Concurrent chemotherapy and radiotherapy with low-dose Cisplatin for nasopharyngeal carcinoma.
Eighty-one patients with nondisseminated nasopharyngeal carcinoma consecutively treated between January 1977 and December 1998 were analyzed to evaluate whether a concurrent adjunction of low-dose cisplatin enhances the outcome of definitive radiotherapy. Ninety-eight percent (n = 79) of the cases were ranked as stage III/IV according to the 1987 Union International Contre le Cancer staging criteria. Patients treated before 1987 and treated after 1988 were mainly managed by radiotherapy alone (historical group: n = 48) and concurrent chemoradiotherapy with relatively low-dose cisplatin (CCRT group: n = 33), respectively. The locoregional failure-free survival rate of the CCRT group was significantly better than that of the historical group (72.8% vs. 35.9% at 5 years, p = 0.0041). However, multivariate analysis identified only the total dose and the T-stage as significant independent factors for locoregional control. No difference was observed on overall, disease-specific, and distant failure-free survival between the two groups. The results of the present study suggest that concurrent adjunction of low-dose cisplatin will not improve the outcome of definitive radiotherapy for nasopharyngeal carcinoma. Full-dose concurrent chemoradiotherapy, as well as the appropriate dose escalation for better locoregional control, will be mandatory to achieve better survival.
Mizowaki
Takashi
T
Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo, Kyoto 606-8507, Japan. mizo@kuhp.kyoto-u.ac.jp
Okajima
Kaoru
K
Nagata
Yasushi
Y
Mitsumori
Michihide
M
Nishimura
Yasumasa
Y
Shoji
Kazuhiko
K
Asato
Ryo
R
Hiraoka
Masahiro
M
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D017211:Treatment Failure
D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D002945:Cisplatin