CONCURRENT CHEMORADIOTHERAPY FOR LOCALLY ADVANCED NASOPHARYNGEAL CARCINOMA; USING CISPLATIN PLUS 5-FU, AT PHRAMONGKUTKLAO HOSPITAL
Abstract
Twenty nine patients with locally advanced nasopharyngeal carcinoma were treated at Phramongkutklao hospital during 1993 and 1995, by concurrent chemoradiotherapy and adjuvant chemotherapy. Chemotherapy regimen consisted of Cisplatin 100 mg/m? on day | plus 5-FU 800 mg/m? as continuous infusion on day 1 to 4 and repeated every 28 days for 6 cycles. Radiation treatment using Cobalt-60 and 10 MV photon or electron beam to boost primary site or cervical node until a total dose reached 6000-7000 cGy/6.6-8 weeks. Initial complete and partial response rate at 4 or 8 weeks after completion of radiotherapy were 67.9% and 28.6% respectively . At one month after completion of the sixth course of chemotherapy; complete response rate was increased to 75%. With a median follow up period of 42.2 months after completion of radiotherapy course, 3 year and 5 year actuarial survival rate( by Kaplan-Meier method) were 71% and 64% respectively. Toxicity from the treatment was acceptable. In conclusion, the concurrent chemoradiotherapy using cisplatin and 5-FU for locally advanced nasopharyngeal carcinoma was feasible and effective without any serious side effects.
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Tumor registry statistical report 1994, Phramongkutklao hospital. 12.
Devita VT, Hellman S, Rosenberg SA. Cancer, principles and practice of oncology; 5th edition, 1997. Philadelphia, Lippincott: 765-777.
Perez CA, Brady LW. Principles and practice of radiation oncology; 3rd edition, 1998.
Philadelphia, Lippincot: 897-940. Prasad U. Nasopharyngeal carcinoma. Medical progress July 1996; 11-16.
Leung SF, Teo PML, Shiu WWT, et al. Clinical features and management of distant metastasis of nasopharyngeal carcinoma. J Otolaryngol 1991;20:27-29.
Fandi A., Aitun M., Azli N., Armand J.P., Cvitkovic E. Nasopharyngeal cancer; epidermiology, staging and treatment. Seminars in Oncology 1994;21:382-397.
Tannock I, Payne D, Cummings B, et al. Sequential chemotherapy and radiation for nasopharyngeal cancer: Absence of long term benefit despite a high rate of tumor response to chemotherapy. J clin Oncol 1987;5:629-634.
Fountzilas G. Danilidis J., Kosmidis P., et al. Platinum - based chemotherapy followed by radiation therapy of locally advanced nasopharyngeal cancer: A retrospective analysis of 39 cases. Acta Oncol 1991;30.831-834.
Vokes EE, Mick R, Lester EP, Panje WR, Weichselbaum RR. Cisplatin and fluorouracil chemotherapy dose not yield longterm benefit in locally advanced head and neck cancer. Results from a single institution. J Clin Oncol 1992; 9: 1376-1384.
Stupp R., Weichselbaum RR., Vokes EE. Combined modality therapy of head and neck cancer. Seminars in Oncology 1994; 21:349-358.
Garden AS, Morrison WH, Ang KK, et al. Dose induction chemotherapy have a role in the management of nasopharyngeal carcinoma? Int J Radiat Oncol Biol Phys. 1995;32(Suppl.1):192.
International nasopharynx cancer study group: VUMCA I Trial. Preliminary results of a randomized trial comparing neoadjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy VS radiotherapy alone in stage IV undifferentiated nasopharyngeal carcinoma: A positive effect on progression - free survival. Int J Radiat Oncol Biol Phys 1996; 35:463-469.
Yamashita S, Kondo M,. Hashimoto S. Squamous cell carcinoma of the nasopharynx: An analysis of failure patterns after radiation therapy. Acta Radiol Oncol 1985; 24:315-320.
Dimery WI, Legha SS, Peters LJ, Goepfert H, Oswald MJ. Adjuvant chemotherapy for advanced nasopharyngeal carcinoma. Cancer 1987; 60: 943-949.
Rossi A, Moliani R, Boracchi P, et al. Adjuvant chemotherapy with vincristine, cyclophosphamide and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: Result of a 4-year multicenter randomized study. J clin Oncol 1988:10:1401-1410.
Chan ATC, Teo PML, Leung TWT, et al. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. IntJ Radiat Oncol Biol Phys 1995; 33:569-577.
Al-Sarraf M, Pajak TF, Marcial VA, et al. Concurrent radiotherapy and chemotherapy with cisplatin in inoperable squamous cell carcinoma of head and neck. An RTOG study. Cancer 1987;59:259-265.
Crissman JD, Pajak TF, Zarbo RJ, Marcial VA.AI-Sarraf M. Improved response and survival to combined cisplatin and radiation in non-keratinizing squamous cell carcinomas of head and neck. An RTOG study of 114 advanced stage tumors. Cancer 1987;59:1391-1397.
Souhami L, Rabinowits M. Combined treatment in carcinoma of the nasophar ynx. Laryngo scope 1988;98:881-883.
Marcial VA, Pajak TF, Mohiuddin M, et al. Concomitant cisplatin chemotherapy and radiotherapy in advanced mucosal squamous cell carcinoma of the head and neck. Long term results of the RTOG study 81-17. Cancer 1990; 66: 1861-1868.
Al-Sarraf M, Pajak TF, Cooper JS, et al. Chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma: A radiation therapy oncology group study. J clin Oncol 1990;8:1342-1351.
Harrison LB, Pfister DG, Fass DE, et al. Concomitant chemotherapy-radiation therapy followed by hyperfractionated radiation therapy for advanced unresectable head and neck cancer. Int J Radiat Oncol Biol Phys 1991;21:703-708.
Turner SL, Tiver KW. Synchronous radiotherapy and chemotherapy in the treatment of nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1993;27:371-377.
Lin JC, Chen KY, Jan JS, Hsu CY. Partially hyperfractionated accelerated radiotherapy and concurrent chemotherapy for advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1996;-36:1127-1136.
Lin JC, Jan JS, Hsy CY. Pilot study of concurrent chemotherapy and radiotherapy for stage IV nasopharyngeal cancer. AmJ Clin Oncol 1997;20:6-10.
Maoleekoonpairoj S, Phromratanapongse P, Puttanuparp S. Phase II study: Concurrent chemoradiotherapy in advanced nasopharyngeal carcinoma. J Med Assoc Thai 1997; 80: 778-784.
Vokes EE, Weichselbaum RR, Lippman SM, Hong WK. Head and neck cancer. N Engl J Med 1993; 21: 184-194.
FuKK, Philips TL. Biologic rational of combined radiotherapy and chemotherapy. Hematol Oncol Clin North Am 1991;5: 737-751.
Decker D, Drelichman A, Al-Sarraf M, et al. Chemotherapy for nasopharyngeal carcinoma: A 10-year experience. Cancer 1983;52:602-605.
Giri, Shankar PG, Leblance M, et al. Improved survival with chemotherapy and radiation therapy versus radiation therapy alone in advanced nasopharyngeal cancer. Preliminary results of an intergroup randomized trial. INT 0099, SWOG 8892, RTOG 8817, ECOG 2388. Int J Radiat Oncol Biol Phys 1996, 36(Suppl.1): 162.
Amdur RJ, Parsons JT, Mendenhall WM, etal. Split course versus continuous course irradiation in the postoperative setting for squamous cell carcinoma of the head and neck. IntJ Radiat Oncol Biol Phys 1989, 17:279-285.
Wang CC, Efird J, Nakfoor B, et al. Local control of T3 carcinomas after accelerated fractionation: A look at the gap. Int J Radiat Oncol Biol Phys 1996,35:140-152
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