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Article: Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: A factorial study

TitleConcurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: A factorial study
Authors
Issue Date2004
PublisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/
Citation
Journal Of Clinical Oncology, 2004, v. 22 n. 13, p. 2643-2653 How to Cite?
AbstractPurpose: To study the efficacy of concurrent chemoradiotherapy (CRT) and adjuvant chemotherapy (AC) for nasopharyngeal carcinoma (NPC). Patients and Methods: Patients with Ho's stage T3 or N2/N3 NPC or neck node ≥ 4 cm were eligible. Patients were randomly assigned to have radiotherapy (RT) or CRT with uracil and tegafur and to have AC or no AC after RT/CRT. AC comprised alternating cisplatin, fluorouracil, vincristine, bleomycin, and methotrexate for six cycles. There were four treatment groups: A, RT; B, CRT; C, RT and AC; D, CRT and AC. For CRT versus RT, groups B and D were compared with groups A and C. For AC versus no AC, groups C and D were compared with groups A and B. Results: Three-year failure-free survival (FFS) and overall survival (OS) for CRT versus RT were 69.3% versus 57.8% and 86.5% versus 76.8%, respectively (P = .14 and .06; n = 110 v 109). Distant metastases rate (DMR) was significantly reduced with CRT (14.8% v 29.4%; P = .026). Locoregional failure rates (LRFR) were similar (20% v 27.6%; P = .39). Three-year FFS and OS for AC versus no AC were 62.5% versus 65% and 80.4% versus 83.1%, respectively (P = .83 and .69; n = 111 v 108). DMR and LRFR were not reduced with AC (P = .34 and .15, respectively). Cox model showed CRT to be a favorable prognostic factor for OS (hazard ratio, 0.42; P = .009). Conclusion: An improvement in OS with CRT was observed but did not achieve statistical significance. The improvement seemed to be associated with a significant reduction in DMR. AC did not improve outcome. © 2004 by American Society of Clinical Oncology.
Persistent Identifierhttp://hdl.handle.net/10722/72026
ISSN
2015 Impact Factor: 20.982
2015 SCImago Journal Rankings: 9.204
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorAu, GKHen_HK
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorKwong, PWKen_HK
dc.contributor.authorCheng, ACKen_HK
dc.contributor.authorWu, PMen_HK
dc.contributor.authorLaw, MWMen_HK
dc.contributor.authorKwok, CCHen_HK
dc.contributor.authorYau, CCen_HK
dc.contributor.authorWan, KYen_HK
dc.contributor.authorChan, RTTen_HK
dc.contributor.authorChoy, DDKen_HK
dc.date.accessioned2010-09-06T06:37:37Z-
dc.date.available2010-09-06T06:37:37Z-
dc.date.issued2004en_HK
dc.identifier.citationJournal Of Clinical Oncology, 2004, v. 22 n. 13, p. 2643-2653en_HK
dc.identifier.issn0732-183Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/72026-
dc.description.abstractPurpose: To study the efficacy of concurrent chemoradiotherapy (CRT) and adjuvant chemotherapy (AC) for nasopharyngeal carcinoma (NPC). Patients and Methods: Patients with Ho's stage T3 or N2/N3 NPC or neck node ≥ 4 cm were eligible. Patients were randomly assigned to have radiotherapy (RT) or CRT with uracil and tegafur and to have AC or no AC after RT/CRT. AC comprised alternating cisplatin, fluorouracil, vincristine, bleomycin, and methotrexate for six cycles. There were four treatment groups: A, RT; B, CRT; C, RT and AC; D, CRT and AC. For CRT versus RT, groups B and D were compared with groups A and C. For AC versus no AC, groups C and D were compared with groups A and B. Results: Three-year failure-free survival (FFS) and overall survival (OS) for CRT versus RT were 69.3% versus 57.8% and 86.5% versus 76.8%, respectively (P = .14 and .06; n = 110 v 109). Distant metastases rate (DMR) was significantly reduced with CRT (14.8% v 29.4%; P = .026). Locoregional failure rates (LRFR) were similar (20% v 27.6%; P = .39). Three-year FFS and OS for AC versus no AC were 62.5% versus 65% and 80.4% versus 83.1%, respectively (P = .83 and .69; n = 111 v 108). DMR and LRFR were not reduced with AC (P = .34 and .15, respectively). Cox model showed CRT to be a favorable prognostic factor for OS (hazard ratio, 0.42; P = .009). Conclusion: An improvement in OS with CRT was observed but did not achieve statistical significance. The improvement seemed to be associated with a significant reduction in DMR. AC did not improve outcome. © 2004 by American Society of Clinical Oncology.en_HK
dc.languageengen_HK
dc.publisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/en_HK
dc.relation.ispartofJournal of Clinical Oncologyen_HK
dc.subject.meshAdministration, Oralen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - therapeutic useen_HK
dc.subject.meshBleomycin - administration & dosageen_HK
dc.subject.meshCarcinoma - drug therapy - pathology - radiotherapyen_HK
dc.subject.meshChemotherapy, Adjuvanten_HK
dc.subject.meshCisplatin - administration & dosageen_HK
dc.subject.meshCombined Modality Therapyen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFluorouracil - administration & dosageen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfusions, Intravenousen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMethotrexate - administration & dosageen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNasopharyngeal Neoplasms - drug therapy - pathology - radiotherapyen_HK
dc.subject.meshNeoplasm Metastasisen_HK
dc.subject.meshTegafur - administration & dosageen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshUracil - administration & dosageen_HK
dc.subject.meshVincristine - administration & dosageen_HK
dc.titleConcurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: A factorial studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0732-183X&volume=22&spage=2643&epage=2653&date=2004&atitle=Concurrent+and+Adjuvant+Chemotherapy+for+Nasopharyngeal+Carcinoma:+A+Factorial+Studyen_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1200/JCO.2004.05.173en_HK
dc.identifier.pmid15226332-
dc.identifier.scopuseid_2-s2.0-4344709667en_HK
dc.identifier.hkuros89615en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-4344709667&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume22en_HK
dc.identifier.issue13en_HK
dc.identifier.spage2643en_HK
dc.identifier.epage2653en_HK
dc.identifier.isiWOS:000222408400018-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridAu, GKH=7003748615en_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridKwong, PWK=7006992418en_HK
dc.identifier.scopusauthoridCheng, ACK=36055097300en_HK
dc.identifier.scopusauthoridWu, PM=8663653900en_HK
dc.identifier.scopusauthoridLaw, MWM=8663654000en_HK
dc.identifier.scopusauthoridKwok, CCH=7102029180en_HK
dc.identifier.scopusauthoridYau, CC=7007038422en_HK
dc.identifier.scopusauthoridWan, KY=7102748975en_HK
dc.identifier.scopusauthoridChan, RTT=8663654400en_HK
dc.identifier.scopusauthoridChoy, DDK=8663654500en_HK

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