Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Jiang, Lin; Js, Jan; Cy, Hsu; Jiang, Rong–San; Wy, Wang

doi:10.1038/sj.bjc.6600716

Cited by 34 publications

(24 citation statements)

References 23 publications

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“…Using MEPFL (mitomycin-C, epirubicin, cisplatin, 5-FU, and leucovorin), Hong et al reported the best metastasis-free survival rate to date for patients with 1997 AJCC stage N3a and N3b disease (26). Preliminary results from an ongoing study by our group using very low-toxic neoadjuvant chemotherapy plus radiotherapy for high-risk patients have been very promising (27). Randomized trials comparing neoadjuvant chemotherapy plus RT vs. CCRT will be initiated soon in our hospital.…”

Section: Discussionmentioning

confidence: 92%

Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate?

Lin

Liang

Jan

et al. 2004

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 92%

Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate?

Lin

Liang

Jan

et al. 2004

International Journal of Radiation Oncology*Biology*Physics

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“…Our institution recommends induction chemotherapy for those with T4 and/or N3 disease. Adjuvant chemotherapy was administered to subjects of AJCC N3 disease or of multiple lymph node involvement with concomitant AJCC classifications of T3 or T4 disease and/or with one of the lymph nodes being >4 cm in size 18. The regimen for induction and adjuvant chemotherapy included cisplatin (80 mg/m 2 , on Day 1) and fluorouracil (1,000 mg/m 2 , 96-hour continuous infusion from Day 2 to Day5) administrated every 3–4 weeks for two to three cycles.…”

Section: Methodsmentioning

confidence: 99%

Pretreatment combination of platelet counts and neutrophil–lymphocyte ratio predicts survival of nasopharyngeal cancer patients receiving intensity-modulated radiotherapy

Lin¹,

Chang²,

Lin³

et al. 2017

OTT

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BackgroundIncreased cancer-related inflammation has been associated with unfavorable clinical outcomes. The combination of platelet count and neutrophil–lymphocyte ratio (COP-NLR) has related outcomes in several cancers, except for nasopharyngeal carcinoma (NPC). This study evaluated the prognostic value of COP-NLR in predicting outcome in NPC patients treated with intensity-modulated radiotherapy (IMRT).Materials and methodsWe analyzed the data collected from 232 NPC patients. Pretreatment total platelet counts, neutrophil–lymphocyte ratio (NLR), and COP-NLR score were evaluated as potential predictors. Optimal cutoff values for NLR and platelets were determined using receiver operating curve. Patients with both elevated NLR (>3) and platelet counts (>300×109/L) were assigned a COP-NLR score of 2; those with one elevated or no elevated value were assigned a COP-NLR a score of 1 or 0. Cox proportional hazards model was used to test the association of these factors and relevant 3-year survivals.ResultsPatients (COP-NLR scores 1 and 2=85; score 0=147) were followed up for 55.19 months. Univariate analysis showed no association between pretreatment NLR >2.23 and platelet counts >290.5×109/L and worse outcomes. Multivariate analysis revealed that those with COP-NLR scores of 0 had better 3-year disease-specific survival (P=0.02), overall survival (P=0.024), locoregional relapse-free survival (P=0.004), and distant metastasis-free survival (P=0.046). Further subgrouping by tumor stage also revealed COP-NLR to be an unfavorable prognostic indicator of 3-year failure-free survival (P=0.001) for locally advanced NPC.ConclusionCOP-NLR score, but not NLR alone or total platelet count alone, predicted survival in NPC patients treated with IMRT-based therapy, especially those with stage III/IVA, B malignancies.

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“…Aggressive NPCs are often incurable due to the high possibility of loco-regional recurrence and long-distance metastasis among these cases. 24 In the long interval centre, a high percentage of aggressive interval NPCs (20%) was observed, but no aggressive interval NPCs were detected in the short interval centre. Even in the long interval centre, only one aggressive interval cancer was detected during the first four years, with the other three detected during the remaining years of the screening interval.…”

Section: Discussionmentioning

confidence: 99%

Interval Cancers in Nasopharyngeal Carcinoma Screening: Comparing Two Screening Intervals after a Negative Initial Screening Result

Chen

Huang²,

Fang

et al. 2012

J Med Screen

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Objectives To examine the optimal screening interval among the individuals who received a negative Epstein-Barr virus immunoglobulin A antibodies against viral capsid antigen (VCA-IgA) serum test result and who comprised the majority of the population screened for nasopharyngeal carcinoma (NPC). Methods Screening was performed in Sihui, Guangdong, China, offering a repeated screening for participants with an initial negative test either after 4-5 years in one centre (short interval centre), or 9-10 years in another (long interval centre). The characteristics and incidence rates (IRs) of interval NPCs (defined as cases diagnosed outside the screening protocol while within the screening interval) were compared between these two centres. Standard incidence ratios (SIRs) were also calculated using the general Sihui population as the reference. Results Seven interval NPCs were detected in the short interval centre (IR: 17.8/10 5 person-years) and 20 in the long interval centre (IR: 20.8/10 5 person-years during the first four years and 43.5/10 5 person-years during the remaining years). The SIR in the short interval centre was 0.43 (95% confidence interval [CI]: 0.17-0.89); SIR in the long interval centre was 0.47 (95% CI: 0.17-1.02) during the first four years and 0.90 (95% CI: 0.49-1.51) during the remaining years. No aggressive interval NPC was observed in the short interval centre; four were identified in the long interval centre. Conclusions The incidence of NPC, especially aggressive NPC, was low during the first few years after a negative screening; the incidence increased to the general population level afterwards. A screening interval of 4-5 years may therefore be more suitable than 9–10 years after a negative VCA-IgA test in NPC screening.

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Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Cited by 34 publications

References 23 publications

Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate?

Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate?

Pretreatment combination of platelet counts and neutrophil–lymphocyte ratio predicts survival of nasopharyngeal cancer patients receiving intensity-modulated radiotherapy

Interval Cancers in Nasopharyngeal Carcinoma Screening: Comparing Two Screening Intervals after a Negative Initial Screening Result

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Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Cited by 34 publications

References 23 publications

Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate?

Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate?

Pretreatment combination of platelet counts and neutrophil&ndash;lymphocyte ratio predicts survival of nasopharyngeal cancer patients receiving intensity-modulated radiotherapy

Interval Cancers in Nasopharyngeal Carcinoma Screening: Comparing Two Screening Intervals after a Negative Initial Screening Result

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Pretreatment combination of platelet counts and neutrophil–lymphocyte ratio predicts survival of nasopharyngeal cancer patients receiving intensity-modulated radiotherapy