Concurrent chemoradiotherapy followed by adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma
- VernacularTitle:局部晚期鼻咽癌同期放化疗及辅助化疗的临床研究
- Author:
Jie FU
;
Chaosu HU
- Publication Type:Journal Article
- Keywords:
nasopharyngeal carcinoma;
chemotherapy;
radiotherapy
- From:China Oncology
2001;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Background and purpose:Concurrent chemoradiotherapy followed by adjuvant chemotherapy have been administrated to locally advance nasopharyngeal carcinoma according to the NCCN guidelines.This study s pecifically evaluated the efficacy,toxicity and compliance of modified concurrent chemoradiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma(NPC).Methods:From Nov.2003 to Apr. 2005,67 patients with stageⅢandⅣlocally advanced nasopharyngeal carcinoma(NPC)were enrolled in this study.A total dosage of radiation,70-74 Gy,was given in 35-37 fractions in 5 fractions per week.Two cycles of chemotherapy, consisting of cisplatin 25 mg/m2?d-1 and 5-fluorouracil 300 mg/m2?d-1 were delivered simultaneously with radiotherapy on the day 1-3 during week 1 and 5.Three cycles of adjuvant chemotherapy,consisting of cisplatin 25 mg/m2?d-1 and fluorouracil 450 mg/m2?d-1,were also given,starting on day 1-3 during week 10,13 and 16.Results:The median follow-up was 20 months(ranged from 11 to 27 months).The 2-year overall survival rate and the 2-year diseasefree survival rate were 91.75%and 81.56%respectively.The 2-year overall survival rate was 96%for stageⅢand 87.65%for stageⅣ(P=0.334).The 2-year disease-free survival rate was 92.16%for stageⅢand 69.35%for stageⅣ respectively(P=0.2358).The compliance rates were 100%for radiotherapy,47 cases(70.1%)for all chemotherapy, 56 cases(83.6%)for concurrent chemotherapy and 48 cases(71.6%)for adjuvant chemotherapy.The main grade Ⅲ/Ⅳacute toxicity events during concurrent chemoradiotherapy were neutropenia in 15 patients(21.4%),vomitting and nausea in 2 patients(3%),mucositis in 56 patients(83.6%),and gradeⅢskin reaction in 10(15%),respectively. The main gradeⅢ/Ⅳacute toxicity events during adjuvant chemotherapy were neutropenia in 13 patients(19.4%), grade 3 anemia in 2 patients(1.5%)respectively.Conclusion:The primary result showed a good compliance,lower incidences of toxicity and improved early outcome of treatments for the patients with stageⅢand stageⅣ(M0)NPC. The ultimate therapeutic ratio will be updated according to longer follow-ups.
