Treatment outcome of locally advanced nasopharyngeal cancer with concurrent chemoradiotherapy.
BACKGROUND
Treatment options for locally advanced Nasopharyngeal lancer include radiation alone or cisplatin based concurrent chemoradiotherapy. Concurrent chemoradiotherapy is associated with higher morbidity but has been shown to yield better survival.


OBJECTIVE
This study was aimed at determining the outcome of treatment of Nasopharyngeal Cancer with concurrent chemoradiotherapy in our setup.


METHODS
Twenty-six patients with biopsy proven disease who had undergone staging procedures were studied according to age, sex, WHO histological type and stage of disease. Treatment consisted of 70 Gy to the primary site and 60 Gy to the neck with disease. Chemotherapy was given as follows: three cycles of three weekly cisplatin at 80 mg/m2 during radiation followed by three cycles of three weekly cisplatin at 60 mg/m2 on day 1 and 5-fluorouracil at 1000 mg/m2 on days 1 to 5 in the adjuvant setting. Side effects of treatment, pattern of failure and survival were determined.


RESULTS
The male to female ratio was 2:1, age range was 10-68 years. WHO type 3 was predominant at 50%. Stage IVB disease was present in 73.1% of patients. Average number of chemotherapy cycles received was three. Median follow up period was 30 months (8-56 months), 42.3% survived beyond 24 months. Twelve patients developed recurrence of disease, of which eight had local regional recurrence only.


CONCLUSIONS
Concurrent chemoradiotherapy is possible in our setting with acceptable morbidity at the prescribed doses. Survival beyond two years is possible in our environment with this regime. Local failure is the predominant cause of death.
Yarney
J
J
National Centre for Radiotherapy and Nuclear Medicine, Korlebu Teaching Hospital/ College of Health Science, University of Ghana, P.O. Box KB 369, Accra, Ghana. kodwoahen@gmail.com
Vanderpuye
V
V
Kitcher
E D
ED
D000293:Adolescent; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011446:Prospective Studies; D012307:Risk Factors; D013534:Survival; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil