Excellent Disease Control and Survival in Patients With Advanced Nasopharyngeal Cancer Treated With Chemoradiation

Rischin, Danny; Corry, June; Smith, Jennifer; Stewart, Josephine; Hughes, Peter; Peters, Lester J.

doi:10.1200/jco.2002.07.011

Cited by 133 publications

(69 citation statements)

References 17 publications

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“…Our PFS and OS results are superimpose able to the most favourable of these four papers [7][8]18] conforming the high activity of NACT + CRT even in a non-endemic population.…”

Section: Discussionsupporting

confidence: 75%

“…Five recently published studies [6][7][8][9] have shown that induction CHT followed by CRT obtained high responses in patients coming from both endemic and non endemic areas: in two trials the authors proposed a three-drugs induction scheme, while in the others cisplatin + epirubicin or paclitaxel and carboplatin were respectively administered.…”

Section: Discussionmentioning

confidence: 99%

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Induction chemotherapy with carboplatin and taxol followed by radiotherapy and concurrent weekly carboplatin + taxol in locally advanced nasopharyngeal carcinoma

Airoldi

Gabriele

et al. 2010

Cancer Chemother Pharmacol

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Methods: Thirty patients were treated with three cycles of carboplatin (AUC6) plus taxol (175mg/m 2 ) on day 1 every 3 weeks, followed by weekly carboplatin (AUC1) plus Taxol (60mg/m2) and concomitant radiotherapy (70Gy). Results:We observed the objective complete response rates of 33% (after chemotherapy) and 87%(after chemo-radiotherapy). Treatment tolerability and toxicity were controllable. Three and five years progression free survival were 80% and 75% respectively and 3 and 5 years overall survival were 85% and 80% (follow-up 49.5 months). Five years loco-regional control was 90.3% and five years distant metastases free survival was 85%.Conclusions: Neoadjuvant-chemotherapy with such protocol represents a feasible, efficient treatment for patients with A-NPC, ensuring excellent locoregional disease control and overall survival with low incidence of distant metastases.

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“…Our PFS and OS results are superimpose able to the most favourable of these four papers [7][8]18] conforming the high activity of NACT + CRT even in a non-endemic population.…”

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Induction chemotherapy with carboplatin and taxol followed by radiotherapy and concurrent weekly carboplatin + taxol in locally advanced nasopharyngeal carcinoma

Airoldi

Gabriele

et al. 2010

Cancer Chemother Pharmacol

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“…Such an approach appears to be more tolerable in patients with a higher compliance rate, and this approach also facilitates subsequent radiotherapy. 36 Our findings suggest that Hb levels should be carefully monitored during radiotherapy whenever induction chemotherapy is used and that these levels should also be considered in analyzing the results of treatment.…”

Section: Discussionmentioning

confidence: 79%

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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“…Recent reports from other centers indicated approximately the same incidence of overall survival using the same sequence of total chemotherapyradiation therapy. 42 Table 8 shows the change in actual 5-year survival of stage IV patients with nasopharyngeal cancer over the last 20 years.…”

Section: Concurrent/adjuvantmentioning

confidence: 99%

Treatment of Locally Advanced Head and Neck Cancer: Historical and Critical Review

Al‐Sarraf

2002

Cancer Control

104

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Background Advanced squamous cell cancers of the head and neck have traditionally been associated with high rates of morbidity and mortality. Advances in management have improved outcomes for most of these patients. Methods The author reviews the historical progress in management of these difficult tumors and adds his own wide experience to describe and evaluate newer approaches to management. Results Over the last 10 years, overall survival rates for patients with head and neck cancers have improved as has quality of life. New standards of care have been defined for patients with nasopharyngeal cancer and for those with advanced unresectable disease. Organ preservation is more commonly achieved. Conclusions Newer targeted therapies are likely to add to the progress that has already been achieved in the multimodality management of patients with head and neck cancers.

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Excellent Disease Control and Survival in Patients With Advanced Nasopharyngeal Cancer Treated With Chemoradiation

Abstract: This regimen was well tolerated, can be delivered as planned, and has resulted in excellent locoregional disease control and survival in patients with locally advanced nasopharyngeal cancer.

Cited by 133 publications

References 17 publications

Induction chemotherapy with carboplatin and taxol followed by radiotherapy and concurrent weekly carboplatin + taxol in locally advanced nasopharyngeal carcinoma

Induction chemotherapy with carboplatin and taxol followed by radiotherapy and concurrent weekly carboplatin + taxol in locally advanced nasopharyngeal carcinoma

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

Treatment of Locally Advanced Head and Neck Cancer: Historical and Critical Review

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