapy with mitomycin, epirubicin, cisplatin, flourouracil, and leucovorin followed by radiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol 2001;19(23):4305–13.

    PubMed  CAS  Google Scholar 

  20. Onat H, et al. High dose epirubicin and cisplatin in locally advanced undifferentiated nasopharyngeal carcinoma. Clin Oncol 2002;14:449–54.

    Article  CAS  Google Scholar 

  21. Hareyama M, et al. A prospective randomized trial comparing neoadjuvant chemotherapy with radiotherapy alone in patients with advanced nasopharyngeal carcinoma. Cancer 2002;94:2217–23.

    Article  PubMed  CAS  Google Scholar 

  22. Chua DT, et al. Patterns of failure after induction chemotherapy and radiotherapy for locoregionally advanced nasopharyngeal carcinoma: The Queen Mary Hospital experience. Int J Radiat Oncol Biol Phys 2001;49:1219–28.

    PubMed  CAS  Google Scholar 

  23. Wee J, et al. Randomized trial of radiotherapy vs concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Commitee on Cancer/International Union against cancer stage III and IV nasopharyngeal carcinoma of the endemic variety. J Clin Oncol.2005;23(27):6730–8.

    Article  PubMed  CAS  Google Scholar 

  24. Lee AW, et al. Hong Kong Nasopharyngeal Carcinoma Study Group. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: Nasopharyngeal Carcinoma-9901 Trial By The Hong Kong Nasopharyngeal Carcinoma Study Group. J Clin Oncol 2005;23(28):6966–75.

    Google Scholar 

  25. Cheng SH, et al. Long term survival of nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy. Int J Radiat Oncol Biol Phys 2000;48(5):1323–30.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Gazi University Medical School, Department of Medical Oncology, Gazi Hospital, Ankara, 06500, Turkey

    Banu Ozturk, Suleyman Buyukberber, Ugur Coskun, Deniz Yamac, Aytug Uner, Emel Yaman, Ramazan Yildiz, A. Osman Kaya & Mustafa Benekli

  2. Gazi University Medical School, Department of Radiation Oncology, Gazi Hospital, Ankara, 06500, Turkey

    Muge Akmansu, Huseyin Bora, Diclehan Unsal & Yucel Pak

Authors
  1. Banu Ozturk
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  2. Suleyman Buyukberber
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  3. Muge Akmansu
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  4. Ugur Coskun
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  5. Deniz Yamac
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  6. Aytug Uner
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  7. Emel Yaman
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  8. Ramazan Yildiz
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  9. A. Osman Kaya
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  11. Diclehan Unsal
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  12. Yucel Pak
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  13. Mustafa Benekli
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Correspondence to Suleyman Buyukberber.

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Ozturk, B., Buyukberber, S., Akmansu, M. et al. The results of three different treatment modalities in patients with locally advanced nasopharyngeal carcinoma. Med Oncol 25, 269–273 (2008). https://doi.org/10.1007/s12032-007-9029-8

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  • DOI: https://doi.org/10.1007/s12032-007-9029-8

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