[Concomitant chemo-radiotherapy for locoregionally advanced nasopharygeal carcinoma].
OBJECTIVE
To evaluate the efficacy and toxicity of concomitant chemo-radiotherapy (CCRT) followed by adjuvant chemotherapy (ACT) in Chinese patients with locoregionally advanced nasopharygeal carcinoma (NPC).


METHODS
Seventy-four patients with stage III and IV (UICC1997) were treated by Intergroup 0099 regimen, consisting of CCRT using cisplatin 100 mg/m(2) on D1, 22, and 43 of radiotherapy, followed by ACT using cisplatin 80 mg x m(-2) x d(-1) and 5-Fu 1 g x m(-2) x 4 d(-1) given from D71, 99, and 127. All the patients were irradiated with conventional fractionation to a total dose of 68 Gy to the nasopharynx and 66 Gy to the neck. Acute toxicity and late complication were assessed by the RTOG radiation morbidity scoring scheme.


RESULTS
With a median follow-up of 49 months, the overall 5-year survival and relapse-free survival rates were 71.3% and 43.5% respectively. No grade 5 toxicity was observed in this series, the main grade 3/4 acute toxicity events were hematologic toxicity in 25 patients (33.8%), mucositis in 19 patients (25.7%), and grade 3 skin disease in 6 (8.1%), respectively. The compliance rates were 100.0% for radiotherapy, 75.7% for CCRT, and 47.3% for CCRT plus ACT. The main grade 3/4 late complications were severe salivary gland toxicity (17 cases), ear injury (13 cases), and the neck skin/subcutaneous tissue disease (7 cases). The 5-year cumulative incidence of late toxicity was 44.3%.


CONCLUSIONS
Compared with routine radiotherapy, the concomitant chemo-radiotherapy may improve the outcome of locoregionally advanced NPC in the Chinese patients, with higher incidence of severe acute toxicities and similar late complications.
Tian
Ye
Y
Department of Radiotherapy & Oncology, Second Hospital, Suzhou University, Suzhou 215004, China.
Chua
Daniel T T
DT
Sham
Jonathan S T
JS
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000009:adverse effects; D016896:Treatment Outcome
D002945:Cisplatin; D005472:Fluorouracil