Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma.
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.
Chan
Anthony T C
AT
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.
Leung
S F
SF
Ngan
Roger K C
RK
Teo
Peter M L
PM
Lau
W H
WH
Kwan
W H
WH
Hui
Edwin P
EP
Yiu
H Y
HY
Yeo
Winnie
W
Cheung
F Y
FY
Yu
K H
KH
Chiu
K W
KW
Chan
D T
DT
Mok
Tony S K
TS
Yau
Stephen
S
Yuen
K T
KT
Mo
Frankie K F
FK
Lai
Maria M P
MM
Ma
Brigette B Y
BB
Kam
Michael K M
MK
Leung
Thomas W T
TW
Johnson
Philip J
PJ
Choi
Peter H K
PH
Zee
Benny C Y
BC
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
D000970:Antineoplastic Agents; D002945:Cisplatin