Treatment outcome of cisplatin-based concurrent chemoradiotherapy in the patients with locally advanced nasopharyngeal cancer.
OBJECTIVE
The standard treatment of locally advanced nasopharyngeal cancer is a concurrent chemoradiotherapy (CCRT), and cisplatin has been used as the most popular chemotherapeutic agent. But many different doses and schedules for cisplatin administration such as daily, weekly and 3 week cycles have been proposed. We compared and analyzed the tumor response, the overall survival, the toxicity and the chemotherapy dose intensity in the patients with locally advanced nasopharyngeal cancer who were treated with CCRT.


METHODS
We performed a retrospective study on 55 patients with locally advanced nasopharyngeal cancer, and they were treated with CCRT as a front-line treatment from Jan 1996 to Jun 2007 at Kangnam Saint Mary's Hospital.


RESULTS
The patients had a median age of 53 years (range: 19 approximately 75 years). Of the total 55 patients, a 3-week cycle of 100mg cisplatin was administered in 31 patients and 30 mg weekly cisplatin was administered in 24 patients combined with radiotherapy. Twenty one patients had a complete response and four patients had a partial response for a response rate of 71.4% (95% CI: 59.5 approximately 83.3) after CCRT and followed by adjuvant chemotherapy. The complete response rates for the 30 mg and 100 mg cisplatin groups were 72.7% (95% CI: 54.9 approximately 90.5) and 54.2% (95% CI: 36.7 approximately 71.7), respectively (p=0.23). The duration of CCRT in the 100mg cisplatin group was significantly longer than that of the 30mg cisplatin group (11.1+/-2.9 weeks vs. 9.0+/-1.2 weeks, p=0.003). The major deviation group, which was defined as prolongation of the radiotherapy duration for more than 2 weeks, had a significantly lower objective response rate than did the non-deviation group (56.3% vs 84.2%, respectively, p=0.002). The major severe toxicities were leucopenia (49.1%), pharyngoesophagitis (49.1%), anorexia (43.6%), nausea (41.8%) and vomiting (40%).


CONCLUSIONS
Weekly 30mg cisplatin-based CCRT is a practical, feasible cisplatin schedule for the patients with locally advanced nasopharyngeal cancer in regard to decreasing the interruption of radiation treatment and decreasing the treatment-related acute toxicities.
Kim
Tae Hee
TH
Head & Neck Cancer Interdisciplinary Team, The Catholic University of Korea College of Medicine, Seoul, Korea.
Ko
Yoon Ho
YH
Lee
Myung Ah
MA
Kim
Bum-soo
BS
Chung
So Ryoung
SR
Yoo
Ie Ryung
IeR
Jung
Chan-Kwon
CK
Kim
Yeon-Sil
YS
Kim
Min Sik
MS
Sun
Dong-Il
DI
Hong
Young Seon
YS
Lee
Kyung Shik
KS
Kang
Jin-Hyoung
JH
Cancer. 1998 Aug 1;83(3):582-8
9690553
Jpn J Clin Oncol. 2000 May;30(5):230-4
10857501
Eur J Cancer. 2007 Jun;43(9):1399-406
17467265
J Clin Oncol. 1990 May;8(5):911-34
2185342
J Clin Oncol. 2004 Jul 1;22(13):2643-53
15226332
J Clin Oncol. 2003 Feb 15;21(4):631-7
12586799
Int J Radiat Oncol Biol Phys. 1997 Oct 1;39(3):703-10
9336153
J Clin Oncol. 2005 May 20;23(15):3568-76
15809453
Lancet. 2005 Jun 11-17;365(9476):2041-54
15950718
Int J Radiat Oncol Biol Phys. 2004 Nov 15;60(4):1127-36
15519784
J Clin Oncol. 2005 Sep 20;23(27):6730-8
16170180
Int J Radiat Oncol Biol Phys. 2004 May 1;59(1):11-20
15093894
Jpn J Clin Oncol. 2003 Oct;33(10):497-500
14623916
Cancer Control. 2002 Sep-Oct;9(5):387-99
12410178
Cancer. 1988 Mar 15;61(6):1117-24
3342372
Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004329
17054200
Curr Opin Oncol. 2005 May;17(3):225-30
15818165
Mol Cancer. 2007 Jan 02;6:1
17199893
J Clin Oncol. 1998 Apr;16(4):1310-7
9552031
Ann Oncol. 2002 Jul;13(7):1007-15
12176778
Int J Radiat Oncol Biol Phys. 2000 Dec 1;48(5):1323-30
11121629
Am J Otolaryngol. 1995 Mar-Apr;16(2):103-8
7540805