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Article: 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
KeywordsInduction chemotherapy
Nasopharyngeal carcinoma
Radical neck dissection
Regional control
Regional metastasis
Issue Date2002
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/38137
Citation
Head And Neck, 2002, v. 24 n. 4, p. 350-360 How to Cite?
AbstractBackground. 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). 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 two to three cycles of cisplatin, 60 mg/m2 day 1, + epirubicin, 110 mg/m2 day 1, followed by radiotherapy. Radiotherapy technique and dose were similar in both arms. The median follow-up time was 71 months (range, 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 = .12). The 5-year nodal relapse-free survival rates in the CT + RT and RT arm were 83% and 75%, respectively (p = .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 = .56), and the corresponding 5-year disease-specific survival rates were 66% and 68%, respectively (p = .55). In subgroup analysis, no significant differences in regional control and survival could be found in patients with Ho's N2-3 stage, AJCC N2-3 stage, or nodal size >6 cm. Conclusions. Induction chemotherapy does not seem to improve the regional control and survival in NPC patients with regional metastasis compared with radiotherapy alone and is not recommended as a routine treatment outside the context of a clinical trial. © 2002 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/84121
ISSN
2015 Impact Factor: 2.76
2015 SCImago Journal Rankings: 1.233
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorHo, WKen_HK
dc.contributor.authorAu, Gen_HK
dc.contributor.authorChoy, Den_HK
dc.date.accessioned2010-09-06T08:49:11Z-
dc.date.available2010-09-06T08:49:11Z-
dc.date.issued2002en_HK
dc.identifier.citationHead And Neck, 2002, v. 24 n. 4, p. 350-360en_HK
dc.identifier.issn1043-3074en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84121-
dc.description.abstractBackground. 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). 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 two to three cycles of cisplatin, 60 mg/m2 day 1, + epirubicin, 110 mg/m2 day 1, followed by radiotherapy. Radiotherapy technique and dose were similar in both arms. The median follow-up time was 71 months (range, 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 = .12). The 5-year nodal relapse-free survival rates in the CT + RT and RT arm were 83% and 75%, respectively (p = .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 = .56), and the corresponding 5-year disease-specific survival rates were 66% and 68%, respectively (p = .55). In subgroup analysis, no significant differences in regional control and survival could be found in patients with Ho's N2-3 stage, AJCC N2-3 stage, or nodal size >6 cm. Conclusions. Induction chemotherapy does not seem to improve the regional control and survival in NPC patients with regional metastasis compared with radiotherapy alone and is not recommended as a routine treatment outside the context of a clinical trial. © 2002 Wiley Periodicals, Inc.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/38137en_HK
dc.relation.ispartofHead and Necken_HK
dc.subjectInduction chemotherapyen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subjectRadical neck dissectionen_HK
dc.subjectRegional controlen_HK
dc.subjectRegional metastasisen_HK
dc.titleControl of regional metastasis after induction chemotherapy and radiotherapy for nasopharyngeal carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0017-8748&volume=24&issue=4&spage=350&epage=360&date=2002&atitle=Control+of+regional+metastasis+after+induction+chemotherapy+and+radiotherapy+for+nasopharyngeal+carcinomaen_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/hed.10056en_HK
dc.identifier.pmid11933177-
dc.identifier.scopuseid_2-s2.0-0036211048en_HK
dc.identifier.hkuros69684en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036211048&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume24en_HK
dc.identifier.issue4en_HK
dc.identifier.spage350en_HK
dc.identifier.epage360en_HK
dc.identifier.isiWOS:000174893300007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridHo, WK=7402968844en_HK
dc.identifier.scopusauthoridAu, G=7003748615en_HK
dc.identifier.scopusauthoridChoy, D=7102939127en_HK

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