title: Potential improvement of tumor control probability by induction chemotherapy for advanced nasopharyngeal carcinoma.
abstract: OBJECTIVE
  To assess the reduction of tumor bulk and improvement of tumor control probability (TCP) by using induction chemotherapy for advanced nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  From February to December 2005, 20 patients with Stage III-IVB NPC were treated with induction-concurrent chemotherapy and intensity-modulated radiotherapy with accelerated fractionation. Combination of cisplatin and 5-fluorouracil was used in the induction phase and single agent Cisplatin in the concurrent phase. All patients were irradiated at 2Gy per fraction, 6 daily fractions per week, to a total dose of 70Gy.
  
  
  RESULTS
  Nineteen (95%) patients completed all 3 cycles of induction chemotherapy and 90% had 2 cycles of concurrent chemotherapy. Induction chemotherapy achieved significant down-staging of T-category in 35% of patients (p=0.016) and reduction of gross tumor volume (GTV_P) from 55.6 to 22.9cc (mean 61.4%, p<0.001). Although the mean radiation dose did not show any substantial change, the volume within GTV_P that failed to reach 70Gy was reduced from 10.2% to 3.8% (p=0.017). The estimated local TCP increased from 0.83 to 0.89 (p=0.002).
  
  
  CONCLUSIONS
  Induction chemotherapy using cisplatin-5-fluorouracil could significantly reduce tumor bulk leading to potential improvement in tumor control.
authors.affiliation: Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong. awmlee@ha.org.hk
authors.forename: Anne W M
authors.initials: AW
authors.lastname: Lee
authors.forename: Kam Ying
authors.initials: KY
authors.lastname: Lau
authors.forename: Wai Man
authors.initials: WM
authors.lastname: Hung
authors.forename: Wai Tong
authors.initials: WT
authors.lastname: Ng
authors.forename: Michael C H
authors.initials: MC
authors.lastname: Lee
authors.forename: Cheuk Wai
authors.initials: CW
authors.lastname: Choi
authors.forename: Connie C C
authors.initials: CC
authors.lastname: Chan
authors.forename: Raymond
authors.initials: R
authors.lastname: Tung
authors.forename: Peter T C
authors.initials: PT
authors.lastname: Cheng
authors.forename: Tsz Kok
authors.initials: TK
authors.lastname: Yau
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D020266:Radiotherapy, Conformal; D012074:Remission Induction; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil