Back to Search
Start Over
A randomized trial on addition of concurrent-adjuvant chemotherapy and/or accelerated fractionation for locally-advanced nasopharyngeal carcinoma.
- Source :
-
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2011 Jan; Vol. 98 (1), pp. 15-22. - Publication Year :
- 2011
-
Abstract
- Background and Purpose: To evaluate the therapeutic benefits by adding chemotherapy (+C) and/or accelerated-fractionation (AF) for patients with T3-4N0-1M0 nasopharyngeal carcinoma.<br />Materials and Methods: From 1999 to 2004, 189 eligible patients were randomized to one of four treatment groups (CF/CF+C/AF/AF+C). The number of fractions/week was 5 for the CF groups and 6 for the AF groups. Patients in the +C groups were given concurrent cisplatin plus adjuvant cisplatin and fluorouracil.<br />Results: The AF+C group achieved significantly higher failure-free rate (88% at 5-year) than the CF group (63%; p=0.013), the AF group (56%; p=0.001) and the CF+C group (65%; p=0.027). As compared with CF alone, the increase in late toxicity was statistically insignificant (36% vs. 20%; p=0.25). Deaths due to cancer progression decreased (7% vs. 33%; p=0.011) but deaths due to incidental causes increased (9% vs. 2%; p=0.62). Improvement in overall survival reached borderline significance (85% vs. 66%; p=0.058).<br />Conclusions: Concurrent-adjuvant chemotherapy combined with AF significantly reduced failure and cancer-specific deaths. Although the increase in major late toxicity and incidental deaths were statistically insignificant, a subtle increase in non-cancer deaths narrowed the overall survival gain.<br /> (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Carcinoma
Chemotherapy, Adjuvant
Cisplatin administration & dosage
Combined Modality Therapy
Female
Fluorouracil administration & dosage
Humans
Male
Middle Aged
Nasopharyngeal Carcinoma
Nasopharyngeal Neoplasms mortality
Nasopharyngeal Neoplasms pathology
Nasopharyngeal Neoplasms therapy
Neoplasm Staging
Patient Compliance
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Dose Fractionation, Radiation
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0887
- Volume :
- 98
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20971520
- Full Text :
- https://doi.org/10.1016/j.radonc.2010.09.023