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- Publisher Website: 10.1016/j.ejca.2010.10.026
- Scopus: eid_2-s2.0-79952103326
- PMID: 21112774
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Article: Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: Combined analyses of NPC-9901 and NPC-9902 Trials
Title | Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: Combined analyses of NPC-9901 and NPC-9902 Trials |
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Authors | |
Keywords | Nasopharyngeal carcinoma Concurrent-adjuvant chemotherapy |
Issue Date | 2011 |
Citation | European Journal of Cancer, 2011, v. 47, n. 5, p. 656-666 How to Cite? |
Abstract | Background: The current standard treatment for locoregionally advanced nasopharyngeal carcinoma (NPC) was conventional-fractionation radiotherapy plus concurrent-adjuvant chemotherapy as recommended by the Intergroup-0099 Study. This combined analysis of the NPC-9901 and the NPC-9902 Trials aims to provide more comprehensive data to evaluate the efficacy of the Intergroup-0099 regimen and the contributing factors. Methods: Eligible patients with stage III-IVB non-keratinizing NPC were randomly assigned to radiotherapy-alone (RT i group: 218 patients) or chemoradiotherapy (CRTi group: 223 patients) using cisplatin (100 mg/m2) for three cycles in concurrence with radiotherapy, followed by cisplatin (80 mg/m2) plus fluorouracil (1000 mg/m2/day for 4 days) for three cycles. The median follow-up was 6.1 years. Findings: Comparison by intention-to-treat showed that the CRTi group achieved significant improvement in overall failure-free rate (FFR), locoregional-FFR and cancer-specific survival (p ≤ 0.019); but the improvements for distant-FFR and overall survival (OS) were statistically insignificant (p ≥ 0.14). Further exploratory studies based on actual treatment showed that an additional improvement achieved was a significant gain in OS (CRTa versus RTa group: 72% versus 63% at 5-year, p = 0.037). Multivariate analyses showed that the dose of cisplatin during the concurrent phase had significant impact on locoregional-FFR and OS, while that of fluorouracil during the adjuvant phase was significant for distant-FFR. The 5-year locoregional-FFR for patients who received 0-1, 2 and 3 concurrent cycles were 79%, 88% and 88%, respectively; the corresponding distant-FFR by adjuvant cycles were 68%, 78% and 77%, respectively. Interpretation: Our results support the current practice of adding concurrent cisplatin plus adjuvant cisplatin-fluorouracil to radiotherapy for treating patients with locoregionally advanced NPC. The concurrent phase is important for locoregional control and survival, cisplatin 200 mg/m2 in two concurrent cycles might be adequate. Additional chemotherapy using fluorouracil-containing combination contributed to improving distant control. © 2010 Elsevier Ltd. All rights reserved. |
Persistent Identifier | http://hdl.handle.net/10722/213945 |
ISSN | 2023 Impact Factor: 7.6 2023 SCImago Journal Rankings: 2.501 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lee, Anne W M | - |
dc.contributor.author | Tung, Stewart Y. | - |
dc.contributor.author | Ngan, Roger K C | - |
dc.contributor.author | Chappell, Rick | - |
dc.contributor.author | Chua, Daniel T T | - |
dc.contributor.author | Lu, T. X. | - |
dc.contributor.author | Siu, Lillian | - |
dc.contributor.author | Tan, Terence | - |
dc.contributor.author | Chan, L. K. | - |
dc.contributor.author | Ng, W. T. | - |
dc.contributor.author | Leung, T. W. | - |
dc.contributor.author | Fu, Y. T. | - |
dc.contributor.author | Au, Gordon K H | - |
dc.contributor.author | Zhao, C. | - |
dc.contributor.author | O'Sullivan, Brian | - |
dc.contributor.author | Tan, E. H. | - |
dc.contributor.author | Lau, W. H. | - |
dc.date.accessioned | 2015-08-19T13:41:18Z | - |
dc.date.available | 2015-08-19T13:41:18Z | - |
dc.date.issued | 2011 | - |
dc.identifier.citation | European Journal of Cancer, 2011, v. 47, n. 5, p. 656-666 | - |
dc.identifier.issn | 0959-8049 | - |
dc.identifier.uri | http://hdl.handle.net/10722/213945 | - |
dc.description.abstract | Background: The current standard treatment for locoregionally advanced nasopharyngeal carcinoma (NPC) was conventional-fractionation radiotherapy plus concurrent-adjuvant chemotherapy as recommended by the Intergroup-0099 Study. This combined analysis of the NPC-9901 and the NPC-9902 Trials aims to provide more comprehensive data to evaluate the efficacy of the Intergroup-0099 regimen and the contributing factors. Methods: Eligible patients with stage III-IVB non-keratinizing NPC were randomly assigned to radiotherapy-alone (RT i group: 218 patients) or chemoradiotherapy (CRTi group: 223 patients) using cisplatin (100 mg/m2) for three cycles in concurrence with radiotherapy, followed by cisplatin (80 mg/m2) plus fluorouracil (1000 mg/m2/day for 4 days) for three cycles. The median follow-up was 6.1 years. Findings: Comparison by intention-to-treat showed that the CRTi group achieved significant improvement in overall failure-free rate (FFR), locoregional-FFR and cancer-specific survival (p ≤ 0.019); but the improvements for distant-FFR and overall survival (OS) were statistically insignificant (p ≥ 0.14). Further exploratory studies based on actual treatment showed that an additional improvement achieved was a significant gain in OS (CRTa versus RTa group: 72% versus 63% at 5-year, p = 0.037). Multivariate analyses showed that the dose of cisplatin during the concurrent phase had significant impact on locoregional-FFR and OS, while that of fluorouracil during the adjuvant phase was significant for distant-FFR. The 5-year locoregional-FFR for patients who received 0-1, 2 and 3 concurrent cycles were 79%, 88% and 88%, respectively; the corresponding distant-FFR by adjuvant cycles were 68%, 78% and 77%, respectively. Interpretation: Our results support the current practice of adding concurrent cisplatin plus adjuvant cisplatin-fluorouracil to radiotherapy for treating patients with locoregionally advanced NPC. The concurrent phase is important for locoregional control and survival, cisplatin 200 mg/m2 in two concurrent cycles might be adequate. Additional chemotherapy using fluorouracil-containing combination contributed to improving distant control. © 2010 Elsevier Ltd. All rights reserved. | - |
dc.language | eng | - |
dc.relation.ispartof | European Journal of Cancer | - |
dc.subject | Nasopharyngeal carcinoma | - |
dc.subject | Concurrent-adjuvant chemotherapy | - |
dc.title | Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: Combined analyses of NPC-9901 and NPC-9902 Trials | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.ejca.2010.10.026 | - |
dc.identifier.pmid | 21112774 | - |
dc.identifier.scopus | eid_2-s2.0-79952103326 | - |
dc.identifier.hkuros | 266232 | - |
dc.identifier.volume | 47 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 656 | - |
dc.identifier.epage | 666 | - |
dc.identifier.isi | WOS:000288881700002 | - |
dc.identifier.issnl | 0959-8049 | - |