title: Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma.
abstract: This phase III randomized study compared concurrent cisplatin-radiotherapy (CRT) versus radiotherapy (RT) alone in patients with locoregionally advanced nasopharyngeal carcinoma. A total of 350 patients were randomly assigned to receive external RT alone or concurrently with cisplatin at a dosage of 40 mg/m(2) weekly. The primary endpoint was overall survival, and the median follow-up was 5.5 years. The 5-year overall survival was 58.6% (95% confidence interval [CI] = 50.9% to 66.2%) for the RT arm and 70.3% (95% CI = 63.4% to 77.3%) for the CRT arm. In Cox regression analysis adjusted for T stage, age, and overall stage, the difference in overall survival was statistically significantly in favor of concurrent CRT (P = .049, hazard ratio [HR] = 0.71 [95% CI = 0.5 to 1.0]). Subgroup analysis demonstrated that there was no difference between overall survival in the arms for T1/T2 stage (P = .74, HR = 0.93 [95% CI = 0.59 to 1.4]), whereas there was a difference between the arms for T3/T4 stage (P = .013, HR = 0.51 [95% CI = 0.3 to 0.88]), favoring the CRT arm. The regimen of weekly concurrent CRT is a promising standard treatment strategy for locoregionally advanced nasopharyngeal carcinoma patients.
authors.affiliation: Department of Clinical Oncology, Sir Y. K. Pao Center for Cancer, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T. Hong Kong.
authors.forename: Anthony T C
authors.initials: AT
authors.lastname: Chan
authors.forename: S F
authors.initials: SF
authors.lastname: Leung
authors.forename: Roger K C
authors.initials: RK
authors.lastname: Ngan
authors.forename: Peter M L
authors.initials: PM
authors.lastname: Teo
authors.forename: W H
authors.initials: WH
authors.lastname: Lau
authors.forename: W H
authors.initials: WH
authors.lastname: Kwan
authors.forename: Edwin P
authors.initials: EP
authors.lastname: Hui
authors.forename: H Y
authors.initials: HY
authors.lastname: Yiu
authors.forename: Winnie
authors.initials: W
authors.lastname: Yeo
authors.forename: F Y
authors.initials: FY
authors.lastname: Cheung
authors.forename: K H
authors.initials: KH
authors.lastname: Yu
authors.forename: K W
authors.initials: KW
authors.lastname: Chiu
authors.forename: D T
authors.initials: DT
authors.lastname: Chan
authors.forename: Tony S K
authors.initials: TS
authors.lastname: Mok
authors.forename: Stephen
authors.initials: S
authors.lastname: Yau
authors.forename: K T
authors.initials: KT
authors.lastname: Yuen
authors.forename: Frankie K F
authors.initials: FK
authors.lastname: Mo
authors.forename: Maria M P
authors.initials: MM
authors.lastname: Lai
authors.forename: Brigette B Y
authors.initials: BB
authors.lastname: Ma
authors.forename: Michael K M
authors.initials: MK
authors.lastname: Kam
authors.forename: Thomas W T
authors.initials: TW
authors.lastname: Leung
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Johnson
authors.forename: Peter H K
authors.initials: PH
authors.lastname: Choi
authors.forename: Benny C Y
authors.initials: BC
authors.lastname: Zee
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D016001:Confidence Intervals; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin