Effectiveness of combined induction chemotherapy and radiotherapy in advanced nasopharyngeal carcinoma.

Dimery, Isaiah W.; Peters, Lester J.; Goepfert, Helmuth; Morrison, William H.; Byers, Robert M.; Guillory, Charleta; McCarthy, Katie; Weber, Randal S.; Hong, Waun Ki

doi:10.1200/jco.1993.11.10.1919

Cited by 98 publications

(33 citation statements)

References 34 publications

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“…Several Phase II trials of sequential chemoradiotherapy using induction chemotherapy for patients with NPC have demonstrated high response rates and suggested improvements in survival. [13][14][15][16] However, randomized Phase III trials have failed to demonstrate any survival benefit associated with the addition of induction chemotherapy to radiotherapy in patients with advanced-stage NPC. [17][18][19][20] One of these randomized Phase III trials was organized by the Asia-Oceania Clinical Oncology Association (AOCOA).…”

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confidence: 99%

Prognostic impact of hemoglobin levels on treatment outcome in patients with nasopharyngeal carcinoma treated with sequential chemoradiotherapy or radiotherapy alone

Chua

Sham

Choy

2004

Cancer

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BACKGROUNDThe goal of the current study was to investigate the impact of hemoglobin (Hb) levels on treatment outcome in a randomized Phase III trial of patients with nasopharyngeal carcinoma (NPC) treated with induction chemotherapy followed by radiotherapy or with radiotherapy alone.METHODSBetween September 1989 and August 1993, 334 patients with advanced NPC were entered into a randomized trial comparing 3 cycles of induction chemotherapy (cisplatin and epirubicin) followed by radiotherapy with radiotherapy alone. Only evaluable patients who completed radiation were included in the analysis (n = 286). Patients were stratified into normal and low Hb groups according to baseline, preradiation, and midradiation Hb levels. Local recurrence–free, distant metastasis–free, and disease‐specific survival rates were estimated using the Kaplan–Meier method. Multivariate analysis was performed using the Cox model.RESULTSIn the chemotherapy arm, the mean baseline, preradiation, and midradiation Hb levels were 13.6, 11.0, and 11.8 g/dL, respectively. In the radiotherapy arm, the mean baseline/preradiation and midradiation Hb levels were 13.7 and 12.9 g/dL, respectively. A midradiation Hb level ≤ 11 g/dL was associated with significantly poorer 5‐year local recurrence–free (60% vs. 80%; P = 0.0059) and disease‐specific survival rates (51% vs. 68%; P = 0.001), with no difference in distant metastasis–free rates (69% vs. 67%; P = 0.83). No significant difference in treatment outcome according to baseline or preradiation Hb levels was noted. Multivariate analysis showed that a low midradiation Hb level, but not a low baseline or preradiation Hb level, was an independent predictor of local disease recurrence and malignancy‐related death.CONCLUSIONSThe current study showed that midradiation Hb level was an important prognostic factor with respect to local control and survival in patients with NPC. The high incidence of anemia after chemotherapy has a negative impact on treatment outcome, and this condition may reduce the benefit of induction chemotherapy. Attempts to correct anemia during radiation and the impact of anemia on treatment outcome requires further study. Cancer 2004. © 2004 American Cancer Society.

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confidence: 99%

Prognostic impact of hemoglobin levels on treatment outcome in patients with nasopharyngeal carcinoma treated with sequential chemoradiotherapy or radiotherapy alone

Chua

Sham

Choy

2004

Cancer

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“…Complete response and overall response rates reported with neoadjuvant cisplatin-containing chemotherapy were between 14% to 66% and 53% to 100%, respectively. [24][25][26][27] Among the controlled studies, only one testing neoadjuvant chemotherapy has reported its preliminary results, showing a significant difference in disease-free survival in favor of the chemotherapy arm. 28 Metastatic UCNT disease is well known for its chemosensitivity, and cisplatin-containing regimens are the most active in this disease.…”

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confidence: 98%

Palliative treatment with low-dose continuous infusion 5-fluorouracil in recurrent and/or metastatic undifferentiated nasopharyngeal carcinoma type

et al. 1997

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Significant advances in identification of etiologies of inherited thrombosis have been recently reported. A point mutation in coagulation factor V (factor V Leiden) results in resistance to activated protein C and probably represents the most common genetic risk factor for venous thrombosis. A metabolic disorder, homocysteinemia, is now known to be an important risk factor for both arterial and venous thrombosis. Many patients with recurrent thrombosis will have more than one genetic risk factor identified. Recognition of these new disorders should permit a diagnosis to be achieved in at least half of patients evaluated for inherited thrombosis. Am. J. Hematol. 54:53–60, 1997 © 1997 Wiley‐Liss, Inc.

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“…In recent years, several reports in children and adults by using a combined therapeutic strategy seem to support this statement. 3,[5][6][7][8][9][17][18][19][20][21] There is a small reported evidence of NPC in children. However, therapy strategies with a combined modality showed that very good long term disease free survival might be obtained.…”

Section: Discussionmentioning

confidence: 99%

“…But in recent years, chemotherapy combined with radiotherapy has been yielding better results, with significant disease free survival improvement in children and young adults in whom the undifferentiated variant is predominant. 3,[5][6][7][8][9] The purpose of this report was to analyze features at onset, treatment results, and outcome of children and adolescents with NPC followed in our hospital since 1988.…”

Section: Discussionmentioning

confidence: 99%

Nasopharyngeal carcinoma in childhood and adolescence

Zubizarreta

D'Antonio

Raslawski

et al. 2000

Cancer

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Effectiveness of combined induction chemotherapy and radiotherapy in advanced nasopharyngeal carcinoma.

Abstract: The results of this prospective study demonstrate that 5-FU plus cisplatin followed by radiotherapy can induce a durable remission in a high proportion of patients with poor-prognosis stage IV nasopharyngeal carcinoma.

Cited by 98 publications

References 34 publications

Prognostic impact of hemoglobin levels on treatment outcome in patients with nasopharyngeal carcinoma treated with sequential chemoradiotherapy or radiotherapy alone

Prognostic impact of hemoglobin levels on treatment outcome in patients with nasopharyngeal carcinoma treated with sequential chemoradiotherapy or radiotherapy alone

Palliative treatment with low-dose continuous infusion 5-fluorouracil in recurrent and/or metastatic undifferentiated nasopharyngeal carcinoma type

Nasopharyngeal carcinoma in childhood and adolescence

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