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Article: Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma

TitlePreliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma
Authors
KeywordsAccelerated fractionation
Nasopharyngeal carcinoma
Chemoradiotherapy
Issue Date2006
Citation
International Journal of Radiation Oncology - Biology - Physics, 2006, v. 66, n. 1, p. 142-151 How to Cite?
AbstractPurpose: To compare the benefit achieved by concurrent chemoradiotherapy (CRT) and/or accelerated fractionation (AF) vs. radiotherapy (RT) alone with conventional fractionation (CF) for patients with T3-4N0-1M0 nasopharyngeal carcinoma (NPC). Methods and Materials: All patients were irradiated with the same RT technique to ≥66 Gy at 2 Gy per fraction, conventional five fractions/week in the CF and CF+C (chemotherapy) arms, and accelerated six fractions/week in the AF and AF+C arms. The CF+C and AF+C patients were given the Intergroup 0099 regimen (concurrent cisplatin plus adjuvant cisplatin and 5-fluorouracil). Results: Between 1999 and April 2004, 189 patients were randomly assigned; the trial was terminated early because of slow accrual. The median follow-up was 2.9 years. When compared with the CF arm, significant improvement in failure-free survival (FFS) was achieved by the AF+C arm (94% vs. 70% at 3 years, p = 0.008), but both the AF arm and the CF+C arm were insignificant (p ≥ 0.38). Multivariate analyses showed that CRT was a significant factor: hazard ratio (HR) = 0.52 (0.28-0.97), AF per se was insignificant: HR = 0.68 (0.37-1.25); the interaction of CRT by AF was strongly significant (p = 0.006). Both CRT arms had significant increase in acute toxicities (p < 0.005), and the AF+C arm also incurred borderline increase in late toxicities (34% vs. 14% at 3 years, p = 0.05). Conclusions: Preliminary results suggest that concurrent chemoradiotherapy with accelerated fractionation could significantly improve tumor control when compared with conventional RT alone; further confirmation of therapeutic ratio is warranted. © 2006 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/213902
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274

 

DC FieldValueLanguage
dc.contributor.authorLee, Anne W M-
dc.contributor.authorTung, Stewart Y.-
dc.contributor.authorChan, Anthony T C-
dc.contributor.authorChappell, Rick-
dc.contributor.authorFu, Yiu Tong-
dc.contributor.authorLu, Tai Xiang-
dc.contributor.authorTan, Terence-
dc.contributor.authorChua, Daniel T T-
dc.contributor.authorO'Sullivan, Brian-
dc.contributor.authorXu, Shirley L.-
dc.contributor.authorPang, Ellie S Y-
dc.contributor.authorSze, Wai Man-
dc.contributor.authorLeung, To Wai-
dc.contributor.authorKwan, Wing Hong-
dc.contributor.authorChan, Paddy T M-
dc.contributor.authorLiu, Xiu Fang-
dc.contributor.authorTan, Eng Huat-
dc.contributor.authorSham, Jonathan S T-
dc.contributor.authorSiu, Lillian-
dc.contributor.authorLau, Wai Hon-
dc.date.accessioned2015-08-19T13:41:09Z-
dc.date.available2015-08-19T13:41:09Z-
dc.date.issued2006-
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 2006, v. 66, n. 1, p. 142-151-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/213902-
dc.description.abstractPurpose: To compare the benefit achieved by concurrent chemoradiotherapy (CRT) and/or accelerated fractionation (AF) vs. radiotherapy (RT) alone with conventional fractionation (CF) for patients with T3-4N0-1M0 nasopharyngeal carcinoma (NPC). Methods and Materials: All patients were irradiated with the same RT technique to ≥66 Gy at 2 Gy per fraction, conventional five fractions/week in the CF and CF+C (chemotherapy) arms, and accelerated six fractions/week in the AF and AF+C arms. The CF+C and AF+C patients were given the Intergroup 0099 regimen (concurrent cisplatin plus adjuvant cisplatin and 5-fluorouracil). Results: Between 1999 and April 2004, 189 patients were randomly assigned; the trial was terminated early because of slow accrual. The median follow-up was 2.9 years. When compared with the CF arm, significant improvement in failure-free survival (FFS) was achieved by the AF+C arm (94% vs. 70% at 3 years, p = 0.008), but both the AF arm and the CF+C arm were insignificant (p ≥ 0.38). Multivariate analyses showed that CRT was a significant factor: hazard ratio (HR) = 0.52 (0.28-0.97), AF per se was insignificant: HR = 0.68 (0.37-1.25); the interaction of CRT by AF was strongly significant (p = 0.006). Both CRT arms had significant increase in acute toxicities (p < 0.005), and the AF+C arm also incurred borderline increase in late toxicities (34% vs. 14% at 3 years, p = 0.05). Conclusions: Preliminary results suggest that concurrent chemoradiotherapy with accelerated fractionation could significantly improve tumor control when compared with conventional RT alone; further confirmation of therapeutic ratio is warranted. © 2006 Elsevier Inc. All rights reserved.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physics-
dc.subjectAccelerated fractionation-
dc.subjectNasopharyngeal carcinoma-
dc.subjectChemoradiotherapy-
dc.titlePreliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2006.03.054-
dc.identifier.pmid16904519-
dc.identifier.scopuseid_2-s2.0-33746799334-
dc.identifier.hkuros266118-
dc.identifier.volume66-
dc.identifier.issue1-
dc.identifier.spage142-
dc.identifier.epage151-

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