Long term results of a prospective randomized study on nasopharyngeal carcinoma by radiotherapy combined with induction or concurrent chemotherapy
- VernacularTitle:不同化疗方案加放射治疗鼻咽癌的远期疗效
- Author:
Jianji PAN
;
Shaojun LIN
;
Junxin WU
- Publication Type:Journal Article
- Keywords:
Nasopharyngeal neoplasms/drug therapy;
Nasopharyngeal neoplasms/radiotherapy;
Prognos
- From:
Chinese Journal of Radiation Oncology
1992;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the long term local control and survival of nasopharyngeal carcinoma using radiotherapy combined with different chemotherapy regimens. Methods From July 1987 to October 1989, 300 patients pathologically confirmed nasopharyngeal carcinoma were randomized into three groups: radiotherapy alone (114 patients), neoadjuvant chemotherapy plus radiotherapy (93) and concurrent chemotherapy and radiotherapy (93). The primary tumor received a total dose of 70 Gy with 2?Gy per day. Patients who had cervical lymph node metastasis received 65～70?Gy to the neck whereas patients who did not have cervical lymph node metastasis received a prophylactic radiation of 50?Gy. The regimen of neoadjuvant chemotherapy consisted of 5 Fu (1?000?mg, 3 times per week) and Cisplatin (100?mg,once a week) alternatively for 4 weeks. Concurrent chemotherapy consisted of Cisplatin (20?mg, twice a week) and 5 Fu (500?mg, twice a week) alternatively to 6 weeks. Results The overall 5 year survival rate (OS), disease free survival rate (DFS), distant metastasis free rate(DMF)and local regional free rate (LRF) were 57.1%, 52.9%, 61.0% and 83.3%, respectively. For all patients, there was not a significant difference in the 5 year OS, DFS, DMF, LRF (P= 0.23, 0.65, 0.54, 0.83) and toxicity between these three groups. Cox regression analysis showed that only N stage was a prognostic factor, while treatment modalities was not. Conclusions Radiotherapy combined with neoadjuvant chemotherapy or concurrent chemotherapy did not significantly improve the survival rate and local control rate as compared to conventional radiotherapy. Therefore, radiotherapy plus chemotherapy, and chemotherapy regimens need to be further studied.
