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Conference Paper: Control of regional metastasis after induction chemotherapy and radiotherapy for nasopharyngeal carcinoma

TitleControl of regional metastasis after induction chemotherapy and radiotherapy for nasopharyngeal carcinoma
Authors
Issue Date2001
PublisherScienceDirect
Citation
The 43rd Annuanl Meeting of American Society for Therapeutic Radiology and Oncology, San Francisco, CA., 4-8 November 2001. In International Journal of Radiation Oncology - Biology - Physics, 2001, v. 53 n. 3 suppl. 1, p. 43 How to Cite?
AbstractPURPOSE: To study the impact of adding induction chemotherapy to radiotherapy on the long term control of regional metastasis and survival in patients with nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: Between February 1988 and August 1993, 240 NPC patients with Ho’s T3 stage, N2-3 stage, or nodal size ≥3 cm were recruited onto two randomized trials comparing induction chemotherapy followed by radiotherapy (CT+RT) and radiotherapy alone (RT) using a similar treatment protocol. Of these, 210 patients (105 in each treatment arm) had cervical nodal metastasis and were included in the analysis. Patients in the CT+RT arm received 2-3 cycles of cisplatin 60mg/m2 day 1 + epirubicin 110mg/m2 day 1 followed by radiotherapy. Radiotherapy technique and dose were similar in both arms. All 210 patients completed the treatment and were evaluable. The median follow-up time was 71 months (5-152 months). RESULTS: The overall response rate of nodal disease to chemotherapy was 86% and the complete response (CR) rate was 44%. At the end of radiotherapy, 92% of patients in the CT+RT arm and 86% in the RT arm achieved CR in the neck (p=0.12). At the time of analysis, failures in the neck occurred in 16% of patients in the CT+RT arm and 25% in the RT arm (p=0.12). The 5-year nodal relapse-free survival rates in the CT+RT and RT arm were 83% and 75%, respectively (p=0.13). Most neck failures (81%) occurred during the first 36 months of follow-up. Radical neck dissection successfully salvaged 41% of neck failures in the CT+RT arm and 46% in the RT arm. The 5-year distant metastases-free survival rates were 70% in the CT+RT arm and 68% in the RT arm (p=0.56), and the corresponding 5-year disease-specific survival rates were 66% and 68%, respectively (p=0.55). In subgroup analysis, no significant differences in regional control and survival could be found in patients with advanced N stage disease as defined by either Ho’s N2-3 stage or AJCC N2-3 stage. In patients with nodal size >6 cm, the 5-year nodal relapse-free survival rates in the CT+RT and RT arm were 84% and 64%, respectively, but the difference was not significant (p=0.1). Complete responders to chemotherapy had significantly improved regional control and survival when compared with non-complete responders. CONCLUSION: Induction chemotherapy does not appear to improve the regional control and survival in NPC patients with regional metastasis when compared to radiotherapy alone, and is not recommended as a routine treatment outside the context of clinical trial. Copyright © 2001 Elsevier Science Inc. All rights reserved.
DescriptionThis journal suppl. entitled: Proceedings of the American Society for Therapeutic Radiology and Oncology 43rd Annual Meeting
Persistent Identifierhttp://hdl.handle.net/10722/107897
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274

 

DC FieldValueLanguage
dc.contributor.authorChua, Den_HK
dc.contributor.authorSham, Jen_HK
dc.contributor.authorChoy, Den_HK
dc.date.accessioned2010-09-26T00:16:59Z-
dc.date.available2010-09-26T00:16:59Z-
dc.date.issued2001en_HK
dc.identifier.citationThe 43rd Annuanl Meeting of American Society for Therapeutic Radiology and Oncology, San Francisco, CA., 4-8 November 2001. In International Journal of Radiation Oncology - Biology - Physics, 2001, v. 53 n. 3 suppl. 1, p. 43-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/107897-
dc.descriptionThis journal suppl. entitled: Proceedings of the American Society for Therapeutic Radiology and Oncology 43rd Annual Meeting-
dc.description.abstractPURPOSE: To study the impact of adding induction chemotherapy to radiotherapy on the long term control of regional metastasis and survival in patients with nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: Between February 1988 and August 1993, 240 NPC patients with Ho’s T3 stage, N2-3 stage, or nodal size ≥3 cm were recruited onto two randomized trials comparing induction chemotherapy followed by radiotherapy (CT+RT) and radiotherapy alone (RT) using a similar treatment protocol. Of these, 210 patients (105 in each treatment arm) had cervical nodal metastasis and were included in the analysis. Patients in the CT+RT arm received 2-3 cycles of cisplatin 60mg/m2 day 1 + epirubicin 110mg/m2 day 1 followed by radiotherapy. Radiotherapy technique and dose were similar in both arms. All 210 patients completed the treatment and were evaluable. The median follow-up time was 71 months (5-152 months). RESULTS: The overall response rate of nodal disease to chemotherapy was 86% and the complete response (CR) rate was 44%. At the end of radiotherapy, 92% of patients in the CT+RT arm and 86% in the RT arm achieved CR in the neck (p=0.12). At the time of analysis, failures in the neck occurred in 16% of patients in the CT+RT arm and 25% in the RT arm (p=0.12). The 5-year nodal relapse-free survival rates in the CT+RT and RT arm were 83% and 75%, respectively (p=0.13). Most neck failures (81%) occurred during the first 36 months of follow-up. Radical neck dissection successfully salvaged 41% of neck failures in the CT+RT arm and 46% in the RT arm. The 5-year distant metastases-free survival rates were 70% in the CT+RT arm and 68% in the RT arm (p=0.56), and the corresponding 5-year disease-specific survival rates were 66% and 68%, respectively (p=0.55). In subgroup analysis, no significant differences in regional control and survival could be found in patients with advanced N stage disease as defined by either Ho’s N2-3 stage or AJCC N2-3 stage. In patients with nodal size >6 cm, the 5-year nodal relapse-free survival rates in the CT+RT and RT arm were 84% and 64%, respectively, but the difference was not significant (p=0.1). Complete responders to chemotherapy had significantly improved regional control and survival when compared with non-complete responders. CONCLUSION: Induction chemotherapy does not appear to improve the regional control and survival in NPC patients with regional metastasis when compared to radiotherapy alone, and is not recommended as a routine treatment outside the context of clinical trial. Copyright © 2001 Elsevier Science Inc. All rights reserved.-
dc.languageengen_HK
dc.publisherScienceDirect-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_HK
dc.titleControl of regional metastasis after induction chemotherapy and radiotherapy for nasopharyngeal carcinomaen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailChua, D: danielchua@hksh.comen_HK
dc.identifier.emailSham, J: jstsham@hku.hken_HK
dc.identifier.authorityChua, D=rp00415en_HK
dc.identifier.doi10.1016/S0360-3016(01)01901-0-
dc.identifier.hkuros70524en_HK
dc.identifier.volume53-
dc.identifier.issue3 suppl. 1-
dc.identifier.spage43-
dc.identifier.epage43-
dc.publisher.placeUnited States-

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