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Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma

Cited 33 time in Web of Science Cited 37 time in Scopus
Authors
Song, Chang Hoon; Wu, Hong-Gyun; Heo, Dae Seog; Kim, Kwang Hyun; Sung, Myung-Whun; Park, Charn Il
Issue Date
2008-01-25
Publisher
Laryngoscope
Citation
Laryngoscope. 2008 Apr;118(4):663-70.
Keywords
AdolescentAdultAgedAntimetabolites, Antineoplastic/administration & dosageAntineoplastic Agents/administration & dosageAntineoplastic Combined Chemotherapy Protocols/therapeutic useCarcinoma/drug therapy/*radiotherapyCarcinoma, Squamous Cell/drug therapy/radiotherapyChildCisplatin/administration & dosageDisease-Free SurvivalFemaleFluorouracil/administration & dosageFollow-Up StudiesHumansLymph Nodes/radiation effectsMaleMiddle AgedNasopharyngeal Neoplasms/drug therapy/*radiotherapy*Neoadjuvant TherapyNeoplasm Recurrence, Local/pathologyNeoplasm StagingRetrospective StudiesSurvival RateTreatment Outcome
Abstract
OBJECTIVES: To analyze the impact of neoadjuvant chemotherapy (CT) on the treatment of early-stage nasopharyngeal carcinoma (NPC) as compared with radiotherapy (RT) alone. METHODS: We analyzed retrospectively the outcome of 60 previously untreated and histologically confirmed early-stage NPC patients treated with either RT alone or with neoadjuvant CT followed by RT (CT/RT) at the Seoul National University Hospital between 1986 and 2004. Neoadjuvant CT consisted of three cycles with 5-fluourouracil and cisplatin. RT was given to the nasopharynx and neck nodes. The median dose to the primary site, involved nodes, and elective nodes was 70.2 Gy, 63 Gy, and 45 Gy, respectively. According to the 1997 American Joint Committee on Cancer staging system, 9 patients had stage I or IIA disease, and 22 patients had stage IIB disease in the RT group. For the CT/RT group, 8 patients had stage I or IIA disease, and 21 patients had stage IIB disease. The median follow-up for all patients was 124.5 (range, 5-239) months. RESULTS: The 5-year locoregional failure-free (LRFF), distant metastasis-free (DMF), disease-free survival (DFS), and overall survival (OS) rate was 84%, 93%, 81%, and 84% for the RT group and 77%, 86%, 71%, and 79% for the CT/RT group, respectively. There were no significant differences in LRFF (P = .728), DMF (P = .433), DFS (P = .562), and OS (P = .625) rates between the RT and CT/RT groups. Multivariate analysis revealed that delaying RT for more than 81 days was significantly associated with an increased risk of locoregional failure in the subgroup of patients with stage IIB disease (P = .044). CONCLUSIONS: In our retrospective analysis, the use of neoadjuvant CT showed no additional benefit to treatment with RT alone. Neoadjuvant CT may cause deleterious effect on stage IIB disease by delaying RT.
ISSN
0023-852X (Print)
0023-852X (Linking)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18216741

http://hdl.handle.net/10371/46302
DOI
https://doi.org/10.1097/MLG.0b013e3181626cfe
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College of Medicine/School of Medicine (의과대학/대학원)Radiation Oncology (방사선종양학전공)Journal Papers (저널논문_방사선종양학전공)
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